Home Drug Guide Clonidine Hydrochloride

Drug Guide

Generic Name

Clonidine Hydrochloride

Brand Names Catapres, Duraclon, Jenloga, Kapvay, Onyda XR

Classification

Therapeutic: Antihypertensive, ADHD agent, Analgesic (epidural)

Pharmacological: Alpha-2 adrenergic agonist

FDA Approved Indications

  • Hypertension (initial or adjunct therapy)
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Epidural management of cancer pain

Mechanism of Action

Clonidine stimulates alpha-2 adrenergic receptors in the central nervous system, resulting in decreased sympathetic outflow, which reduces blood pressure and alleviates pain.

Dosage and Administration

Adult: Dose varies based on indication; for hypertension, typically 0.1-0.3 mg orally twice daily. Titration is gradual to minimize side effects.

Pediatric: For ADHD, starting dose is usually 0.1 mg at bedtime, titrated as needed.

Geriatric: Start at lower doses due to increased sensitivity and risk of side effects.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Use with caution; data limited.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses blood-brain barrier.

Metabolism: Partially metabolized in the liver.

Excretion: Primarily excreted in urine.

Half Life: 12-16 hours.

Contraindications

  • Hypersensitivity to clonidine or other imidazoline compounds.
  • Use with caution in patients with hepatic impairment, renal impairment, or cardiac conduction abnormalities.

Precautions

  • Monitor blood pressure regularly.
  • Beware of rebound hypertension if abruptly discontinued.
  • CNS depression risk.

Adverse Reactions - Common

  • Dry mouth (Common)
  • Sedation (Common)
  • Drowsiness (Common)
  • Constipation (Common)
  • Rebound hypertension if discontinued abruptly (Serious)

Adverse Reactions - Serious

  • Hypotension (Serious)
  • Bradycardia (Serious)
  • Depression or mood changes (Serious)
  • Seizures (Serious)

Drug-Drug Interactions

  • Beta-blockers (additive effects on blood pressure)
  • CNS depressants (enhanced sedation)
  • Digoxin (bradycardia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, heart rate, mental status.

Diagnoses:

  • Risk for decreased cardiac output.
  • Impaired skin integrity (for epidural form).

Implementation: Administer as prescribed, monitor vitals, observe for side effects, educate patient.

Evaluation: Assess efficacy in blood pressure control or ADHD symptom reduction, monitor for adverse effects.

Patient/Family Teaching

  • Do not stop medication abruptly to avoid rebound hypertension.
  • Report signs of hypotension, sedation, or mood changes.
  • Use caution when performing activities requiring alertness.
  • Follow dosing schedule carefully.

Special Considerations

Black Box Warnings:

  • Rebound hypertension can occur if medication is abruptly discontinued.

Genetic Factors: N/A

Lab Test Interference: No significant interference noted with common lab tests.

Overdose Management

Signs/Symptoms: Extreme hypotension, bradycardia, sedation, respiratory depression.

Treatment: Supportive care, activated charcoal if ingestion is recent, vasopressors or atropine for bradycardia, and urgent medical attention.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.