From the Guidelines
Clonidine is recommended at a dose of 0.1-0.8 mg/day, taken twice daily, for the treatment of hypertension 1.
Key Points
- The dose range for clonidine is 0.1-0.8 mg/day, with a daily frequency of 2 1.
- Clonidine is generally reserved as a last-line treatment due to significant CNS adverse effects, especially in older adults 1.
- Abrupt discontinuation of clonidine should be avoided, as it may induce hypertensive crisis, and the medication must be tapered to avoid rebound hypertension 1.
- The clonidine patch is an alternative formulation, with a dose range of 0.1-0.3 mg, applied once weekly 1.
- It is essential to monitor patients for potential side effects, such as orthostatic hypotension, and adjust the dose accordingly.
- Clonidine can be used in combination with other antihypertensive agents, but careful monitoring of blood pressure and potential interactions is necessary.
From the FDA Drug Label
The dose of clonidine hydrochloride tablets, USP must be adjusted according to the patient’s individual blood pressure response. 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 for treating hypertension is:
- Initial dose: 0.1 mg twice daily (morning and bedtime)
- 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 until the desired response is achieved 2.
From the Research
Recommended Dose and Frequency of Clonidine for Hypertension
- The recommended initial oral dose of clonidine for hypertensive emergencies is 0.1 to 0.2 mg, followed by hourly doses of 0.05 or 0.1 mg until goal blood pressure is attained, with a total dose not exceeding 0.7 mg 3.
- For mild or moderate essential hypertension, a low-dose clonidine regimen of 75 micrograms twice daily has been shown to be effective in reducing blood pressure 4.
- In cases of severe hypertension, rapid oral clonidine titration with an initial dose of 0.2 mg, followed by 0.2 or 0.1 mg at one hour, and then 0.1 mg/hour, has been used to control blood pressure 5.
- In elderly patients with mild essential hypertension, clonidine monotherapy with dosages of 0.05 mg twice daily to 0.2 mg three times daily has been effective in reducing blood pressure without major side effects 6.
- Clonidine can also be administered intramuscularly in a dose of 150 microng, producing a satisfactory reduction in blood pressure in hypertensive patients, with its effect occurring within five minutes and persisting for five hours 7.
Dosage Considerations
- The dose of clonidine may need to be adjusted based on the patient's response to treatment and the presence of any side effects.
- Clonidine can be used in combination with other antihypertensive agents, such as diuretics, to achieve better blood pressure control 4, 6.
- Patients should be closely monitored for any adverse effects, such as dry mouth, drowsiness, or orthostatic hypotension, and the dose of clonidine should be adjusted accordingly.