Drawing

Generic Name
Brand Name

Clonidine hydrochloride
Catapres
Antihypertensive

Classification

Sympatholytic
Central analgesic
Stimulates CNS alpha2-adrenergic receptors, inhibits sympathetic

Action

cardioaccelerator and vasoconstrictor centers, and decrease

sympathetic outflow from the CNS
Initial dose is 0.1 mg bid; for maintenance dosage, increase in

Dosage

increments of 0.1 or 0.2 mg to reach desired response. Common

rage is 0.2-0.6 mg/day, in divided doses; maximum dose is 2.4
mg/day.
Hypertension used alone or as part of combination therapy

Indication

Treatment of severe pain in cancer patients in combination with

opiates,

epidural

more

effective

with

neurophatic

pain

(Duraclon)
Contraindicated with hypersensitivity to clonidine or any adhesive
Contraindicatio
n

layer components of the transdermal system

Use cautiously with severe coronary insufficiency, recent MI,
cerebrovascular disease, chronic renal failure; pregnancy,
lactation
Decreased antihypertensive effects with TCAs (imipramine)

Drug Interaction

Paradoxical hypertension with propanolol; also greater withdrawal

hypertension when abruptly discontinued and patient is taking
beta-adrenergic blocking agents

CNS: headache, dizziness, asthenia, vertigo, insomnia, apathy,

anxiety, delirium, nervousness, depression

Dermatologic: rash, inflammation, urticaria, pruritus, dry skin,

Side Effects and

itching, pallor

Adverse Effects

GI:

diarrhea,

and

abdominal

pain,

nausea,

vomiting,

constipation, malaise, anorexia

GU: impotence, decreased sexual activity, diminished libido,

nocturia, difficulty in micturation, urinary retention

1. Do not discontinue abruptly; discontinue therapy by reducing
the dosage gradually over 2-4 days to avoid rebound
hypertension, tachycardia, flushing, nausea, vomiting, cardiac
arrythmias
2. Do not discontinue prior to surgery; monitor BP carefully
during surgery; have BP controlling drugs readily available
3. Re-evaluate therapy if clonidine tolerance occurs, giving
concomitant diuretic increases the antihypertensive efficacy of
Nursing

clonidine

Responsibilities 4. Monitor

BP

carefully

when

discontinuing

clonidine;

hypertension usually returns within 48 hr

5. Assess compliance with drug regimen in a supportive manner
with pill counts or other methods
6. Determine weight daily. Patients not receiving a concomitant
diuretic agent may gain weight, particularly during first 3 or 4 d
of therapy, because of marked sodium and water retention.
7. Monitor I&O during period of dosage adjustment. Report
change in I&O ratio or change in voiding pattern.