Skip to main content

Kapvay

(Clonidine hydrochloride)

Full Prescribing Information DailyMed Drug Information

Forms/Strengths

  • Tablets: 0.1 mg, 0.2 mg, 0.3 mg

Dosing

  • Age: ≥ 6 y/o
  • Onset: 
  • Duration: 12-24 hours
  • Considerations: Monitor for hypotension, bradycardia, and sedation. Titrate slowly.
  • Initial Dose: 0.1 mg orally once daily at bedtime
  • Titration: Increase by 0.1 mg weekly
  • Max Dose: 0.4 mg once daily

Quick Facts

  • Selective alpha-2 adrenergic receptor agonist; reduces sympathetic outflow
  • Improves prefrontal cortex regulation; decreases hyperactivity and impulsivity
  • Extended-release formulation for adjunctive ADHD management; may improve sleep
  • Less effective for inattention compared to stimulants
  • Common side effects: drowsiness, sedation, dry mouth, hypotension

Indications

  •  ADHD (ICD-10: F90.0)

Off-Label Uses

  •  

How to Take

  • Take twice daily, with doses about 12 hours apart.
  • Swallow the tablet whole; do not crush, chew, or split.
  • Can be taken with or without food, but be consistent with food intake for stable absorption.
  • If a dose is missed, take it as soon as possible unless it is close to the next dose—do not double up.
  • Do not abruptly stop taking; tapering may be required to prevent rebound hypertension.

Side Effects

  • Common: Somnolence, fatigue, headache, abdominal pain, increased heart rate, nasal congestion, irritability, throat pain, rash.
  • Serious: Hypotension, bradycardia, cardiac conduction abnormalities.

Monitoring / Labs

  • Monitor heart rate and blood pressure prior to initiation, following dose increases, and periodically during therapy.

Education

  • When to Call the Doctor:

    • Severe dizziness, fainting, or low blood pressure.
    • Slow or irregular heart rate.
    • Excessive drowsiness or difficulty waking.
    • Mood changes, depression, 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.
    • Use caution when driving or operating heavy machinery due to possible sedation.
    • Taper gradually when discontinuing to avoid withdrawal symptoms.

  • Parent Tips for Pediatric Patients:

    • May cause daytime drowsiness; consider giving the larger dose at bedtime if drowsiness is problematic.
    • Monitor for irritability, mood swings, or behavioral changes.
    • Encourage hydration and balanced nutrition to minimize side effects.
    • Ensure children do not engage in high-risk activities (e.g., swimming, biking) if excessively drowsy.
    • Store 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 when using together.
    • Stimulants (e.g., amphetamines) may counteract Kapvay’s effects.
    • Antihypertensive medications may lead to excessive blood pressure lowering.
Back to top