Quick brief
Clonidine as the primary active ingredient.
Common indication: management of hypertension. Available as oral tablets and, in some cases, transdermal patches by special supply.
- Typical tablet strength commonly used in Australia: 0.1 mg (100 microgram).
- Patches are worn for seven days and may require special order.
- Clonidine requires a prescription from an Australian registered prescriber.
Clonidine defined
Clonidine is a prescription medicine most often prescribed to reduce raised blood pressure. It can lower blood pressure when taken by mouth or, where available, via a skin patch that releases drug slowly.
It is used alone or with other antihypertensives depending on clinical need. In some situations clinicians may prescribe clonidine for off label uses, but this should only be done under medical supervision.
How clonidine lowers blood pressure and its an apparatus
Clonidine acts on alpha 2 adrenoceptors in the brain stem. By stimulating these receptors it reduces sympathetic nervous system activity. This results in less nerve driven constriction of blood vessels, a slower heart rate in some patients, and a fall in blood pressure.
The effects on central nervous system tone also explain why clonidine can cause drowsiness and other central lingering effects. For more on safety see the protective steps section.
Steps for using the dose
Individual dosing is set by a clinician. Typical starting regimens and practical points are listed below.
- Oral tablets: many adults begin on 0.1 mg twice daily, with dose adjusted based on response and long term effects. Some regimens use once daily dosing at night to reduce daytime drowsiness.
- Transdermal patches: apply to clean, dry, hairless skin on the upper arm or torso. Replace the patch every seven days and rotate application sites to avoid irritation.
- Never stop clonidine suddenly. A gradual taper supervised by your prescriber reduces the risk of rebound hypertension and other withdrawal effects.
If you are uncertain about how to take advantage of your formulation consult your prescriber or pharmacist. Other sources instructions when a dose is missed for what to do if you skip a dose.
Warning and safety handbooks and guidance
Ahead of the start clonidine tell your doctor about any kidney disease, mood disorder, history of fainting, slow heart rate, abnormal heart rhythm, recent heart attack, or circulation problems such as Raynaud phenomenon.
- Avoid alcohol and be cautious with other medicines that make you sleepy. Clonidine can impair alertness.
- Maternity care for pregnancy and lactation: discuss risks and benefits in partnership with your clinician. Methyldopa is an a different path sometimes preferred in pregnancy.
- Do not discontinue therapy abruptly without medical advice. Withdrawal can cause rapid increase in blood pressure, nervousness, tremor, and cephalalgia.
If you need to drive or operate machinery, confirm with your prescriber that it is safe. For legal responsibilities about driving while taking sedating medicines refer to the legal status and driving guidance next section.
Exclusions and Temperature warnings: Cases where treatment is not appropriate
Clonidine should not be used by people with known hypersensitivity to the drug or to any formulation component.
- Avoid if you have clinically significant bradycardia, sick sinus syndrome, or advanced atrioventricular block unless a pacemaker is present.
- Use caution and specialist supervision in acute coronary syndromes, severe coronary artery disease, and advanced renal impairment.
Where special caution is needed, treatment should be initiated and monitored by clinicians experienced in managing complex cardiovascular conditions.
Expected acute side effects
Some effects require urgent medical attention. Seek emergency care if you experience signs of allergy such as swelling of the face, lips, mouth, or throat, or difficulty breathing.
Common and less common adverse symptoms include:
- The mouth feels dry, drowsiness, dizziness, constipation, and general tiredness.
- Cardiovascular: slow heart rate, palpitations, fluid retention leading to swelling.
- Neuropsychiatric: confusion, mood changes, rare hallucinations.
- Urinary effects: reduced urine output in some cases.
If minor side effects are severe or persistent speak to your prescriber. They may suggest dose changes or consider an nontraditional medical therapies.
Drug interpersonal engagement guidance
Clonidine interacts with several common medicines. Provide a full medicines list to your prescriber and pharmacist, including over the counter and herbal products.
- Other central nervous system depressants, including alcohol, opioids, benzodiazepines: increased sedation and risk of respiratory depression.
- Tricyclic antidepressants: may blunt clonidine effects on blood pressure.
- Drugs that reduce heart rate, such as beta blockers: combined use can cause symptomatic bradycardia; changes should be supervised.
- Calcineurin inhibitor cyclosporine: clonidine may raise cyclosporine concentrations paired with the risk of kidney toxicity in some patients.
If you are starting or stopping medicines that affect blood pressure or heart rate, do so only under medical advice to prevent rebound hypertension or excessive bradycardia.
Missed dosing and take too much medicine
Missed tablet dose: take the a dose was missed when you remember unless the next dose is due soon. Do not exceed the usual dose by taking a double dose to cover a a dose was missed.
Missed patch change: apply a new patch as soon as you remember and set the next change day accordingly. If in doubt contact your pharmacist.
Symptoms indicating overdosing: severe drowsiness, very low heart rate, very low blood pressure, shallow breathing, fainting, or loss of consciousness. Drug overdosing may start with paradoxical symptoms such as severe a headache or high blood pressure followed by marked hypotension and bradycardia.
If taking an overdose is suspected, call emergency services or head to the nearest emergency department right away.
Requirements for the warehouse provides ample storage for all shipments.
Keep tablets and patches at room temperature, ideally 15 to 30 C, away from excess heat, moisture and direct sunlight. Put this item in a high place beyond the reach of children and pets.
Discard used patches safely. If you have any the storage of files is essential for data management. questions check the product leaflet or ask your pharmacist.
Equivalent medicines and different options
If clonidine is unsuitable due to long term effects or health risks that preclude therapy there are many other classes of antihypertensive medicines. Selection depends on your overall health, other conditions and pharmacologic interpersonal engagements among teammates fuel progress. between drugs.
- Thiazide diuretics: hydrochlorothiazide, indapamide.
- ACE inhibitors: enalapril, perindopril, ramipril.
- Angiotensin receptor blockers (ARBs): losartan, irbesartan, candesartan.
- Calcium channel blocker class comprises amlodipine and diltiazem.
- Beta blockers: metoprolol, bisoprolol.
- Other centrally acting agents: moxonidine, methyldopa, guanfacine in its extended release formulation.
Notes on a few substitute options:
- Moxonidine targets imidazoline receptors and may cause fewer central possible side effects in some patients compared with clonidine.
- Methyldopa is commonly considered in pregnancy and is often used under specialist supervision.
- Guanfacine extended release is generally registered in Australia for ADHD; its role in hypertension is limited compared with clonidine.
Talk through the available options by consulting your prescriber. For cost comparison among brandss among sellers, access the comparison page the transparent pricing section.
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Rough pricing information in Australia (AUD)
Prices change over time and vary between pharmacies, brand choices and pack sizes. Where products are on the PBS most patients pay the PBS co payment rather than the private price. Below are indicative private retail ranges only.
- Clonidine 100 microgram tablets, pack of 100: approximately AUD 8 to 20 privately; PBS fee schedule may apply for eligible patients.
- Clonidine weekly patches, 4 patch pack by special order: roughly AUD 40 to 80 privately.
- Comparable drugs (private price examples):
- Amlodipine 5 mg, 30 tablets: about AUD 5 to 15.
- Losartan potassium 50 mg, 30 tablets: about AUD 6 to 18.
- Hydrochlorothiazide 25 mg, 50 tablets: about AUD 4 to 12.
- Moxonidine 200 microgram, 30 tablets: about AUD 10 to 25.
Ask your pharmacist to check current retail prices and whether PBS or concession rates apply to your prescription.
The legal authorization status and import regulations in Australia
- Scheduling: clonidine is a Schedule 4 prescription only medicine situated in Australia. A current prescription from an Australian registered prescriber is required to obtain it legally.
- Dispensing: community pharmacies dispense clonidine; some strengths or transdermal patches may need to be specially ordered.
- Pharmaceutical Benefits Scheme: some clonidine products are listed on the PBS. Eligible patients pay the PBS co payment which is usually lower than private retail prices.
- Personal importation: under the Therapeutic Goods Administration personal importation rules you may import up to three months supply for personal use if you hold a valid prescription and also the product is permitted. Additional documentation may be required and customs rules apply.
- Driving and work safety: because clonidine can cause sedation you must comply with Australian road rules and workplace safety standards when assessing fitness to drive or operate machinery.
For authoritative and up to date legal and subsidy details consult the TGA and PBS websites or ask your pharmacist.
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