What is Clonidine: How to use, Side Effects, Dosage

What is Clonidine: How to use, Side Effects, Dosage

What is Clonidine

Clonidine gets used alone or with other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps 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.

Jenloga (clonidine hydrochloride) extended-release is a centrally acting alpha-2 adrenergic agonist available as 0.1 mg or 0.2 mg extended-release tablets for oral administration. Each 0.1 mg and 0.2 mg tablet is equivalent to 0.087 mg and 0.174 mg, respectively, of the free base.

The inactive ingredients are sodium lauryl sulfate, lactose monohydrate, hypromellose type 2208, partially pregelatinized starch, colloidal silicon dioxide, and magnesium stearate. Clonidine hydrochloride is an imidazoline derivative and exists as a mesomeric compound. The chemical name is 2-(2,6-dichlorophenylamino)-2-imidazoline hydrochloride. The following is the structural formula:

Structural Formula Illustration;

C9H9Cl2N3 - HCI.......Mol, Wt, 266,56

Clonidine hydrochloride is an odorless, white, bitter, crystalline substance soluble in water and alcohol.

Clonidine lowers blood pressure by decreasing the levels of certain chemicals in your blood. This allows your blood vessels to relax and your heart to beat more slowly and easily.

The Catapres brand of clonidine is used to treat hypertension (high blood pressure). The Kapvay brand is used to treat attention deficit hyperactivity disorder (ADHD).

Clonidine is sometimes given with other medications, either.

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How to use Clonidine

Take this medication by mouth with or without food as directed by your doctor, usually twice daily (in the morning and at bedtime). If the doses are not equal, take the larger dose at bedtime to decrease the risk of side effects.

When used for a long time, this medication may not work as well and may require different dosing or an additional medication. Talk with your doctor if this medication stops working well (such as your blood pressure readings remain high or increase).

Take clonidine exactly as it was told to you by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Do not use two forms of clonidine at the same time. This medicine is also available as a transdermal patch worn on the skin.

Dosage of Clonidine

Adjust the dose of Jenloga (clonidine tablets) based on the patient's individual blood pressure response. Initiate cure with one 0.1 mg tablet at bedtime. Increase the dose in increments of 0.1 mg per day at weekly intervals, if necessary, until the desired response is recived. Total daily doses above 0.1 mg per day should be divided and taken at morning and bedtime. For example, a daily dose of 0.2 mg should be taken as 0.1 mg in the morning and 0.1 mg at bedtime or a daily dose of 0.4 mg taken as 0.2 mg in the morning and 0.2 mg at bedtime. If morning and bedtime doses are not equal, the bedtime dose should be the larger of the two.

Jenloga (clonidine tablets) was studied at doses of 0.2 to 0.6 mg per day, with little or no therapeutic benefit seen for the 0.6 mg dose over the 0.4 mg dose [see Clinical Studies]. Doses of Jenloga (clonidine tablets) higher than 0.6 mg per day (0.3 mg twice daily) were not evaluated in clinical trials and are not recommended.

Symptoms of overdose 

In a clonidine overdose, hypertension may develop early and may be followed by hypotension, bradycardia, respiratory depression, hypothermia, drowsiness, decreased or absent reflexes, weakness, irritability, and miosis. The frequency of CMS depression may be higher in children than adults. Large overdoses may result in reversible cardiac conduction defects or dysrhythmias, apnea, coma, and seizures. Signs and symptoms of overdose generally occur within 30 minutes to two hours after exposure. As little as 0.1 mg of clonidine has produced signs of toxicity in children.

Overdose symptoms may include dangerously high blood pressure (severe headache, pounding in your neck or ears, nosebleed, anxiety, chest pain, shortness of breath) followed by low blood pressure (feeling like you might pass out). Other overdose symptoms may include feeling cold, extreme weakness or drowsiness, weak or shallow breathing, pinpoint pupils, fainting, or seizure (convulsions).

There is no specific antidote for clonidine overdosage. Gastric lavage may be indicated following recent and/or large ingestions. Administration of activated charcoal and/or a cathartic may be beneficial. Because clonidine overdosage may result in the rapid development of CMS depression administration of ipecac syrup to induce vomiting is not suggested. Supportive care may include atropine sulfate for bradycardia, intravenous fluids and/or vasopressor agents for hypotension and vasodilators for hypertension. Naloxone may be a useful adjunct for the management of clonidine-induced respiratory depression, hypotension or coma; monitor blood pressure as the administration of naloxone has occasionally resulted in paradoxical hypertension. Dialysis is not likely to significantly enhance the elimination of clonidine.

Clonidine

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Side effects of Clonidine

Dizziness, lightheadedness, drowsiness, dry mouth, or constipation may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To decrease the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

Tell your doctor right away if you have any serious side effects, like: fainting, slow/irregular heartbeat, mental/mood changes (such as irritability, depression).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

The following serious adverse reactions are discussed in detail elsewhere in the labeling:

Withdrawal [see WARNINGS AND PRECAUTIONS]

Allergic reactions [see WARNINGS AND PRECAUTIONS]

Jenloga (clonidine tablets) Clinical Trials Experience

Table 1 displays the most common treatment-emergent adverse reactions (ARs) reported by more than one patient in the mild to moderate hypertension study. The incidence of ARs progressively increased with increasing doses and was notably less in the 0.2 mg per day treatment group compared with the 0.4 mg per day and 0.6 mg per day treatments groups. The majority of ARs were mild. ARs of moderate severity occurred in 6 patients and included two reports each of insomnia and dry mouth. One patient (0.4 mg per day group) experienced symptomatic sinus bradycardia two weeks after initiating study drug. This event was the only severe AR, the only serious AR, and the only AR that led to discontinuation of study drug. Because the number of subjects is small and the duration of exposure short, no inferences regarding differences in adverse events between Jenloga (clonidine tablets) and other clonidine formulations is warranted.

Call your doctor at once if you have:

severe chest pain, shortness of breath, irregular heartbeats;

a very slow heart rate;

severe headache, pounding in your neck or ears, blurred vision;

nosebleeds;

dry mouth, loss of appetite;

anxiety, confusion; or

a light-headed feeling, like you might pass out.

Serious side effects may be more likely in older adults.

Common clonidine side effects may include:

drowsiness, dizziness;

feeling tired or irritable;

constipation;

dry eyes, contact lens discomfort; or

sleep problems (insomnia), nightmares.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Drugs that may interact to Clonidine

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions that may be expected. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).

Some products have ingredients that could raise your blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

Tell your doctor about all your current medicines and any you start or stop using, especially:

other heart or blood pressure medications;

an antidepressant; or

any other medicine that contains clonidine.

This list is not complete. Other drugs may interact with clonidine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Can you use Clonidine while pregnancy?

Oral administration of clonidine HCI to pregnant rabbits during embryo/fetal organogenesis, at doses up to 80 mcg/kg/day (human equivalent dose 26 mcg/kg/day), produced no evidence of teratogenic or embryotoxic potential. In pregnant rats, however, doses as low as 15 mcg/kg/day (HED 2.4 mcg/kg/day) were associated with increased resorptions in a study in which dams were treated continuously from 2 months prior to mating and throughout gestation. Increased resorptions were not associated with treatment at the same or higher dose levels (up to 150 mcg/kg/day (HED 24 mcg/kg/day)) when treatment of the dams was restricted to gestation days 6-15. Increases in resorptions were observed in both mice and rats at 500 or more mcg/kg/day (HED 80 mcg/kg/day for rats and 40 mcg/kg/day for mice) when the animals were treated on gestation days 1-14.

Warnings of Clonidine

Before taking clonidine, tell your doctor or pharmacist if you are allergic to it (including having a rash while using clonidine patches); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor your medical history, especially of: kidney disease, heart rhythm problems (such as slow/irregular heartbeat, second- or third-degree atrioventricular block).

This drug might make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Contact lens wearers may need to use wetting eye drops since this medication can cause dry eyes.

Older adults may be more sensitive to the side effects of this product, especially dizziness, or drowsiness. These side effects may increase the risk of falling.

ThisStore at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Clonidine

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