clonidine-hcl-er

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Apr 24, 2023

Warnings

Clonidine (Catapres) Risks, Warnings, and Complications

Clonidine can cause new or worsening health problems in some people. Talk to your doctor or pharmacist about other treatments for high blood pressure or ADHD if you are at increased risk of complications from clonidine use.

DIZZINESS AND DROWSINESS: Clonidine can make you dizzy and drowsy, which can increase your risk of falls, accidents, and injuries. The risk of these side effects is higher if you drink alcohol or take other medications that also make you drowsy, such as certain antidepressants, sleeping pills, muscle relaxants, and opioids. Do not drive a car or do any hazardous activities until you know how clonidine affects you. If you develop excessive drowsiness or severe lightheadedness or confusion on this medicine, get medical help right away.
HEART PROBLEMS: In a small number of people, clonidine can cause heartbeat problems or a heart rhythm disorder. The risk is higher if you're an older adult or are taking other medications that also slow the heart rate, such as calcium channel blockers (diltiazem, verapamil). Keep all your healthcare appointments during treatment with this medicine. Your provider may want to monitor your heart rate. Call your doctor for medical advice if you frequently feel tired, out of breath, or dizzy after taking clonidine.
SKIN REACTIONS WITH PATCHES: Clonidine patches can cause redness, swelling, itching, and burning at the application site. Tell your provider without delay if you notice any skin reactions after applying clonidine patches. You may need to switch to another form of clonidine or another medication, depending on the severity of the skin reaction. You should not get an MRI while wearing a clonidine patch as it contains aluminum and can cause skin burns.
WITHDRAWAL SYMPTOMS: Stopping clonidine abruptly can cause rebound hypertension (a rapid rise in blood pressure) and other withdrawal symptoms such as headache, nervousness, agitation, and tremor. These withdrawal effects can be life-threatening. The risk of this happening is higher if you also take beta blockers like carvedilol (Coreg) or suddenly stop taking clonidine after taking a larger dose. Your healthcare provider will tell you how to lower your dose gradually to reduce the risk of withdrawal. Call your doctor for medical advice if you have stomach problems and frequent vomiting, as this can lead to decreased absorption of clonidine, increasing your risk of withdrawal symptoms.

Precautions Before Starting Clonidine (Catapres)

Tell your doctor if you have ever had an allergic reaction to clonidine, any of the active or inactive ingredients in clonidine tablets or patches, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions between your medications.

Give your doctor a complete medical history. Clonidine may not be right for people with certain medical conditions such as severe coronary artery disease (heart disease), recent heart attack, stroke, kidney disease, renal impairment, or kidney failure.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

If you are an older adult (65 years of age or older), discuss the pros and cons of taking clonidine with your healthcare professional. There may be other safer medications available.

Talk to your provider about a total treatment program for attention deficit hyperactivity disorder (ADHD) which should include counseling and special education in addition to clonidine extended-release tablets.

Ask your doctor for advice about lifestyle modifications to treat high blood pressure, such as eating a low-salt diet.

Precautions During Use of Clonidine (Catapres)

Keep all your healthcare appointments while on clonidine. Your doctor may want to adjust your dose and monitor you for side effects.

Clonidine can cause drowsiness and dizziness. Avoid drinking alcohol because this can make these side effects worse. Do not drive, operate machinery, or do anything that requires your full concentration until you know how clonidine affects you. Get up slowly from a sitting or lying position to lower your risk of falls.

Tell all your healthcare providers you are on clonidine before any surgery, including dental procedures.

Tell your doctor if you become pregnant while on clonidine.

Clonidine (Catapres) Drug Interactions

Certain other drugs can affect how clonidine works. Possible interactions between clonidine and other medicines can increase the risk of severe adverse reactions. Some of the medications that can interact with clonidine include:
Certain antidepressants including tricyclic antidepressants like imipramine (Tofranil), amoxapine, amitriptyline, maprotiline, desipramine (Norpramin), clomipramine (Anafranil), doxepin (Silenor), protriptyline (Vivactil), nortriptyline (Pamelor), and trimipramine (Surmontil)
Calcium channel blockers such as diltiazem (Cardizem, Dilt-CD, Dilacor XR, Taztia XT, Tiazac, others), amlodipine (Norvasc, in Amturnide, in Tekamlo, others), isradipine, felodipine (Plendil), nifedipine (Procardia, Adalat CC, Afeditab CR), nicardipine (Cardene), nisoldipine (Sular), nimodipine, and verapamil (Covera, Calan, Verelan, others, in Tarka)
Beta blockers such as atenolol (Tenormin, in Tenoretic), acebutolol (Sectral), bisoprolol (Zebeta, in Ziac), betaxolol, carvedilol (Coreg), metoprolol (Lopressor, Toprol XL, in Dutoprol), labetalol , nadolol (Corgard, in Corzide), propranolol (Inderal, Innopran XL, in Inderide), timolol, pindolol, and sotalol (Betapace, Sorine)
Heart medications like digoxin (Lanoxin)
Medications used to treat mental illness such as anxiety
Anti-seizure medications
Sedatives, sleeping pills, and tranquilizers

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, OTC medications, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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