# Clonidine ### (clonidine)
**[Full Prescribing Information](https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=a842ab83-3531-44dd-a8a8-64dd89e87026&type=display)**[**DailyMed Drug Information**](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a842ab83-3531-44dd-a8a8-64dd89e87026)
--- **Forms/Strengths** - **Tablets:** 0.1 mg, 0.2 mg, 0.3 mg --- ### **Dosing** - **Age:** ≥ 6yr - **Onset:** 30-60 min (oral) - **Duration:** 6-12 hours - **Considerations:** Monitor for bradycardia and hypotension; taper off gradually to avoid rebound hypertension - **Initial Dose:** - 27-40 kg: 0.05 mg nightly - 40+ kg: 0.1 mg nightly - **Titration:** - Increase 0.05mg every 3-7 d taper gradually over 2-4 days to discontinue - **Max Dose:** - 27-40 kg: 0.2 mg/day - 40+ kg: 0.4 mg/day --- ### **Quick Facts** - Alpha-2 adrenergic agonist; reduces sympathetic outflow - Decreases hyperactivity, impulsivity, and improves sleep in ADHD - Off-label use for ADHD, especially in patients with comorbid tic disorders or poor stimulant response; often used as an adjunct to stimulants - Common side effects: drowsiness, sedation, dry mouth, hypotension --- ### **Indications** - ADHD** (ICD-10: F90.0) --- ### **Off-Label Uses** - **Tourette syndrome** (ICD-10: F95.2) - **Oppositional defiant disorder:** (ICD-10: F91.3) - **Sleep disturbances associated with ADHD** (ICD-10: G47.00) --- ### **How to Take** - Take at the **same time each day** for consistency. - Can be taken **with or without food**. - **Swallow whole**; do not crush or chew. - If used for **ADHD**, often given **twice daily**, with the larger dose at bedtime to minimize drowsiness. - Do not **suddenly stop** taking; tapering may be required to prevent **rebound hypertension**. - Transdermal patches should be applied to a hairless area on the upper outer arm or chest. --- ### **Side Effects** - Common - Dry mouth - Drowsiness - Dizziness - Constipation - Serious - Bradycardia - Hypotension - Withdrawal syndrome --- ### **Monitoring / Labs** - Blood pressure and heart rate monitoring - Renal function tests --- ### **Education** - **When to Call the Doctor:** - Severe **dizziness, fainting, or low blood pressure**. - Slow or irregular heart rate. - Signs of **over-sedation**, such as excessive drowsiness or difficulty waking. - Mood changes, hallucinations, or unusual behavior. - Severe headache, blurred vision, or confusion (**possible hypertensive rebound if stopped abruptly**). - **Safety Tips:** - Monitor **blood pressure and heart rate** regularly. - Avoid **alcohol and sedatives**, which may enhance drowsiness. - Rise slowly from sitting or lying positions to prevent dizziness. - Do not **suddenly discontinue**, as this may lead to **rebound hypertension**. - Be cautious when driving or operating machinery until individual response is known. - **Parent Tips for Pediatric Patients:** - May cause **daytime drowsiness**; consider giving the **larger dose at bedtime**. - Monitor for **irritability, behavioral changes, or mood swings**. - Encourage **hydration and salt intake** if dizziness occurs. - Ensure the child does not engage in **high-risk activities (e.g., climbing, swimming unsupervised) if excessively drowsy**. - Keep in **child-proof packaging** to prevent accidental overdose. --- ### **Additional Information** - **Contraindications:** - **Hypersensitivity** to clonidine or formulation components. - Use with caution in patients with **severe heart disease, bradycardia, or hypotension**. - **Pregnancy:** - **Category C**; use only if benefits outweigh risks. - May cause **neonatal withdrawal symptoms**. - **Lactation:** - **Excreted in breast milk**; use with caution due to potential effects on infant blood pressure. - **Drug Interactions:** - **CNS depressants** (e.g., alcohol, benzodiazepines) may increase sedation. - **Beta-blockers** may enhance bradycardia; caution if discontinuing either drug. - **Stimulants (e.g., amphetamines)** may counteract clonidine’s effects. - **Antihypertensive medications** may lead to excessive blood pressure lowering.