Clonidine
Administration
- Type: Antihypertensive, Central alpha-2 agonist
- Dosage Forms: Tablets (0.1mg, 0.2mg, 0.3mg); Transdermal patches; Injectable
- Routes of Administration: PO, IV, Transdermal
- Common Trade Names: Catapres, Duraclon
Adult Dosing
General
- Hypertension: 0.1mg PO BID, titrate as needed
- Acute hypertension: 0.1-0.2mg PO, may repeat hourly (max 0.6mg)
Pediatric Dosing
General
- 5-10mcg/kg/day PO divided q8-12h
Special Populations
- Pregnancy Rating: C
- Lactation risk: Enters breast milk, use caution
Renal Dosing
- Adjust dose; reduce in renal impairment
Hepatic Dosing
- Use caution in hepatic impairment
Contraindications
- Allergy to class/drug
Adverse Drug Reactions
Serious
- Rebound hypertension with abrupt discontinuation
- Bradycardia
- Hypotension
Common
- Dry mouth
- Drowsiness/sedation
- Constipation
- Dizziness
Pharmacology
- Onset of action: 30-60 minutes (PO)
- Half-life: 12-16 hours
- Metabolism: Hepatic (50%)
- Excretion: Renal (40-60% unchanged)
Mechanism of Action
- Stimulates alpha-2 adrenergic receptors in the brainstem, reducing sympathetic outflow from the CNS
- Decreases peripheral resistance, heart rate, and blood pressure
Indications by Condition
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Opioid withdrawal | 0.1mg q60min PRN | Suppress sympathetic hyperactivity during withdrawal | PO | Adult |
| Opioid withdrawal (peds) | 0.1mg PO q60min PRN (or 5mcg/kg if SBP >90) | Suppress sympathetic hyperactivity | PO | Adult |