clonidine hydrochloride

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Related to clonidine hydrochloride: Catapres



clonidine hydrochloride

Apo-Clonidine (CA) Catapres, Dixarit (CA) Dom-Clonidine (CA), Duraclon (UK), Novo-Clonidine (CA), Nu-Clonidine (CA)

Pharmacologic class: Centrally acting sympatholytic

Therapeutic class: Antihypertensive

Pregnancy risk category C

FDA Box Warning

• Before use, dilute clonidine hydrochloride 500-μg/mL strength product in appropriate solution.

• Epidural form (clonidine hydrochloride) isn't recommended for obstetric, postpartum, or perioperative pain management. In these cases, risk of hemodynamic instability may be unacceptable, except in rare patients for whom potential benefits may outweigh possible risks.


Stimulates alpha-adrenergic receptors in CNS, decreasing sympathetic outflow, inhibiting vasoconstriction, and ultimately reducing blood pressure. Also prevents transmission of pain impulses by inhibiting pain pathway signals in brain.


Solution for epidural injection: 100 mcg/ml in 10-ml vials, 500 mcg/ml in 10-ml vials

Tablets: 100 mcg (0.1 mg), 200 mcg (0.2 mg), 300 mcg (0.3 mg)

Transdermal systems: 2.5 mg total released as 0.1 mg/24 hours (TTS 1), 5 mg total released as 0.2 mg/24 hours (TTS 2), 7.5 mg total released as 0.3 mg/24 hours (TTS 3)

Indications and dosages

Mild to moderate hypertension

Adults: 0.1 mg P.O. b.i.d. (morning and bedtime) alone or with other anti-hypertensives; increase in increments of 0.1 mg/day q week until desired response occurs. Or, one transdermal system applied once q 7 days to hairless area of intact skin on upper outer arm or chest.

Severe pain in cancer patients unresponsive to opioids alone

Adults: Initially, 30 mcg/hour by continuous epidural infusion, titrated upward or downward depending on patient response

Dosage adjustment

• Renal impairment

Off-label uses

• Acute alcohol withdrawal

• Akathisia

• Diarrhea

• Prolonged surgical anesthesia


• Hypersensitivity to drug

• Hypersensitivity to components of adhesive layer (transdermal form)

• Infection at epidural injection site, bleeding problems (epidural use)

• Concurrent anticoagulant therapy


Use cautiously in:

• renal insufficiency, serious cardiac or cerebrovascular disease

• elderly patients

• pregnant or breastfeeding patients.


• For epidural use, dilute drug solution in normal saline solution, as ordered.

• To minimize sedative effects, give largest portion of maintenance P.O. dose at bedtime.

Adverse reactions

CNS: drowsiness, depression, dizziness, nervousness, nightmares

CV: hypotension (especially with epidural use), palpitations, bradycardia

GI: nausea, vomiting, constipation, dry mouth

GU: urinary retention, nocturia, erectile dysfunction

Metabolic: sodium retention

Skin: rash, sweating, pruritus, dermatitis

Other: weight gain, withdrawal phenomenon


Drug-drug. Amphetamines, beta-adrenergic blockers, MAO inhibitors, prazosin, tricyclic antidepressants: decreased antihypertensive effect Beta-adrenergic blockers: increased withdrawal phenomenon

CNS depressants (including antihistamines, opioids, sedative-hypnotics): additive sedation

Epidurally administered local anesthetics: prolonged clonidine effects

Levodopa: decreased levodopa efficacy

Myocardial depressants (including beta-adrenergic blockers): additive bradycardia

Other antihypertensives, nitrates: additive hypotension

Verapamil: increased risk of adverse cardiovascular reactions

Drug-herbs. Capsicum: reduced anti-hypertensive effect

Drug-behaviors. Alcohol use: increased sedation

Patient monitoring

• Monitor patient for signs and symptoms of adverse cardiovascular reactions.

• Frequently assess vital signs, especially blood pressure and pulse.

• Monitor patient for drug tolerance and efficacy.

Patient teaching

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness caused by sudden blood pressure decrease.

Caution patient not to stop taking drug abruptly.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

clonidine hydrochloride

A centrally acting alpha-agonist drug used to treat hypertension and opiate withdrawal.
Medical Dictionary, © 2009 Farlex and Partners
References in periodicals archive ?
Proper volumes of one of the above-mentioned working solutions to produce the standard curve points were equivalent to 0.05, 0.20, 1.0, 5.0, 10.0, 20.0, 50.0 and 100.0 ng/ml of clonidine hydrochloride and each sample was processed as described.
Quality control samples were prepared daily by spiking different samples of 0.1 ml plasma each with proper volume of the corresponding standard solution to produce a final concentration equivalent to low level (0.01 ng/ml), middle level (1.0 ng/ml) and high level (10.0 ng/ml) of clonidine hydrochloride. The following procedures were the same as described above.
The LLOQ and LOD for clonidine hydrochloride was proved to be 0.010 and 0.005 ng/ml, respectively.
The extraction recovery determined for clonidine hydrochloride was shown to be consistent, precise and reproducible.
As indicated, the developed method shows an acceptable intermediate precision for clonidine hydrochloride assay.
Table 6 summarizes the freeze and thaw stability, short term stability, long-term stability and post-preparative stability data of clonidine hydrochloride. All the results showed the stability behavior during these tests and there were no stability related problems during the samples routine analysis for the pharmacokinetic, bioavailability or bioequivalence studies.
For a safety reason, coadministration of the drug with food can reduce nausea, a common side effect of clonidine hydrochloride. In general, the pharmacokinetic parameters for both formulations were similar to the pharmacokinetic parameters of clonidine hydrochloride in previous published data.
A sensitive, selective, accurate and precise HPLC method with selected ion monitoring by triple quadrupole mass spectrometer with ESI interface was developed and validated for determination of clonidine hydrochloride in human plasma.
According to the company, this approval of Clonidine Hydrochloride further strengthens its analgesic portfolio of products and helps solidify its continued leadership as a leading generic injectable company.
Clonidine Hydrochloride is a centrally-acting analgesic, which is indicated in combination with opiates for the treatment of severe pain in cancer patients that is not adequately relieved by opioid analgesics alone.