Clonidine

Administration

• Type: Antihypertensive, Central alpha-2 agonist
• Dosage Forms: Tablets (0.1mg, 0.2mg, 0.3mg); Transdermal patches; Injectable
• Routes of Administration: PO, IV, Transdermal
• Common Trade Names: Catapres, Duraclon

Adult Dosing

General

• Hypertension: 0.1mg PO BID, titrate as needed
• Acute hypertension: 0.1-0.2mg PO, may repeat hourly (max 0.6mg)

Pediatric Dosing

General

• 5-10mcg/kg/day PO divided q8-12h

Special Populations

• Pregnancy Rating: C
• Lactation risk: Enters breast milk, use caution

Renal Dosing

• Adjust dose; reduce in renal impairment

Hepatic Dosing

• Use caution in hepatic impairment

Contraindications

• Allergy to class/drug

Adverse Drug Reactions

Serious

• Rebound hypertension with abrupt discontinuation
• Bradycardia
• Hypotension

Common

• Dry mouth
• Drowsiness/sedation
• Constipation
• Dizziness

Pharmacology

• Onset of action: 30-60 minutes (PO)
• Half-life: 12-16 hours
• Metabolism: Hepatic (50%)
• Excretion: Renal (40-60% unchanged)

Mechanism of Action

• Stimulates alpha-2 adrenergic receptors in the brainstem, reducing sympathetic outflow from the CNS
• Decreases peripheral resistance, heart rate, and blood pressure

Indications by Condition

Indication	Dose	Context	Route	Population
Opioid withdrawal	0.1mg q60min PRN	Suppress sympathetic hyperactivity during withdrawal	PO	Adult
Opioid withdrawal (peds)	0.1mg PO q60min PRN (or 5mcg/kg if SBP >90)	Suppress sympathetic hyperactivity	PO	Adult

See Also

• Clonidine toxicity
• Opioid withdrawal
• Hypertensive emergency
• Antihypertensives