From the Guidelines
Clonidine is recommended to be prescribed at an initial dose of 0.1 mg taken orally twice daily, with a usual maintenance dose range of 0.1–0.8 mg per day divided into 2 doses, as stated in the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1.
Key Points to Consider
- The dose and frequency of Clonidine may vary depending on the patient's response and tolerance to the medication.
- Clonidine should not be stopped abruptly, as this can cause rebound hypertension; instead, it should be tapered to avoid this complication.
- Blood pressure should be monitored regularly during treatment, especially when initiating therapy or adjusting doses.
- Common side effects of Clonidine include dry mouth, drowsiness, dizziness, and constipation, which often improve with continued use.
Important Considerations for Clonidine Use
- Clonidine is generally reserved as a last-line treatment due to its significant CNS adverse effects, especially in older adults.
- The medication works by stimulating alpha-2 adrenergic receptors in the brain, reducing sympathetic outflow and decreasing blood pressure.
- Clonidine can be used for various conditions, including hypertension, attention deficit hyperactivity disorder (ADHD), and opioid withdrawal, with different dosing regimens for each condition.
Monitoring and Adjustments
- Regular monitoring of blood pressure and adjustment of the dose as needed is crucial to ensure the effectiveness and safety of Clonidine treatment.
- Patients should be educated on the potential side effects and the importance of gradual dose tapering when discontinuing the medication to prevent rebound hypertension.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Adults The dose of clonidine hydrochloride tablets, USP must be adjusted according to the patient’s individual blood pressure response. The following is a general guide to its administration. Initial Dose 0.1 mg tablet twice daily (morning and bedtime). Maintenance Dose Further increments of 0. 1 mg per day may be made at weekly intervals if necessary until the desired response is achieved. The therapeutic doses most commonly employed have ranged from 0.2 mg to 0.6 mg per day given in divided doses.
The recommended dose and frequency of Clonidine is:
- Initial dose: 0.1 mg tablet twice daily (morning and bedtime) 2
- Maintenance dose: 0.2 mg to 0.6 mg per day given in divided doses, with further increments of 0.1 mg per day made at weekly intervals if necessary 2
- Maximum effective daily dose: 2.4 mg, but doses as high as this are rarely employed 2
From the Research
Recommended Dose and Frequency of Clonidine
The recommended dose and frequency of Clonidine, an antihypertensive medication, can vary depending on the specific clinical situation.
- Initial dose:
- 0.1 to 0.2 mg as the initial dose, followed by hourly doses of 0.05 or 0.1 mg until goal blood pressure is attained 3
- 0.2 mg as the initial dose, followed by 0.2 or 0.1 mg at one hour and then 0.1 mg/hour, for a total dose of 0.8 mg 4
- 0.1 to 0.2 mg, followed by another 0.1 mg every hour until the diastolic blood pressure had been lowered to a level allowing treatment to be continued on an ambulatory basis or until a total of 0.5 mg had been given 5
- Maintenance dose:
- 0.05 mg twice daily to 0.2 mg three times daily for clonidine monotherapy in elderly patients 6
- 0.1 mg to 0.3 mg twice daily when clonidine is added to chlorthalidone, 25 mg daily, for step-care therapy in elderly patients 6
- 0.375 mg daily for chronic treatment in patients with accelerated hypertension 5