Indicated in the treatment of hypertension. CATAPRES tablets may be employed alone or concomitantly with other antihypertensive agents.

Sudden cessation of clonidine treatment has, in some cases, resulted in symptoms such as nervousness, agitation, headache, and tremor accompanied or followed by a rapid rise in blood pressure and elevated catecholamine concentrations in the plasma.

In hypertension caused by pheochromocytoma, no therapeutic effect of clonidine hydrochloride tablets can be expected.

Rare instances of hypertensive encephalopathy, cerebrovascular accidents and death have been reported after clonidine withdrawal. When discontinuing therapy with clonidine hydrochloride tablets, the physician should reduce the dose gradually over 2 to 4 days to avoid withdrawal symptomatology.

An excessive rise in blood pressure following discontinuation of clonidine hydrochloride tablet therapy can be reversed by administration of oral clonidine hydrochloride or by intravenous phentolamine. If therapy is to be discontinued in patients receiving a beta-blocker and clonidine concurrently, the beta-blocker should be withdrawn several days before the gradual discontinuation of clonidine hydrochloride tablets.

In patients who have developed localized contact sensitization to transdermal clonidine, continuation of transdermal clonidine, or substitution of oral clonidine hydrochloride therapy may be associated with the development of a generalized skin rash.

In patients who develop an allergic reaction to transdermal clonidine, substitution of oral clonidine hydrochloride may also elicit an allergic reaction (including generalized rash, urticaria, or angioedema).

Patients with renal impairment may benefit from a lower initial dose. Patients should be carefully monitored.

The sympatholytic action of clonidine may worsen sinus node dysfunction and atrioventricular (AV) block, especially in patients taking other sympatholytic drugs. There are post-marketing reports of patients with conduction abnormalities and/or taking other sympatholytic drugs who developed severe bradycardia requiring IV atropine, IV isoproterenol and temporary cardiac pacing while taking clonidine.

Clonidine acutely stimulates growth hormone release in both children and adults, but does not produce a chronic elevation of growth hormone with long-term use.

Administration of clonidine hydrochloride tablets should be continued to within 4 hours of surgery and resumed as soon as possible thereafter.

Since patients may experience a possible sedative effect, dizziness or accommodation disorder with use of clonidine, caution patients about engaging in activities such as driving a vehicle or operating appliances or machinery. Also, inform patients that this sedative effect may be increased by concomitant use of alcohol, barbiturates or other sedating drugs.

Patients who wear contact lenses should be cautioned that treatment with clonidine hydrochloride tablets may cause dryness of eyes.

Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported in association with the use of clonidine concomitantly with diltiazem or verapamil.

Clonidine may potentiate the CNS-depressive effects of alcohol, barbiturates or other sedating drugs.

If a patient receiving clonidine hydrochloride is also taking tricyclic antidepressants, the hypotensive effect of clonidine may be reduced, necessitating an increase in the clonidine dose.

If a patient receiving clonidine is also taking neuroleptics, orthostatic regulation disturbances (e.g., orthostatic hypotension, dizziness, fatigue) may be induced or exacerbated.

Monitor heart rate in patients receiving clonidine concomitantly with agents known to affect sinus node function or AV nodal conduction, e.g., digitalis, calcium channel blockers and beta-blockers.

Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported in association with the use of clonidine concomitantly with diltiazem or verapamil.

Based on observations in patients in a state of alcoholic delirium it has been suggested that high intravenous doses of clonidine may increase the arrhythmogenic potential (QT prolongation, ventricular fibrillation) of high intravenous doses of haloperidol. Causal relationship and relevance for clonidine oral tablets have not been established.

Amitriptyline in combination with clonidine enhances the manifestation of corneal lesions in animal studies.

No adequate, well-controlled studies have been conducted in pregnant women. Clonidine crosses the placental barrier.

As clonidine hydrochloride is excreted in human milk, caution should be exercised when clonidine hydrochloride tablets are administered to a nursing woman.

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• Dosage greater than 2.4 mg per day. GoToSource

• Use in patients under the age of 18. GoToSource

• Diabetic diarrhea. GoToSource

• Tourette syndrome. GoToSource

• Tardive dyskinesia. GoToSource

• Thioridazine withdrawal. GoToSource

• Opiate and cocaine withdrawal. GoToSource

• Acute pain management. GoToSource

• Heroin withdrawal. GoToSource

• Glaucoma, muscle spasticity impulse and behavior disorders. GoToSource

• Hypersalivation. GoToSource

• Reflex sympathetic dystrophy syndrome. GoToSource

• Restless legs syndrome. GoToSource

• Hyperhidrosis. GoToSource

• Ulcerative colitis. GoToSource

• Diabetic neuropathy. GoToSource

• Intermittent explosive disorder associated with autism. GoToSource 

• Preoperative use for prevention of ocular hypertension after cataract surgery. GoToSource

• Enhance analgesic efficacy of paravertebral blocks. GoToSource

• Hot flashes in breast cancer patients. GoToSource

• Phantom limb pain. GoToSource

• Cirrhosis and refractory or recurrent ascites. GoToSource

• Use with topical bupivacaine for acute and chronic post-mastectomy pain. GoToSource

• Decrease adrenergic or sympathetic hyperactivity after severe traumatic brain injury. GoToSource

• Use with morphine for acute postoperative pain. GoToSource

• Sexual function and autonomic dysreflexia in male patients with spinal cord injuries. GoToSource

• Sensorimotor gating deficits in patients with schizophrenia. GoToSource

• Post-traumatic stress disorder. GoToSource

• Adjunctive therapy for neonatal abstinence syndrome. GoToSource

• Irritable bowel syndrome. GoToSource

• Reduce vasopressor requirements in septic shock. GoToSource

• Reduce shivering response to therapeutic hypothermia. GoToSource

• Proctalgia fugax. GoToSource

Worsen sinus node dysfunction. GoToSource

Bradycardia (slow heart rate). GoToSource

Sexual dysfunction. GoToSource

Rebound increase in blood pressure associated with withdrawal syndrome. GoToSource 

Intrauterine death associated with preeclamptic toxemia. GoToSource

Depression, insomnia and night terrors. GoToSource

Lawsuits filed for severe depression.