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Clonidine

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Clonidine, Catapres

  • See Also
  1. Alpha Adrenergic Central Agonist
  2. Clonidine Overdose
  3. Clonidine Withdrawal
  • Indications
  1. Hypertension
  2. Vasomotor Symptoms of Menopause
  3. Tic Management
  • Mechanism
  1. See Alpha Adrenergic Central Agonist
  2. See Alpha Adrenergic Receptor
  • Precautions
  1. See Clonidine Withdrawal
  2. Acute withdrawal risk (do not stop suddenly, esp. if Clonidine dose >1.2 mg per day)
  • Preparations
  1. Clonidine (Catapres) Tablet
    1. Start: 0.2 mg PO load
    2. Titrate 0.1 mg/hour to:
      1. Maximum of 0.7 mg
      2. Diastolic Blood Pressure drops more than 20 mmHg
    3. Activity
      1. Onset in 30-60 min
      2. Duration: 6-10 hours
  2. Clonidine Transdermal Patch
    1. Available in 0.1, 0.2 and 0.3 mg/day dosing
    2. Costs $40-100/month (depending on dose)
    3. Changed every 7 days
    4. Does not reach peak effect for 2-3 days
    5. Once at level, delivers constant Clonidine rate over 7 days
    6. Transition from oral to patch
      1. Day 1
        1. Apply transdermal Clonidine
        2. Take full oral Clonidine dose
      2. Day 2
        1. Take 50% of oral Clonidine dose
      3. Day 3
        1. Take 25% of oral Clonidine dose
        2. Discontinue oral Clonidine
  3. Other forms
    1. Clonidine IV
    2. Epidural Clonidine (for Chronic Pain)
  • Resources
  1. Clonidine (Stat Pearls)
    1. https://www.ncbi.nlm.nih.gov/books/NBK459124/
  • References
  1. Mishler and Lovecchio (2017) Crit Dec Emerg Med 31(11): 15-20