CLONIDINE

Drugs in Pregnancy and Lactation.

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Name: CLONIDINE
Class: Antihypertensive/Central Analgesic
Risk Factor:    CM

Fetal Risk Summary

No reports linking the use of clonidine with congenital defects have been located. The drug has been used during all trimesters, but experience during the 1st trimester is very limited. Adverse fetal effects attributable to clonidine have not been observed (1,2,3,4,5,6,7 and 8).

Reproduction studies in rats at doses as low as 1/3 the oral maximum recommended daily human dose [MRDHD] on a weight basis (1/15 times the MRDHD on a mg/m2 basis), started before gestation, resulted in increased resorptions (9). Decreased embryo/fetal survival was not observed when these doses were used on gestation days 6–15, but did occur in both mice and rats at doses 40 times the MRDHD based on weight or 4 to 8 times the MRDHD based on surface area. No embryo or fetal toxicity or teratogenicity was observed in rabbits given doses up to 3 times the MRDHD (weight basis) (9).

In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 59 newborns had been exposed to clonidine during the 1st trimester (F. Rosa, personal communication, FDA, 1993). Three (5.1%) major birth defects were observed (three expected), two of which were cardiovascular defects (0.6 expected). No anomalies were observed in five other categories of defects (oral clefts, spina bifida, polydactyly, limb reduction defects, and hypospadias) for which specific data were available. The number of exposures is too small to draw any conclusions.

The pharmacokinetics of clonidine during pregnancy have been reported (10). The mean maternal and cord serum concentrations in 10 women were 0.46 and 0.41 ng/mL, respectively, corresponding to a cord:maternal ratio of 0.89. The mean amniotic fluid concentration was 1.50 ng/mL. The mean maternal dose was 330 µg/day. Results of neurologic examinations and limited blood chemistry tests in the exposed infants were similar to those in untreated controls. No neonatal hypotension was observed.

Breast Feeding Summary

Clonidine is secreted into breast milk (8,10). Following a 150-µg oral dose, milk concentrations of 1.5 ng/mL may be achieved (milk:plasma ratio 1.5) (P.A. Bowers, personal communication, Boehringer Ingelheim, Ltd., 1981). In a study of nine nursing women taking mean daily doses of 391.7 µg (postpartum days 1–5), 309.4 µg (postpartum days 10–14), and 241.7 µg (postpartum days 45–60), milk concentrations were approximately twice those in maternal serum (10). Mean milk levels were close to 2 ng/mL or higher during the three sampling periods. Hypotension was not observed in the nursing infants, although clonidine was found in the serum of the infants (mean levels less than maternal). The long-term significance of this exposure is not known.

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References

  1. Turnbull AC, Ahmed S. Catapres in the treatment of hypertension in pregnancy, a preliminary study. In Catapres in Hypertension. Symposium of the Royal College of Surgeons. London, 1970:237–45.
  2. Johnston CI, Aickin DR. The control of high blood pressure during labour with clonidine. Med J Aust 1971;2:132.
  3. Raftos J, Bauer GE, Lewis RG, Stokes GS, Mitchell AS, Young AA, Maclachlan I. Clonidine in the treatment of severe hypertension. Med J Aust 1973;1:786–93.
  4. Horvath JS, Phippard A, Korda A, Henderson-Smart DJ, Child A, Tiller DJ. Clonidine hydrochloride a safe and effective antihypertensive agent in pregnancy. Obstet Gynecol 1985;66:634–8.
  5. Horvath JS, Korda A, Child A, Henderson-Smart D, Phippard A, Duggin GC, Hall BM, Tiller DJ. Hypertension in pregnancy: a study of 142 women presenting before 32 weeks' gestation. Med J Aust 1985;143:19–21.
  6. NG Wingtin L, Frelon JH, Beaute Y, Pellerin M, Guillaumin JP. Clonidine et traitement de l'hypertension arterielle de la femme enceinte. Cah Anesthesiol 1986;34:389–93.
  7. Ng-Wing Tin L, Frelon JH, Beaute Y, Pellerin M, Guillaumin JP, Bazin C. Clonidine et traitement de l'hypertension arterielle de la femme enceinte. Rev Franc Gynecol Obstet 1986;81:563–6.
  8. Wing-Tin LNG, Frelon JH, Hardy F, Bazin C. Clonidine et traitement des urgences hypertensives de la femme enceinte. Rev Franc Gynecol Obstet 1987;82:519–22.
  9. Product information. Catapres. Boehringer Ingelheim Pharmaceuticals, 2000.
  10. Hartikainen-Sorri A-L, Heikkinen JE, Koivisto M. Pharmacokinetics of clonidine during pregnancy and nursing. Obstet Gynecol 1987;69:598–600.

Index

Q&A about Clonidine

my2cats1...
Can anyone tell me their experiances with clonidine for Percocet withdrawels?
I am ready to stop Percocet and my DR suggested clonidine. Can anyone share their experiances?
Shaun T
I had used clonidine for hydrocodone withdrawals once. I did not make it with the clonidine I still had to much withdrawal for my comfort. I ended up using a med called suboxone. That worked perfect as there were no withdrawals and I was off the hydrocodone instantly and the suboxone within two weeks. The only thing with the suboxone is that you have to see a Dr. that has a certain license in order to precribe. Im not saying that the clonidine won't help you as everybody reacts to meds differently, im just saying it was not that great for me. Long story short if the clonidine don't work I would ask about the suboxone because if you are serious and can't stand the withdrawals that is the most comfortable way to go. Give the clonodine a try though because if you can make it with the clonidine you won't have to replace an opiate with an opiate. Also if you do go the suboxone route they do ween you off the suboxone and there is no withdrawal. Kind of long winded I hope this helps though. I wish you the best.
Budro77
How long should I wait to start taking clonidine after quitting methadone?
I have been on 90 mg's/d for 6 months, but have gradually decreased to 20 mg's/d.
Dr. Rodrigo Lisboa M.D. Ph.D.
You should speak to your doctor about this. It all depends on the patient. If your doctor recommended that you take clonidine. Then you should wait approximately 3 months with Methadone blood tests every 3 weeks. You should directly speak to your doctor about this.
sokrates
Do you know of any contraindications between clonidine and ativan?
Is it dangerous to take both of these drugs simultaneously?
IAmLegen...
No, you shouldn't have any problems. Clonidine is a beta blocker that lowers your blood pressure, and ativan is an anti-anxiety drug.
Dottie
It says clonidine for adhd She told me High blood pressure?
I went on internet and they say its for alot of things anybody been on it. Iam tense and sleepy on it and more depressed.
Naughty
Clonidine is for high blood pressure. i give it all the time.
faithful...
Does clonidine hurt your eyes in any way?
I had read somewhere before about it and i can't find it now. If anyone could help me i would appreciate it. Thank you so much.
Edenia
Catapres side effects

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Catapres.

Side effects may include:

Agitation, constipation, dizziness, drowsiness, dry mouth, fatigue, impotence, loss of sex drive, nausea, nervousness, sedation (calm), vomiting, weakness
aprilfoo...
if i stop taking clonidine would that cause a sudden weight gain?
i have been taking clonidine for 2 years and i stopped taking it about 3 months ago. i have noticed a weight gain of 20 pounds since then.
dizzii10
consult your doctor
obie 1
What are the problems if you don't take the medicine "clonidine."?
I have high blood pressure and I was warned not to skip taking a single pill because there would be reprocussions, serious ones, but noonw said what they were.
DTD
If you skip your pills, your BP goes up, if your BP goes up, it means your heart has to work much harder than it needs to. If your heart works too hard, it becomes bigger (it's a muscle, so extra workout buffs it up, but unlike other muscles, a big heart is a bad thing). If your heart is bigger, you have heart disease, and at risk for things like heart attacks, decreased blood flow (increase infections, decrease wound healing) blood clots (that can in turn break off and go anywhere, most commonly your lungs, causing pulmonary embolism, brain-causing stroke, etc). Let's just say if your heart and circulation is malfunctioning, everything goes haywire.

In short, the high blood pressure doesn't kill you by itself (unless you have like 250/150 BP and break your blood vessels). But maintaining your BP within the normal range (120/80 is ideal, but for hypertensive patients, the goal is usually anything under 130/80).
TRINA H
is clonidine ever used to treat tourettes?
is clonidine used to treat tics, if so what other medications can be used , if the clonidine is causing insomnia.
Juliart
Yes, it is. My son was on this medication for about two years. For him, it caused loss of appetite.

Tourettes is a spectrum disorder and it is different for every person who has it. What works for one person might not have the same effect on someone else. Unfortunately, medications for TS are all hit and miss. You just have to keep trying until you find something you are comfortable with.

Ask your Neurologist.

We took my son off this medication to kind of "take stock" and see where his TS was (as you probably know TS changes often and sometimes subsides). We decided to go off all medications as a first and important step toward self acceptance. So far so good!

Best wishes.

jixsluin...
Can clonidine cause loss of appetite?
I was prescribed clonidine for my insomnia and have been taking it for the past 3 weeks and since then I just have no appetite. I literally have to remind myself to eat and force it down. I usually just eat dinner now because of this. Could clonidine be the cause? Ive looked up some of the side effects and found nothing. Maybe someone else who has experienced it or knows?
Dr. Jon
Do you have any symptoms of depression? You can get depression with clonidine withdrawal/non-compliance...I also found this that may help you:

Possible Side Effects

Please note these are possible side effects, not all people experience side effects and these can be experienced in any combination. Most side effects should disappear within a few weeks of taking the medication. Contact your physician if you should experience side effects or have any questions.

Dizziness

Drowsiness

Headache

Constipation

Loss of Appetite

Fatigue

Dry eyes
momma31
is clonidine a good treatment for tourette syndrome ?
my son's motor tics are very violent and need to be controled they hurt him.the only information i can find on it says it is a blood presure medicine.
Alabama
It is used because it slows everything down including the brain. Another medicine that can be used along with clonidine is Strattera, non amphetamine for adhd. It does have some bad side effects but they go away in time.

Mind racing is the worst symptom of TS and clonidine should help. Make sure you start with a low dose and work up.

In the U. S., the most frequently prescribed medications are clonidine hydrochloride (Catapres®) and guanfacine (Tenex®), two alpha 2-adrenergic agonists. Clonidine is actually a blood pressure medication that was found to ameliorate tics. Clonidine and guanfacine can generally be taken by individuals who have normal blood pressure. Clonidine is available in tablet and sustained-release (transdermal) patch form. At the present time, guanfacine is not available in patch form.

http://www.tourettesyndrome.net/tourette...