clonidine, Catapres, Catapres-TTS, Jenloga

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GENERIC NAME: clonidine

BRAND NAME: Catapres, Catapres-TTS, Jenloga

DRUG CLASS AND MECHANISM: Clonidine is an oral and topical (applied to the skin) drug for treating high blood pressure (hypertension). Clonidine acts by stimulating receptors on nerves in the brain that reduces the transmission of messages from nerves in the brain to nerves in other areas of the body. As a result, clonidine slows heart rate and reduces blood pressure. The FDA approved clonidine in September 1974.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes (tablets), No (patches).

PREPARATIONS: Tablets: 0.1, 0.2, and 0.3 mg. Transdermal patches: 0.1, 0.2, and 0.3 mg delivered over 24 hours.

STORAGE: Tablets and patches should be kept at room temperature, 15-30 C (59-86 F).

PRESCRIBED FOR: Clonidine is approved for the treatment of high blood pressure. Non-FDA approved (off-label) uses include treatment of symptoms of narcotic withdrawal, nicotine withdrawal, diabetes-associated diarrhea, diabetic neuropathy (nerve damage), hot flashes associated with menopause, and as an adjunct to manage severe cancer-related pain.

DOSING: The usual oral adult dose is 0.1–0.3 mg twice daily. The maximum oral dose is 2.4 mg daily. Patches should be applied to an area of hairless skin on the upper arm or torso, once every 7 days. When applying a new patch, a different area of skin should be used.

DRUG INTERACTIONS: Clonidine can increase the sedating effects of other medications that cause sedation. Such drugs include narcotic pain relievers, barbiturates, sedatives such as alprazolam (Xanax) and clonazepam (Klonopin) as well as ethanol.

Tricyclic antidepressants, for example, amitriptyline (Elavil, Endep), imipramine (Tofranil), desipramine (Norpramin), and clomipramine (Anafranil), can block the blood pressure lowering effects of clonidine. This may cause blood pressure to rise.

Since clonidine can reduce heart rate, it should be used cautiously in persons who are receiving other medications that lower heart rate such as beta-blockers, for example, atenolol (Tenormin), metoprolol (Lopressor), propranolol (Inderal)], digoxin (Lanoxin), diltiazem (Cardizem) or verapamil (Calan; Covera HS). Abnormal heart rhythms can occur with the combination of clonidine and verapamil.

Cyclosporine (Sandimmune, Neoral) concentrations in the blood can increase when clonidine is begun. This interaction could result in kidney damage from the increased levels of cyclosporine.

Nonsteroidal antiinflammatory drugs (NSAIDs), for example, ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve), and nabumetone (Relafen) can reduce the antihypertensive effects of clonidine.




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