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clonidine and diuretics

C02LC01

Forms & Strengths

Clonidine 0.1-0.3 mg, Hydrochlorothiazide 25 mg tablets
Clonidine 0.1-0.3 mg, Chlorthalidone 15-30 mg tablets
Oral capsules and extended-release formulations

Adult Dosing

Initial dose: Clonidine 0.1 mg, Hydrochlorothiazide 25 mg orally twice daily
Titrate to 0.2-0.3 mg Clonidine and 25-50 mg Hydrochlorothiazide as needed
Maximum dose: Clonidine 2.4 mg, Hydrochlorothiazide 100 mg per day

Pediatric Dosing

Safety and efficacy not established in children under 12 years
For hypertensive children over 12 years, start with 0.1 mg Clonidine, 12.5 mg Hydrochlorothiazide orally twice daily
Titrate with caution, not exceeding adult maximum doses

Indications

Hypertension in patients who are not adequately controlled with single-agent therapy
Treatment of resistant hypertension
Management of hypertension in patients with renal impairment

Mechanism of Action

Clonidine stimulates alpha-2 adrenergic receptors, reducing sympathetic nervous system activity and blood pressure
Diuretic component (e.g. Hydrochlorothiazide) increases sodium and water excretion, reducing blood volume and pressure

Contraindications

Hypersensitivity to Clonidine, Hydrochlorothiazide, or sulfonamide-derived diuretics
Anuria, severe renal impairment, or patients on hemodialysis
Concomitant use of MAO inhibitors

Adverse Reactions

Drowsiness, dizziness, fatigue, dry mouth, and constipation from Clonidine
Hypokalemia, hyperglycemia, and increased uric acid levels from diuretic component
Rebound hypertension with abrupt Clonidine withdrawal

Drug Interactions

Enhanced hypotensive effects with other antihypertensives, especially beta-blockers
Potentiation of sedative effects by CNS depressants, such as opioids and sedatives
Increased risk of lithium toxicity with diuretic-induced sodium depletion

Curated Content: Needs Vetting Before Put to Clinical Use