Brand Name: Catapres, Catapres-TTS, Duraclon, Jenloga, Kapvay
Generic Name: Clonidine
Drug Class: Central Alpha2 Agonists; ADHD Agents
What Is Clonidine and How Does It Work?
Clonidine is a prescription medication that is used alone or with other medications to treat high blood pressure, to lower blood pressure to help prevent strokes, heart attacks and kidney problems. Clonidine belongs to a class of drugs (central alpha agonists) that act in the brain to lower blood pressure. It works by relaxing blood vessels so blood can flow more easily.
Dosages of Clonidine:
Adult and pediatric dosages
- 100 mcg/ml
- 500 mcg/ml
- 0.1 mg/day
- 0.2 mg/day
- 0.3 mg/day
- 0.1 mg
- 0.2 mg
- 0.3 mg
- 0.1 mg
Dosage Considerations – Should be Given as Follows:
- 0.1 mg orally every 12 hours
- Range: 0.1-0.2 mg/day every 12 hours, not to exceed 2.4 mg/day
- Apply 1 patch every 7 days, start with 0.1 mg; increase by 0.1 mg after every 1-2 week interval; usual dose range is 0.1-0.3 mg each week
Children older than 12 years
- 0.2 mg/day orally divided every 12 hours; increase each week; maintenance dose range, 0.2-0.6 mg/day every 12 hours; not to exceed 2.4 mg/day
- 0.1 mg patch every 7 day initially; may increase by weekly 0.1-mg increments after 1-2 weeks if desired blood pressure reduction not achieved; not to exceed 0.6 mg/week (2 clonidine 0.3 mg patches)
Children under 12 years old
- Immediate-release tablets and transdermal patch: Safety and efficacy not established
- immediate-release tablets: 0.1 mg orally at bedtime
Geriatric dosing considerations
- Not recommended as routine treatment for hypertension (Beers criteria)
- Potential for orthostatic hypotension and adverse central nervous system effects
- May cause lower heart rate
Severe pain in patients with cancer not adequately relieved by opioid analgesics alone
- 30 mcg/hr, adjust dose as required for pain relief or presence of side effects
- Limited data on doses exceeding 40 mcg/hr
Epidural infusion considered as adjunct to intraspinal opiate therapy; epidural administration (Duraclon) is indicated in combination with opiates for the treatment of severe pain in patients with cancer not adequately relieved by opioid analgesics alone.
Pediatric epidural infusion: 0.5 mcg/kg/hr initially; adjust according to clinical response.
Epidural administration (Duraclon) is indicated in combination with opiates for the treatment of severe pain in patients with cancer not adequately relieved by opioid analgesics alone. Restrict use to pediatric patients with severe, intractable pain from malignancy that is unresponsive to epidural or spinal opiates or to other, more conventional analgesic techniques. More likely to be effective in patients with neuropathic pain than in those with somatic or visceral pain. Safety and effectiveness of epidural administration in this limited indication and clinical population have been established in patients old enough to tolerate placement and management of an epidural catheter; these conclusions are based on evidence from adequate and well-controlled studies in adults and through experience with the use of clonidine in the pediatric age group for other indications.
Acute Hypertension (Off-label)
- 0.1-0.2 mg orally, may follow with additional doses of 0.1 mg every hour as needed to maximum 0.6 mg total dose
ETOH Withdrawal (Off-label)
- 0.3-0.6 mg orally every 6 hours
Smoking Cessation (Off-label)
- 0.1 mg each day; increase by 0.1 mg/day to 0.15-0.75 mg/day if required
- 100-200 mcg/day patch every 7 days
- 0.3-0.6 mg orally every 6 hours
Restless Legs Syndrome (Off-label)
- 100-300 mcg orally every 2 hours before bedtime, up to 900 mcg/day
Tourette's Syndrome (Off-label)
- 0.0025-0.015 mg/kg/day orally for 6 weeks to 3 months
Cyclosporine Nephrotoxicity (Off-label)
- 100-200 mcg/day transdermal patch; change every 7 days
Menopausal Flushing (Off-label)
- Apply 100 mcg/day patch; change every 7 days, OR
- 50 mcg orally every 12 hours initially; may increase up to 400 mcg every 12 hours
- 0.025 mg every 12 hours for 2 weeks prior to menstruation
Opioid Withdrawal (Off-label)
- 0.1-0.3 mg every 4-6 hours, increase by 0.1 mg/day to 0.15-0.75 mg/day if required; do not exceed 2.4 mg/day
- 100-200 mcg/day patch every 7 days initiate 0.1-0.3 mg orally every 4-6 hours for first 2 days to allow for adequate drug levels
Postherpetic Neuralgia (Off-label)
- 0.1 mg every 12 hours
- 0.4-1.4 mg/day in divided doses
Pheochromocytoma Diagnosis (Off-label)
Clonidine suppression testing
- 0.3 mg orally for 60-80 kg patient; obtain blood sample 3 hours after administration to supine patient
Extended-release is not to be used interchangeably with immediate-release tablets.
Conversion from oral to transdermal
- Day 1: Place Catapress-TTS-1; administer 100% of oral dose
- Day 2: Administer 50% of oral dose
- Day 3: Administer 25% of oral dose
- Day 4: Patch remains, no further oral supplement needed
Children under 6 years old: Not established
Children 6 years or older: (extended-release tablets, Kapvay): 0.1 mg orally at bedtime initially; may adjust dose by increments of 0.1 mg/day at weekly intervals until desired response; not to exceed 0.4 mg/day.
When discontinuing, taper gradually by decrements not to exceed 0.1 mg every 3-7 days.
May be given as monotherapy or as adjunctive therapy with stimulants. Extended-release not interchangeable with immediate-release product.
Doses 0.2 mg/day or greater should be divided twice a day, with either an equal or higher split dosage being given at bedtime. Swallow tablet whole; do not crush, chew, or split.
Impact of renal impairment not assessed
Initial dose should be based on amount of renal impairment
Monitor carefully for low blood pressure and lower heart rate.
Geriatric: immediate release: Lower initial doses than for non-geriatric adult dosing, as well as gradual adjustments, are recommended.
Extended release: May require lower initial dose than for non-geriatric adult dosing.
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