Clonidine Hydrochloride is used in the management of hypertension. It may be given alone or together with other antihypertensive medicines. It is also indicated for the treatment of menopausal flushing, opioid withdrawal, and alcohol withdrawal syndrome. The extended-release formulation of clonidine hydrochloride is additionally used as a single therapy for attention deficit hyperactivity disorder (ADHD).

Clonidine Hydrochloride acts by stimulating alpha-adrenoceptors in the brainstem. Following oral administration of immediate-release clonidine, blood pressure begins to decrease within 30 to 60 minutes, with peak reduction occurring within 2 to 4 hours. Renal blood flow and glomerular filtration rate generally remain unchanged. Postural reflexes are usually preserved, so orthostatic symptoms are mild and occur infrequently.

Adult: The dose of Clonidine must be adjusted according to the patient's individual blood pressure response.

Initial dose: 0.1 mg twice a day (morning & bed time). Elderly patients may be benefited from a lower initial dose.

Maintenance dose: Further increments of 0.1 mg per day may be made at weekly intervals if necessary, until the desired result is achieved. The therapeutic dose most commonly employed have ranged from 0.2 mg to 0.6 mg per day given in divided doses. In renal impairment, dose of Clonidine Hydrochloride must be adjusted according to the degree of impairment & patient should be monitored carefully.

Attention deficit hyperactivity disorder: Clonidine IR 5 mcg/kg/day or Clonidine ER 0.1 mg/day for 8 weeks

Menopausal flushing: 0.1 mg to 0.4 mg daily

Alcohol withdrawal: 0.3 to 0.6 mg every 6 hourly or as directed by the physician.

Use in Children & Adolescents: Safety and effectiveness in pediatric patients have not been established in adequate and well-controlled trials.

Clonidine may enhance the central nervous system depressant effects of alcohol, barbiturates, and other sedative medications. Its blood pressure-lowering effect can be reduced when used together with tricyclic antidepressants, which may require dose adjustment. Because of possible additive effects (such as bradycardia and atrioventricular block), caution is advised when clonidine is used with drugs like digitalis, calcium channel blockers, and β-blockers that influence sinus node function or AV conduction.

Clonidine is contraindicated in patients with a known hypersensitivity to clonidine.

Most side effects of clonidine are mild and often decrease with continued use. Common adverse effects include dry mouth, drowsiness, dizziness, constipation, sedation, ear pain, irritability, diarrhea, abdominal discomfort, and nausea.

Clonidine falls under Pregnancy Category C; therefore, it should generally be avoided during pregnancy. As clonidine is excreted in breast milk, caution is required when administering it to breastfeeding mothers.

Patients should not stop clonidine therapy without consulting a physician. Abrupt discontinuation may lead to symptoms such as nervousness, agitation, headache, and tremor, along with a rapid increase in blood pressure and elevated catecholamine levels. When stopping clonidine extended-release tablets, the dose should be gradually reduced over 2 to 4 days to prevent withdrawal effects. If both a beta-blocker and clonidine are being used, the beta-blocker should be withdrawn first before gradually stopping clonidine.

Overdose may result in hypotension, bradycardia, respiratory depression, hypothermia, sedation, abnormal reflexes, weakness, and miosis.

Centrally acting antihypertensive drugs (central sympatholytic)

Store below 30°C, protected from light and moisture. Keep out of reach of children.