Onyda XR

(generic)

Forms/Strengths

• Liquid (organe flavored): 0.1 mg/mL

Dosing

• Age: ≥ 6 y/o
• Onset: 60-90 min
• Duration: 12-24 hours
• Considerations: Orange flavored; 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

For patients switching from another clonidine product, discontinue that treatment, and titrate with ONYDA XR using the titration schedule

Quick Facts

• Increases synaptic dopamine and norepinephrine via presynaptic release and reuptake inhibition
• Enhances focus, attention, and impulse control
• Extended-release formulation with dual-phase release for rapid onset and sustained control
• Unique delivery system provides consistent plasma levels throughout the day
• Common side effects: decreased appetite, insomnia, headache, gastrointestinal discomfort

Indications

•  ADHD (ICD-10: F90.0)

Off-Label Uses

• N/A

How to Take

• Take once daily at bedtime to minimize daytime sedation.
• Administer orally as a suspension; shake the bottle gently for at least 10 seconds before each use to ensure proper mixing.
• Use the provided oral dosing dispenser for accurate measurement; do not use household spoons.
• Can be taken with or without food, but maintain consistency in relation to meals to ensure stable absorption.
• If a dose is missed, skip that dose and take the next dose as scheduled; do not double up.
• Do not abruptly discontinue; tapering may be required to prevent rebound hypertension.

Side Effects

• Common: Somnolence, fatigue, irritability, headache, abdominal pain, constipation, dry mouth
• Serious: Hypotension, bradycardia, rebound hypertension, allergic reactions

Monitoring / Labs

• Cardiovascular: Baseline and routine monitoring of heart rate and blood pressure.
• Growth in Pediatrics: Regular monitoring of height and weight to detect growth suppression.
• Psychiatric Symptoms: Observe for mood changes, anxiety, or psychosis.
• Abuse Potential: Monitor for misuse or diversion.

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; administering at bedtime helps minimize this effect.
  • 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 ONYDA XR’s effects.
  • Antihypertensive medications may lead to excessive blood pressure lowering.