Clonidine transdermal

Clonidine transdermal TTS-1 to TTS-3 Autonomic tone rebound and hyperactivity... 

Burris JF. The USA experience with the clonidine transdermal therapeutic system. Clin Auton Res. 1993 3 391-6. 

As little as 0.1 mg of clonidine has produced toxicity in children determination of adult toxicity is based on observation as there is no milligram per kilogram toxic dose established. Clonidine levels are not clinically useful. Toxicity can result from ingestion of used clonidine transdermal patches as residual clonidine remains after full therapeutic use. Symptoms generally begin within 30-90 min and include hypotension, central nervous system depression, bradycardia, and... 

Despite the limitations imposed by the physiology of the skin, several marketed controUed release transdermal dmg dehvery systems are available in the United States for example, scopolamine [51-34-3] for the treatment of motion sickness, nitroglycerin [55-63-0] for angina, estradiol [50-28-2] for the rehef of postmenopausal symptoms and osteoporosis, clonidine [4205-90-7] for the treatment of hypertension, fentanyl [437-38-7] as an analgesic, and nicotine [54-11-5] as an aid to smoking cessation. These systems are designed to dehver dmg for periods of one to seven days. 

Antihypertensive drugp are contraindicated in patients with known hypersensitivity to the individual dm. When an antihypertensive is administered by a trans-derrnal system (eg, clonidine), the system is contraindicated if the patient is allergic to any component of the adhesive layer of the transdermal system. Use of the angiotensin II receptor antagonists during the second and third trimester of pregnancy is contraindicated... 

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). 

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. 

Hilleman DE, Mohiuddin SM, Delcore MG, Lucas BD Jr. (1993). Randomized, controlled trial of transdermal clonidine for smoking cessation. Ann Pharmacother. 27(9) 1025-28. 

Transdermal system-The system, a 0.2 mm thick film with 4 layers, contains a drug reservoir of clonidine, released at an approximately constant rate for 7 days. 

Hypersensitivity to clonidine or any component of adhesive layer of transdermal system. 

Perioperative use Continue administration of clonidine to within 4 hours of surgery and resume as soon as possible thereafter. Carefully monitor blood pressure and institute appropriate measures to control it. If transdermal therapy is started during the perioperative period, note that therapeutic plasma levels are not achieved until 2 to 3 days after initial application. 

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

Nagamanl M, Kelver ME, Smith ER. Treatment of menopausal hot flashes with transdermal administration of clonidine. Am I Obstet Gynecol 1987 156 561-565. 

Clonidine 0.003-0.01 bid or tid Tourette s syndrome ADHD Aggression/self-abuse Severe agitation Withdrawal syndromes Sedation (very frequent) Hypotension (rare) Dry mouth Confusion (with high dose) Depression Rebound hypertension Localized irritation with transdermal preparation... 

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. 

Clonidine is also available as a transdermal patch (Catapres-TTS [transdermal therapeutic system]) that has the advantages of avoiding the need for repeated doses during the day and of reportedly lower rates of dry mouth and drowsiness (Burris, 1993). Steady-state plasma levels are reached within 2-3 days after applying the patch and clonidine concentrations reportedly diminish gradually over 2-3 days following patch removal, without rebound hypertension in adult hyper-... 

Fankhauser, M.P., Karumanchi, V.C., German, M.L., Yates, A., and Katumanchi, S.D. (1992) A douhle-hlind, placeho-controlled study of the efficacy of transdermal clonidine in autism. J Clin Psychiatry 53 77-82. 

Clonidine (open) Frankhauser et al., 1982 PDD + hyperarousal 0.005 mgfkg/day (transdermal)... 

There are a number of uncontrolled studies that indicate that clonidine may be effective in reducing aggression (Comings et al., 1990 Kemph et al., 1993 Schvehla et al., 1994). Transdermal clonidine decreased hyperarousal in nine children with autism in an uncontrolled study (Frankhauser et al., 1982). In a doubleblind study of eight FDD children with ADHD-like symptoms, Jaselski et al. (1992) reported that clonidine had nonsignificant overall effects compared to placebo, however, some of the ratings of aberrant (by teacher) and oppositional (by parent) behavior decreased. 

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