Clonidine (HCl)

Clonidine (HCl) is 2-imidazoline derivative, is a adrenergic agonist. It was discovered in the course of testing the drugfor use as a topically applied nasal decongestant. and used to treat high blood pressure. It relaxes and dilates blood vessels which results in lowere blood pressure. Clonidine (HCl) is also used to ease withdrawal symptoms associated with the long term use of narcotics or benzodiazipine.

Brands
Adult Dose
Dose: 1.428 mg/kg
Single Dose: 1.4 (1.428)
Frequency: 12 hourly
Route: PO
Instructions: Initial
Neonatal
Paedriatic
Dose: 6.5 ug/kg
Single Dose: 6.5 (6.5)
Frequency: 24 hourly
Route: Oral
Instructions:
Characteristics
. It is of Synthetic origin and belongs to Imidazoline. It belongs to Alpha-2 adrenergic agonist pharmacological group on the basis of mechanism of action and also classified in Antihypertensive Agents pharmacological group.The Molecular Weight of Clonidine (HCl) is 266.60. Its pKa is 8.05.
Contraindications
Clonidine (HCl) is contraindicated in conditions like Sinoatrial node disease,Atrioventricular node disease.
Effects
The severe or irreversible adverse effects of Clonidine (HCl), which give rise to further complications include Cardiac arrhythmias, Cardiac arrhythmias, Acute pancreatitis, Bowel pseudo-obstruction, Systemic lupus erythematosus, Acute pancreatitis, Dilutional hyponatremia, Withdrawal syndrome.The signs and symptoms that are produced after the acute overdosage of Clonidine (HCl) include Bradycardia, Cardiac arrhythmias, Coma, Dry mouth, Hypothermia, Ataxia, Miosis, Hypertension, Sedation, Conduction disturbances.The symptomatic adverse reactions produced by Clonidine (HCl) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Fatigue, Nausea, Anxiety, Constipation, Abdominal pain, Dry mouth, Rashes, Pruritus, Bradycardia, Sedation, Hallucination, Impotence, Sleep disturbance, Depression, Postural hypotension, Asthenia, Fluid retention, Contact dermatitis, Nightmares, Swelling, Agitation, Xerostomia, Urinary RetentionX, Parotid pain, Dry mouth, dizziness.
Indications
Clonidine (HCl) is primarily indicated in conditions like Chronic diarrhoea, Diagnosis of pheochromocytoma, Diarrhoea, Glucoma, Hypertension, Menopausal flushing, Migraine prophylaxis, Opiate withdrawal syndrome, Psychiatric disease, and can also be given in adjunctive therapy as an alternative drug of choice in Prevention of recurrent migraine, vascular headache, menopausal flushing.
Interactions
Clonidine (HCl) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAcebutololAcebutolol may enhance the rebound hypertensive effect of Clonidine.This effect can occur when the Clonidine is abruptly withdrawn.MajorRapidIf possible, withdraw the Acebutolol several days before the clonidine is gradually withdrawn.Consider the use of labetalol in place of clonidine, as it has both alpha- and beta-blocking activity. Monitor closely for acute increases in blood pressure. Ophthalmic beta-blockers are likely of little concern. AlcoholAldesleukinEnhanced hypotensive effect when aldesleukin given with Clonidine (HCl).AlprostadilEnhanced hypotensive effects when alprostadil given with Clonidine.Amitriptyline (HCl)AmoxapineAmoxapine antagonises hypotensive effect of Clonidine, also increased risk of hypertension on clonidine withdrawal MajorApraclonidine (HCl)AtenololAtenolol may enhance the rebound hypertensive effect of Clonidine (HCl).This effect can occur when the Clonidine Hcl is abruptly withdrawn.MajorRapidIf possible, withdraw Atenolol several days before slowly withdrawing. clonidine. Consider the use of labetalol in place of clonidine, as it has both alpha- and beta-blocking activity. Use a cardioselective beta-blocker (such should pose less risk than nonselective agents). Monitor closely for acute rise in blood pressure.Betaxolol (HCl)Increased risk of withdrawal hypertension when beta-blockers (e.g Betaxolol) given with Clonidine.MajorBisoprolol (Fumarate)Bovine InsulinCaptoprilPrevious treatment with clonidine possibly delays antihypertensive effect of captopril.Carteolol (HCl)CarvedilolChlorpromazine (HCl)Chlorpromazine (HCl)Clomipramine (HCl)Desipramine (HCl)Desipramine (HCl)DiazoxideEnhanced hypotensive effect when Diazoxide given with Clonidine.Dothiepin (HCl)Doxepin (HCl)FluphenazineHaloperidolHalothaneHuman InsulinHuman Regular InsulinHydralazine (HCl)Insulin LisproIprindoleTheoretical potential for IPRINDOLE reducing the HYPOTENSIVE effect of CLONIDINE.MajorLevobunolol (HCl)LevodopaClonidine decreases the efficacy of levodopa.ModerateClosely monitor for the signs of akinesia and increased rigidity.MetipranololLikely interaction of METIPRANOLOL [EYE] increasing the HYPOTENSIVE effect of CLONIDINE. MajorMay need to avoid combinationMetoprolol (Tartrate)Metoprolol may enhance the rebound hypertensive effect of Clonidine (HCl).This effect can occur when the Clonidine Hcl is abruptly withdrawn. ModerateIf possible, withdraw metoprolol several days before slowly withdrawing. clonidine. Consider the use of labetalol in place of clonidine, as it has both alpha- and beta-blocking activity. Use a cardioselective beta-blocker (such should pose less risk than nonselective agents). Monitor closely for acute rise in blood pressure.MianserinMinoxidilNadololNaloxone (HCl)NifedipineNortriptyline (HCl)Oxprenolol (HCl)OxymorphoneThe concomitant administration of agents with hypotensive effects and psychotherapeutic agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics), narcotic analgesics, alcohol, or muscle relaxants may additively increase hypotensive and/or central nervous system depressant effects.ModerateDuring concomitant use of these drugs, patients should be monitored for hypotension and excessive or prolonged CNS depression. Ambulatory patients should be made aware of the possibility of additive effects (e.g., drowsiness, dizziness, lightheadedness, confusion, orthostasis, fainting) and be cautioned about driving, operating machinery, or performing other hazardous tasks, and to arise slowly from a sitting or lying position. Patients should also be advised to notify their doctor if they experience excessive side effects that interfere with their normal activities, or dizziness and fainting.PenbutololPerphenazinePhenoxybenzamine (HCl)Phentolamine (Mesylate)PindololPorcine InsulinPractololPropranolol (HCl)Protriptyline (HCl)Tamsulosin HydrochlorideConcomitant use of these two drugs can potentially cause symptomatic hypotension. Timolol (Maleate)Tolazoline (HCl)Trazodone (HCl)Trimipramine (Maleate)Verapamil (HCl)Coadministration causes complete AV block or profound hypotension.MinorClosely monitored the blood pressure of patient. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Paediatrics, patients suffering from Kidney dysfunction, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab, Inj Store Below 40°C. Protect from Sunlight.
Warnings
It should be used with caution in cerebrovascular disease, myocardial infarction, or severe heart failure. The hypotensive effects of clonidine may decrease perfusion and worsen ischemia in theses conditions. Discontinue therapy, by reducing dose gradually over 2-4 days to avoid rapid rise in blood pressure (B.P). Do not discontinue the therapy without consulting a physician. Do not interrupt therapy during surgical period. Carefully monitor blood pressure (B.P) during surgery. It should be used with caution in patient with a history of major depression because the drug can induce depressive episodes.
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