Clonidine - Instructions For Use, Indications, Doses, Analogues

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Clonidine

Instructions for use:

1. 1. Release form and composition
2. 2. Indications for use
3. 3. Contraindications
4. 4. Method of application and dosage
5. 5. Side effects
6. 6. Special instructions
7. 7. Drug interactions
8. 8. Analogs
9. 9. Terms and conditions of storage
10. 10. Terms of dispensing from pharmacies

Clonidine is an antihypertensive drug.

Release form and composition

Clonidine is available in the following dosage forms:

• Tablets (in dark glass or polymer jars of 50 pcs., 1 can in a cardboard box; in blister packs of 10 pcs., 1, 2 or 5 packages in a cardboard box);
• Solution for intravenous administration (in 1 ml ampoules with an ampoule knife, 10 ampoules in a cardboard box);
• Eye drops (in dropper tubes of 1.3 ml, 5 tubes in a cardboard box).

The composition of 1 tablet includes:

• Active ingredient: clonidine - 0.075 or 0.15 mg (in the form of hydrochloride);
• Auxiliary components: lactose monohydrate (milk sugar) - 47.925 / 133.35 mg, potato starch - 11.4 / 15 mg, magnesium stearate - 0.6 / 1.5 mg.

The composition of 1 ml of solution for intravenous administration includes:

• Active ingredient: clonidine - 0.1 mg (in the form of hydrochloride);
• Auxiliary components: 0.1 M hydrochloric acid solution - up to pH 4-5.5, water for injection - up to 1 ml.

The composition of 1 ml of eye drops includes:

• Active ingredient: clonidine - 1.25, 2.5 or 5 mg (in the form of hydrochloride);
• Auxiliary components: sodium chloride, sodium dihydrogen phosphate dihydrate, sodium hydrogen phosphate dodecahydrate, water for injection.

Indications for use

• Tablets: arterial hypertension;
• Solution for intravenous administration: relief of hypertensive crisis;
• Eye drops: primary open-angle glaucoma with moderately increased or high intraocular pressure and stabilized visual functions.

Contraindications

• Severe atherosclerotic changes in the vessels of the brain;
• Depression;
• Arterial hypotension;
• Pregnancy and lactation;
• Age up to 18 years (the effectiveness and safety of the use of Clonidine in this group of patients has not been established);
• Hypersensitivity to drug components.

Additionally, contraindications to the use of Clonidine in the form of tablets and solution for injection are:

• Atrioventricular block II and III degree;
• Severe sinus bradycardia;
• Cardiogenic shock;
• Sick sinus syndrome;
• Obliterating arterial disease;
• Simultaneous use with tricyclic antidepressants and ethanol.

The drug should be used with caution in patients after a recent myocardial infarction, as well as in patients with chronic renal failure and atrioventricular block of the 1st degree.

Method of administration and dosage

Clonidine in the form of tablets is taken orally without chewing and with a small amount of liquid, preferably during or after a meal.

The drug is effective in fairly small doses (the doctor sets the dosage regimen individually).

Therapy, as a rule, begins with small doses (2-3 times a day, 0.075 mg). If the antihypertensive effect is insufficient, a gradual (every 1-2 days by 0.0375 mg) increase in a single dose to 0.15 mg is possible.

In elderly patients, especially with manifestations of sclerosis of the cerebral vessels, treatment begins with a dose of 0.0375 mg (due to the possible presence of hypersensitivity to the components of the drug).

Usually, daily doses range from 0.3-0.45 mg, in some cases - 1.2-1.5 mg. The maximum single dose is 0.3 mg, the daily dose is 2.4 mg.

Clonidine solution is administered intravenously. The doctor selects the doses individually.

For intravenous administration, 0.5-1.5 ml of Clonidine solution is diluted in 10-20 ml of 0.9% sodium chloride solution. The drug is administered slowly - over 3-5 minutes.

For drip injection, 4 ml of the solution should be diluted in 500 ml of 5% glucose solution. The introduction is carried out at an average speed of 20 drops per minute. The maximum infusion rate is 120 drops per minute. In stationary conditions, Clonidine can be administered parenterally 3-4 times a day.

Eye drops are used as instillations. Single dose - 1 drop, frequency of application - 2-4 times a day. If the effect is insufficient, it is possible to carry out a combined treatment (simultaneously with miotics).

Therapy begins with a 0.25% solution. With an insufficient decrease in intraocular pressure, they switch to the use of a 0.5% solution, with the development of side effects - 0.125% solution.

Side effects

When using Clonidine orally and intravenously, the following side effects may develop (very often - from 1/10; often - from 1/100 to 1/10; infrequently - from 1/1000 to 1/100; rarely - from 1/10000 and up to 1/1000; very rarely - up to 1/10000, including single messages):

• Cardiovascular system: in rare cases, at the beginning of therapy - a short-term paradoxical increase in blood pressure; very often - orthostatic hypotension; infrequently - Raynaud's syndrome, sinus bradycardia; rarely - atrioventricular block; with an unknown frequency - bradyarrhythmia;
• Digestive system: very often - dryness of the oral mucosa; often - constipation, nausea, decreased appetite, pain in the salivary glands, decreased gastric secretion, vomiting; rarely - pseudo-obstruction of the colon; with an unknown frequency - hepatitis;
• Central nervous system: very often - drowsiness, dizziness, increased fatigue, slowing down of the speed of motor and mental reactions; often - sleep disturbances, nervousness, headache, depression; infrequently - paresthesia; rarely - impaired perception, asthenia, hallucinations, "nightmarish" or vivid dreams; with an unknown frequency - confusion;
• Respiratory system: rarely - dryness of the nasal mucosa;
• Reproductive system: often - erectile dysfunction; with an unknown frequency - decreased libido; rarely - gynecomastia;
• Skin: infrequently - rash (including urticaria), itchy skin; rarely - alopecia;
• Senses: rarely - decreased lacrimation; with an unknown frequency - violation of accommodation;
• Laboratory indicators: rarely - hyperglycemia; with an unknown frequency - changes in liver function tests;
• Others: with an unknown frequency - Raynaud's phenomenon, water and sodium retention, manifested by edema of the ankles and feet; infrequently - nasal congestion; in case of sudden cancellation, the "cancellation" syndrome.

When using Clonidine in the form of eye drops, disorders such as bradycardia, weakness, dry mouth, drowsiness, an excessive decrease in blood pressure, a feeling of a foreign object or a burning sensation in the eye can occur.

special instructions

During the use of Clonidine, alcohol is prohibited.

The duration of the course of therapy is determined by the results obtained. In order to avoid the development of a withdrawal syndrome, the drug is discontinued gradually over 7-10 days. In case of the development of the syndrome, you should immediately return to taking Clonidine, in the future it is canceled gradually with replacement by other antihypertensive drugs.

With intravenous use of Clonidine to prevent the occurrence of orthostatic hypotension, the patient needs to be in the supine position during the administration of the drug and for 1.5-2 hours after the end of the procedure.

If there is no effect in the first 2 days of using the eye drops, therapy is canceled.

It should be borne in mind that Clonidine in all dosage forms reduces physical and mental reactions in different types of operator activities. Treatment of patients whose work requires a quick physical and mental response (drivers, pilots, etc.) is recommended to be carried out only in stationary conditions or on an outpatient basis with release from work for the duration of treatment.

Drug interactions

With the simultaneous use of Clonidine with certain drugs, the following effects may occur:

• Drugs that depress the central nervous system: the development of depressive disorders and an increase in the depressing effect on the central nervous system;
• Tricyclic antidepressants, sympathomimetic, anorexigenic (except fenfluramine) drugs, nifedipine and non-steroidal anti-inflammatory drugs: weakening the hypotensive effect of Clonidine;
• Cardiac glycosides and beta-blockers: increased risk of bradycardia or (in some cases) atrioventricular block;
• Atenolol, propranolol: development of an additive hypotensive effect, sedation, dry mouth;
• Levodopa, piribedil: decrease in their effectiveness;
• Diuretics, vasodilators, antihistamines: an increase in the hypotensive effect of Clonidine;
• Prazosin: alteration of the antihypertensive action of clonidine;
• Cyclosporine: an increase in its concentration in blood plasma;
• Oral hormonal contraceptives: enhancing the sedative effect of clonidine;
• Tolperisone: increased muscle relaxant action;
• Tofisopam: increased anxiolytic action;
• Phenylephrine: increased pressor effect;
• Mirtazapine: development of hypertensive crisis;
• Haloperidol: increased central nervous system depression;
• Sulpiride: enhancing the effect of clonidine;
• Insulin, hypoglycemic agents for oral administration: weakening the hypoglycemic effect of Clonidine.

Analogs

Clonidine analogs are: Gemiton, Katapresan, Chlofazolin.

Terms and conditions of storage

Store in a dark place, out of reach of children.

Shelf life:

• Eye drops - 2 years at temperatures up to 15 ° C;
• Solution for intravenous administration - 3 years at temperatures up to 30 ° C;
• Tablets - 4 years at temperatures up to 30 ° C.

Terms of dispensing from pharmacies

Dispensed by prescription.

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!