Forms: 0.1, 0.2, 0.3mg tablet; 0.1, 0.2mg extended-release tablets (Kapvay) Dose Range: 0.05-0.4 mg/day Starting: for ADHD, 0.1 mg qhs, can ↑ by 0.1mg/day each week with dosing divided (larger dose @hs); max dose generally 0.4mg/day Stopping: Discontinuation should be done incrementally over ≥ 2-4 days, as discontinuation symptoms are common and can be severe (for example, rapid rise in blood pressure, rare hypertensive encephalopathy, rare cerebrovascular accident, and rare death)
Contraindications: Caution w/ concomitantly use with agents known to affect sinus node function or AV nodal conduction,
e.g., digitalis, calcium channel blockers and beta-blockers Serious Side Effects: Hypotension, syncope, ↓ HR, AV block, angioedema, depression Side Effects: headache, sedation/somnolence, dizziness, weakness/asthenia, xerostomia
1° MOA: Nonselective α2-adrenergic receptor agonism—its action at α2A enhances PFC functioning → strengthens working memory, ↓ susceptibility to distraction, ↑ attention, ↑ behavioral inhibition, & ↑ impulse control Target: α2A, α2B, α2C, I1, α1 (mild)
- can potentiate the action of, other CNS depressants, such as opiates or other analgesics, barbiturates or other sedatives, anesthetics, or alcohol
- sedation is common and may be intolerable for many patients
↓ autonomic symptoms of opioid withdrawal, i.e. sweating, diarrhea, cramping nausea, anxiety & irritability (BUT NOT AS EFFECTIVE in treating myalgia, restlessness, insomnia and cravings)
remember, if using in setting of alcohol or benzodiazepine withdrawal, clonidine may decrease vital signs and tremor but will not prevent seizures (like beta-blockers, they can 'mask' autonomic signs of withdrawal w/o addressing seizure risk)
Category C—Limited Human Data—Animal Data Suggest Risk
Limited Human Data—Probably Compatible
Prescribe with caution d/t ↑ risk of adverse CNS effects; may cause bradycardia and orthostatic hypotension; generally not recommended
Patients with renal impairment may require a reduced dose of clonidine
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Last updated March 25 2019 15:25:58. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.
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