# Kapvay ### (Clonidine hydrochloride)
**[Full Prescribing Information](https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/022331s014lbl.pdf)**[**DailyMed Drug Information**](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm)
--- **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.