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NERVOUS SYSTEM › ANALGESICS › ANTIMIGRAINE PREPARATIONS › Other antimigraine preparations
clonidine
N02CX02
Forms & Strengths
- Oral tablets: 0.1 mg, 0.2 mg, 0.3 mg
- Transdermal patch: 0.1 mg/24 hr, 0.2 mg/24 hr, 0.3 mg/24 hr
- Epidural injection: 500 mcg/mL, 100 mcg/mL
Adult Dosing
- Hypertension: Oral: Initial 0.1 mg twice daily; titrate by 0.1-0.2 mg/day at weekly intervals; max 2.4 mg/day
- Hypertension: Transdermal: Apply one patch every 7 days; start with 0.1 mg/24 hr
- Attention Deficit Hyperactivity Disorder (ADHD): Extended-release oral: Initial 0.1 mg at bedtime; titrate by 0.1 mg/week; max 0.4 mg/day
- Cancer Pain (Epidural): Initial 30 mcg/hr; titrate based on clinical response
Pediatric Dosing
- ADHD (Children and Adolescents 6-17 years): Extended-release oral: Initial 0.1 mg at bedtime; titrate by 0.1 mg/week; max 0.4 mg/day
- Hypertension (Pediatric): Safety and efficacy have not been established in patients under 18 years
Indications
- Hypertension
- Attention Deficit Hyperactivity Disorder (ADHD) as adjunctive therapy
- Severe cancer pain refractory to systemic analgesics (epidural administration)
Mechanism of Action
- Central alpha-2 adrenergic receptor agonist
- Stimulates alpha-2 receptors in the brainstem, reducing sympathetic outflow from the central nervous system
- Decreases peripheral resistance, renal vascular resistance, heart rate, and blood pressure
Contraindications
- Hypersensitivity to clonidine or any component of the formulation
- Use of epidural clonidine in patients with anticoagulation therapy or bleeding diathesis
- Epidural administration in the presence of an infection at the injection site
Adverse Reactions
- Dry mouth
- Drowsiness and sedation
- Dizziness
- Constipation
- Sedation and fatigue
- Hypotension and orthostatic hypotension
- Rebound hypertension upon abrupt cessation
Drug Interactions
- Beta-blockers: May exacerbate rebound hypertension upon discontinuation; potential for bradycardia and AV block
- CNS depressants (alcohol, barbiturates, opioids): Enhanced sedative and CNS depressant effects
- Tricyclic antidepressants: May decrease the antihypertensive effect of clonidine
- Digitalis glycosides, calcium channel blockers: Potential additive effects on slowing AV nodal conduction
Curated Content: Needs Vetting Before Put to Clinical Use