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.