Clonidine

Overview

What is Clonidine?

Clonidine is an extended-release formulation of clonidine hydrochloride used for the treatment of attention deficit hyperactivity disorder (ADHD) as monotherapy or as adjunctive therapy to stimulant medications. It is not a central nervous system (CNS) stimulant. The mechanism of action of clonidine in ADHD is not clear, and it is thought to involve alteration of prefrontal cortex brain activity.

Global Name

• Generic names: Clonidine / Clonidine hydrochloride 
• Brand names: Kapvay (ADHD), Onyda XR (ADHD), JENLOGA (Hypertension), Catapres (Hypertension), Nexiclon (Hypertension) 

Usage

What is Clonidine used for? 

How do you use Clonidine? 

Dosage form: Clonidine for ADHD is available in oral tablet (e.g. Kapvay) and extended-release oral suspension (Onyda XR).  

Note: Both Kapvay and Onyda XR are not available in Hong Kong.   

Dosage information:

The dose of clonidine should be individualised according to the therapeutic needs and response of the patient.

• 0.1 mg twice daily (morning and bedtime) 

• 0.2 mg twice daily (morning and bedtime)

Are the following suitable for getting the drug?

• Children: Suitable for paediatric patients aged 6–17 years. 
• Adults: Off-label use.
• Elderlies: Not recommended in older adults with hypertension due to the high risk of adverse effects.
• Patients with hepatic impairment: No dosage adjustment.
• Patients with renal impairment: Start with a low dose and titrate the dose cautiously. The initial dose should be adjusted based on renal function.

• Children: Not recommended for children under 6 years old. 
• Pregnant women: Not recommended during pregnancy unless clearly needed. 
• Nursing mothers: Clonidine hydrochloride is excreted in human milk, exercise caution when administered to a nursing woman.
• Patients with known hypersensitivity to clonidine

Warnings and Precautions: 

• Hypotension/bradycardia: Use clonidine with caution in patients at risk for hypotension, bradycardia and heart block. Monitor heart rate and blood pressure prior to initiation, following dose adjustment and periodically while on therapy. 
• Somnolence/Sedation: Caution patients against operating heavy equipment or driving. 
• Abrupt Discontinuation: Clonidine is associated with potential risk of withdrawal effects. Do not discontinue therapy without consultation with physicians. 
• Allergic Reactions: Initiate appropriate treatment if anaphylaxis, angioedema, urticaria and erythema multiforme occurs or is suspected. 
• Use in patients with vascular disease, cardiac conduction disease, or chronic renal failure: Monitor carefully and up titrate slowly. 
• Concomitant use with other clonidine-containing products: Do not use clonidine with other products containing clonidine. 

Interactions and Contraindications of Clonidine:  

• Drug interactions: Be cautious when clonidine is co-administered with sedating drugs, tricyclic antidepressants, drugs known to affect sinus node function or AV nodal conduction, other clonidine products and antihypertensive drugs.
• Contraindications: Do not use clonidine in patients with known hypersensitivity to clonidine. 

Side Effects

Common side effects may include:

• Somnolence 
• Fatigue 
• Upper Respiratory Tract Infection (cough, rhinitis, sneezing) 
• Irritability 
• Throat Pain (sore throat) 
• Insomnia 
• Nightmares 
• Emotional Disorder 
• Constipation 
• Nasal Congestion 
• Increased Body Temperature 
• Dry Mouth 
• Ear Pain 
• Orthostatic hypotension 

Pharmacist Tips

• Storage information: Store at 20°-25°C. Dispense in a tight, light-resistant container.   

• Administration: Swallow the tablet whole. Do not crush, cut or chew the tablet. Clonidine can be taken with or without food.   

Availability

Where is imipramine available in Hong Kong?

Clonidine is a prescription medication available upon doctor’s prescription. 

FAQs

Does clonidine lower blood pressure?

Yes. Clonidine (Catapres) is indicated for the treatment of hypertension.

How long does Clonidine stay in your system? 

The "half-life" of Clonidine—the time it takes for half the drug to be eliminated from your body—is generally between 12 and 16 hours in patients with normal kidney function. The half-life increases up to 41 hours in patients with severe impairment of renal function.

Can I drink alcohol if I am currently on clonidine therapy?

It is strongly advised to avoid alcohol while taking Clonidine.

How much does clonidine cost? 

Clonidine is a prescription-only medicine, and the price varies depending on the healthcare provider.