Clonidine ER suspension

FDA label

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Titration Increase by 0.1 mg/day at weekly intervals

Renal Adjust initial dose to degree of renal impairment; monitor for hypotension/bradycardia; no supplemental dose after routine hemodialysis

Hepatic Undefined

Instructions

• Gently shake ≥10 seconds before each dose; use the provided oral dosing dispenser and bottle adapter
• Take once daily at bedtime, with or without food
• Do NOT substitute for other clonidine products on a mg-per-mg basis (different PK)
• When discontinuing, taper by no more than 0.1 mg every 3–7 days to avoid rebound hypertension

Available strengths

• ER susp 0.1 mg/mL
• tab 0.05, 0.1, 0.2, 0.3 mg
• ER tab 0.1, 0.17 mg
• sol 0.02, 0.05 mg/mL
• patch 0.1, 0.2, 0.3 mg/24 hr
• inj 100, 500 mcg/mL
• inj 0.1 mg/mL

Contraindications

• History of a hypersensitivity reaction to clonidine (reactions have included generalized rash, urticaria, and angioedema)

Cautions

• Hypotension/bradycardia (titrate slowly; monitor vitals)
• Somnolence/sedation (additive with CNS depressants; avoid alcohol)
• Rebound hypertension on abrupt discontinuation
• Allergic reactions (cross-sensitization with clonidine transdermal system)
• Cardiac conduction abnormalities (may worsen sinus node dysfunction/AV block)

Adverse reactions

• Somnolence
• Fatigue
• Irritability
• Nightmare
• Insomnia
• Constipation
• Dry mouth
• Decreased appetite
• Dizziness

Pregnancy Prolonged clonidine experience has not identified a drug-associated risk of major birth defects or miscarriage

Lactation Clonidine present in human milk (relative infant dose 4.1–8.4%); monitor breastfed infant for hypotension/bradycardia (sedation, lethargy, poor feeding)