What is the oral dose and frequency of Clonidine for a hypertensive emergency?

From the Guidelines

The oral dose of Clonidine for a hypertensive emergency is 0.1-0.8 mg given 2 times a day.

Key Considerations

• The dose and frequency of Clonidine may vary depending on the individual patient's response and medical history 1.
• Clonidine is generally reserved as a last-line treatment due to its significant CNS adverse effects, especially in older adults 1.
• It is essential to avoid abrupt discontinuation of Clonidine, as it may induce a hypertensive crisis; instead, the medication must be tapered to avoid rebound hypertension 1.
• The dosages listed may vary from those listed in the FDA-approved labeling, and clinicians should consult the FDA website for the most up-to-date information 1.

Clinical Context

In the context of real-life clinical medicine, it is crucial to exercise caution when prescribing Clonidine, particularly in older adults, due to its potential for significant CNS adverse effects 1.

Additional Guidance

Clinicians should carefully monitor patients receiving Clonidine and adjust the dose and frequency as needed to achieve optimal blood pressure control while minimizing adverse effects 1.

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. 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 oral dose and frequency of Clonidine for hypertension is:

• Initial dose: 0.1 mg twice daily
• Maintenance dose: 0.2 mg to 0.6 mg per day given in divided doses However, the FDA drug label does not specifically address the dose for a hypertensive emergency. The FDA drug label 2 does not provide a specific dose for a hypertensive emergency.

From the Research

Oral Dose and Frequency of Clonidine for Hypertensive Emergency

• The oral dose of clonidine for a hypertensive emergency can be initiated with 0.1 to 0.2 mg, followed by hourly doses of 0.05 or 0.1 mg until the goal blood pressure is attained, or a total of 0.7 mg is given 3.
• Another study suggests an initial oral dose of 0.2 mg of clonidine hydrochloride, followed by 0.1 mg each hour until a dose of 0.7 mg has been given, or the diastolic blood pressure reaches a predetermined goal 4.
• A similar dosing regimen is also recommended in another study, where an initial "loading" dose of 0.2 mg clonidine is given, followed by 0.1 mg hourly until the blood pressure is substantially reduced, or until a total dose of 0.8 mg has been administered 5.
• The frequency of administration is typically hourly, with the goal of achieving a significant reduction in blood pressure within a few hours 3, 4, 5.
• It is essential to monitor the patient's blood pressure closely and adjust the dose accordingly to avoid excessive reduction in blood pressure 3, 4, 5.