Can Neuben Plus (clonidine) cause palpitations and shivering?

Can Neuben Plus (Clonidine) Cause Palpitations and Shivering?

Yes, Neuben Plus (clonidine) can cause palpitations and shivering as documented side effects, particularly during treatment or with missed doses and abrupt discontinuation. 1, 2

Cardiovascular Effects of Clonidine

• Clonidine's FDA label specifically lists palpitations among its cardiovascular adverse effects 2
• Cardiovascular side effects also include bradycardia, tachycardia, syncope, and arrhythmias 2
• Palpitations are more common during rebound sympathetic activity, which can occur with missed doses or abrupt discontinuation 1, 3
• Clonidine affects the cardiovascular system by stimulating central alpha receptors in the medulla oblongata and hypothalamus, which reduces sympathetic tone to the heart and peripheral vasculature 4

Shivering and Other Temperature-Related Effects

• While shivering is not specifically listed in the FDA label, clonidine can cause temperature regulation disturbances that may manifest as shivering 1
• Clonidine affects the central nervous system's thermoregulatory mechanisms, which can lead to temperature sensitivity 1
• Other related symptoms that may accompany or be confused with shivering include:
  • Weakness and fatigue 2
  • Withdrawal syndrome with sympathetic overactivity 2, 5
  • Paresthesia (abnormal sensations) 2

Risk Factors for Experiencing These Side Effects

• Missed doses or irregular administration schedule 1, 3
• Abrupt discontinuation (significantly increases risk of palpitations) 1, 5, 3
• Elderly patients are at higher risk for cardiovascular side effects 1
• Concomitant use of other medications affecting heart rate or blood pressure 2
• Underlying cardiovascular conditions 6

Management Recommendations

• If experiencing palpitations or shivering:
  • Do not abruptly stop taking clonidine as this can trigger severe rebound hypertension and worsen palpitations 1, 3
  • Ensure consistent dosing schedule to minimize fluctuations in drug levels 1
  • Consult healthcare provider for dose adjustment if symptoms are troublesome 1
• For healthcare providers:
  • Consider gradual dose reduction if symptoms are severe and persistent 1
  • Evaluate for alternative antihypertensive medications if side effects remain intolerable 1
  • Monitor patients with underlying cardiovascular conditions more closely 6

Important Precautions

• Clonidine must never be discontinued abruptly due to risk of hypertensive crisis 1, 5, 3
• Any dose changes should be gradual and supervised by a healthcare provider 1
• Patients should be educated about the importance of medication adherence and not missing doses 1
• Patients should report persistent or severe palpitations or shivering to their healthcare provider immediately 1, 2