Clonidine oral

Nicotine vapor inhaler Buccal Bupropion Oral tablets Clonidine Oral tablets 6-16 mg/day continuous puffing up to 10 puffs per cartridge maximum of 12 cartridges daily (approx. 120 puffs) Begin at 150 mg/day x 3-7 days then 300 mg/day in twice-per-day dosing 0.6-1.2 mg/day, 2-3 times/day... 

NS with 20 mEq of KCI per liter) Clonidine oral 0.05-03 mg Autonomic tone rebound and hyperactivity... 

Sensitization to transdermal clonidine In patients who develop an allergic reaction to transdermal clonidine, oral clonidine hydrochloride substitution may elicit a similar reaction. 

Clonidine also appears to have significant analgesic properties to which tolerance does not develop. Antinociceptive effects have been demonstrated in many of laboratory tests used to demonstrate analgesia. The effect is centrally mediated. For example, the hot plate assay that demonstrated analgetic properties for clonidine orally failed to do so for other imidazole a-mimetics such as oxymetazoline and tetrahydrazoline, which do not cross the BBB unless administered intracerebrally. 

Dobrydnjov I, Axelsson K, Berggren L, et al Intrathecal and oral clonidine as prophylaxis for postoperative alcohol withdrawal syndrome a randomized double-blinded study. Anesth Analg 98 738—744, 2004... 

Note. Clonidine alone may not adequately treat insomnia, diarrhea, muscle aches, restlessness, irritability, or other withdrawal symptoms, which may require other medications. For this reason many programs use lower doses of clonidine than outlined in this table, in combination with oral... 

Cionidine. Clonidine dampens sympathetic activity originating at the locus coeruleus by stimulation of presynaptic a2-adrenergic receptors in the sympathetic chain (Covey and Classman 1991 Hughes 1994). It appears to have some efficacy for alcohol and opioid withdrawal and thus was evaluated for treatment of nicotine withdrawal as well (Covey and Classman 1991 Hughes 1994). Several clinical trials used oral or transdermal clonidine in doses of 0.1—0.4 mg/day for 2—6 weeks with or without behavior therapy. Three meta-analytic reviews reported that clonidine improved quit rates (Covey and Classman 1991 Courlay and Benowitz 1995 Law and Tang 1995). 

Acute administration of a short-acting oral drug (captopril, clonidine, or labetalol) followed by careful observation for several hours to ensure a gradual BP reduction is an option. 

Clonidine, delivered transdermally or orally, is an effective smoking-cessation treatment. It is given for 3 to 10 weeks and should not be discontinued abruptly. Abrupt discontinuation may cause nervousness, agitation, headache, tremor, and rapid rise in blood pressure. 

Dosing of clonidine initially is 0.1 mg orally twice daily or 0.1 mg/day transdermally, increasing by 0.1 mg/day each week if needed. 

Besides the tablet form, clonidine is also available in a patch that is worn on the arm and changed once every 5-7 days. Once the appropriate dose has been found using oral clonidine, both children and adults can be switched to the patch. The patch provides more consistent levels of the medication and obviously minimizes the potential for rebound effects due to poor compliance. This patch does sometimes cause local skin irritation. Rotating the application site from arm to arm each week can minimize this. 

Clonidine is a selective Oj-adrenergic agonist that exhibits pronounced hypotensive action that is associated with a reduction of overall peripheral vascular resistance, decline in frequency of cardiac contraction, and reduced cardiac output. Clonidine is the drug of choice for treating various degrees of hypertension when used in combination with oral diuretics. 

Unlabeled route of administration - Sublingual clonidine, using a dosage of 0.2 to 0.4 mg/day, may be effective in hypertensive patients unable to take oral medication. The onset occurs within 30 to 60 minutes and blood pressure appears to be maintained on a twice daily regimen. 

Pharmacology Initially, clonidine stimulates peripheral -adrenergic receptors producing transient vasoconstriction. Stimulation of alpha-adrenergic in the brain stem results in reduced sympathetic outflow from the CNS and a decrease in peripheral resistance, renal vascular resistance, heart rate, and blood pressure. Pharmacokinetics Blood pressure declines within 30 to 60 minutes after an oral... 

Therapeutic plasma levels, achieved 2 to 3 days after initial application, are lower than during oral therapy with equipotent doses. When system is removed, therapeutic plasma clonidine levels persist for approximately 8 hours and then decline slowly over several days blood pressure returns gradually to pretreatment levels. Elimination half-life is approximately 19 hours. 

Clonidine (Catapres) is effective orally and is used primarily for the treatment of moderate hypertension. It is... 

Clonidine is well absorbed after oral administration. Peak plasma levels occur between 2 and 4 hours after drug administration and correlate well with pharmacological activity. The plasma half-life in patients with normal renal function is 12 hours. Urinary excretion of clonidine and its metabolites accounts for almost 90% of the administered dose, and fecal excretion accounts for the rest. Approximately 50% of an administered dose is excreted unchanged the remainder is oxidatively metabolized in the liver. 

An acute intravenous injection of clonidine may produce a transient pressor response that apparently is due to stimulation of peripheral vascular a-receptors. The pressor response does not occur after oral administration, because the drug s centrally mediated depressor action overrides it. 

A A 26-year-old woman with nephrotic syndrome comes to your office because of worsening edema. Her medications include clonidine 0.1 mg orally twice daily and furosemide 200 mg orally twice daily. On physical examination, her blood pressure is 120/85 mm Hg, and she has generalized massive edema (anasarca). The rest of the examination is unremarkable. 

Beta-blockers interact with a large number of other medications. The combination of beta-blockers with calcium antagonists should be avoided, given the risk for hypotension and cardiac arrhythmias. Cimetidine, hydralazine, and alcohol all increase blood levels of beta-blockers, whereas rifampicin decreases their concentrations. Beta-blockers may increase blood levels of phenothiazines and other neuroleptics, clonidine, phen-ytoin, anesthetics, lidocaine, epinephrine, monoamine oxidase inhibitors and other antidepressants, benzodiazepines, and thyroxine. Beta-blockers decrease the effects of insulin and oral hypoglycemic agents. Smoking, oral contraceptives, carbamazepine, and nonsteroidal anti-inflammatory analgesics decrease the effects of beta-blockers (Coffey, 1990). 

Hunt, R.D. (1987). Treatment effects of oral and transdermal clonidine in relation to methylphenidate An open pilot study in ADD-H. Psychopharmacol Bull 23 111-114. 

Because the smallest tablet size for clonidine is currently 0.1 mg, it may be difficult to adjust the dosage for younger children. In such cases, it is possible to compound an oral liquid preparation that permits more accurate adjustment of pediatric doses (Levinson and Johnson, 1992)... 

Levinson, M.L. and Johnson, C.E. (1992) Stability of an extemporaneously compounded clonidine hydrochloride oral liquid. Am J Hosp Pharm 49 122-125. 

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