Clonidine oral
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Oral formulations of clonidine hydrochloride.
Drugs List
Therapeutic Indications
Uses
Management of vasomotor conditions (especially flushing) due to menopause
Migraine (prophylaxis)
Vascular headache: prophylaxis
Dosage
Adults
Initial dose: 50micrograms twice a day.
If considered necessary, after 2 weeks, the dose may be increased to 75micrograms twice a day.
Contraindications
Children under 18 years
Breastfeeding
Severe bradycardia due to AV block (2nd/3rd degree)
Severe bradycardia due to sinus node dysfunction
Precautions and Warnings
Constipation
Acute porphyria
Cardiac conduction defects
Cardiac failure
Cerebrovascular disorder
Depression
Galactosaemia
Glucose-galactose malabsorption syndrome
Hereditary fructose intolerance
History of depression
Ischaemic heart disease
Lactose intolerance
Occlusive peripheral vascular disorder
Polyneuropathy
Pregnancy
Raynaud's syndrome
Renal impairment
Advise ability to drive/operate machinery may be affected by side effects
Some formulations contain hydroxybenzoate
Some formulations contain lactose
Stop betablocker several days before clonidine if withdrawing combination
Do not withdraw this drug suddenly
Advise patient to avoid alcohol during treatment
Advise contact lens wearers of possibility of reduced lacrimation
Advise patient on possible rebound phenomena on withdrawal
Clonidine Hydrochloride can cause bradycardia. In patients with pre-existing cardiac conduction abnormalities, arrhythmias have been observed after high doses.
Pregnancy and Lactation
Pregnancy
Use clonidine with caution in pregnancy, particularly in the 1st trimester.
The manufacturer advises not using clonidine in pregnancy, espicially during the first trimester, unless the expected benefit is thought to outweigh any possible risk to the foetus.
Clonidine passes the placental barrier and may lower the heart rate of the foetus. Post partum a transient rise in blood pressure in the newborn cannot be excluded. Available reports regarding animal studies indicate no foetal malformations. Effects on foetal development were seen in one species only. Careful monitoring of mother and child is recommended.
Schaefer (2015) states clonidine should not be used during pregnancy, however if used during the first trimester, a follow up sonography may be considered.
Lactation
Clonidine is contraindicated during breastfeeding.
The manufacturer recommends not using clonidine during breastfeeding. Clonidine is excreted in human milk. However, there is limited information on the effects of the newborn.
Side Effects
Abnormal liver function tests
Alopecia
Atrioventricular block
Bradyarrhythmias
Bradycardia
Cardiac failure
Confusion
Constipation
Decreased lacrimation
Depression
Disturbances in accommodation
Dizziness
Drowsiness
Dry mouth
Dryness and irritation of eyes
Dryness of nasal mucosa
Erectile dysfunction
Fatigue
Fluid retention
Gynaecomastia
Hallucinations
Headache
Hyperglycaemia
Hypersensitivity reactions
Impotence
Malaise
Nausea
Nightmares
Orthostatic hypotension
Pain in salivary glands
Paraesthesia
Perceptual disturbances
Pruritus
Pseudo-obstruction of the large intestine
Rash
Raynaud's phenomenon
Reduced libido
Restlessness (nocturnal)
Sedation
Sinus bradycardia
Sleep disturbances
Urticaria
Vomiting
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: November 2018
Reference Sources
Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3nd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.
Summary of Product Characteristics: Clonidine 25mcg Tablets BP. Sandoz Ltd. Revised July 2016.
Summary of Product Characteristics: Clonidine 50mcg/5ml oral solution. Thame Laboratories. Revised August 2018.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 23 November 2018
The Welsh Medicines Information Centre (WMIC) Porphyria Information Service.
Available at: https://www.wmic.wales.nhs.uk/porphyria_info.php
Last revised: 05 May 17
Last accessed: 23 November 2018
The Norwegian Porphyria Centre (NAPOS).
Available at: https://www.drugs-porphyria.org
Last revised: 22 September 2018
Last accessed: 23 November 2018
US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Clonidine Last revised: 31 August 2018
Last accessed: 23 Novemeber 2018
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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