Is Clonidine Safe for Children?

  • Medical Author:
    Dennis S. Phillips, MD

    Dr. Phillips received his bachelor's degree in Psychology from Stanford University. After graduating from medical school at the University of Southern California, he completed his residency training and served as Chief Pediatric Resident at UCLA- Harbor General Hospital in Los Angeles.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Ask the experts

Is clonidine safe for children? I saw on the news that clonidine is not to be prescribed to children, only adults.

Doctor's response

Your question raises a very common concern amongst both doctors and patients (and in pediatrics, the parents of the patients!). When drug companies develop new medications, it is very common that their research and development and subsequent clinical testing does not involve children. One would have to ask the companies why this is so, but it is a reality. And so when these drugs are released for use, the drug companies are forced to state that "Safety and effectiveness in pediatric patients below the age of 12 have not been established" when they describe the drug in their formal product descriptions (most readily found by doctors and laymen alike in the Physicians Desk Reference [PDR]). Notice that this statement does not prohibit the drug's prescription to patients under age 12. But it leaves physicians and patients quite anxious.

Clonidine is such a medication. Once these types of medications are released, they are very frequently wonderful and very effective medications within the pediatric age group. But very often, their use is first applied to the pediatric-age patients in teaching hospitals and learning centers, effectively doing the "testing" at this level. Appropriate adjustments in dosages are made and the effects (and side effects) observed and the results published within the pediatric literature. As a private-practice pediatrician myself, it is only after such data is well-established that I feel comfortable enough to prescribe such a drug.

In reality, clonidine is now a frequently prescribed medication in children under age 12. It has indications for use in a wide variety of conditions such as high blood pressure, as a second-line medication in ADHD, treatment for Tourette syndrome, and treatment in some of the disruptive behavioral disorders, to name a few. Like all medications, it has some significant potential side effects that must be carefully monitored, but it is a very important medication in current pediatric use.

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Medically reviewed by Margaret Walsh, MD; American Board of Pediatrics

REFERENCE:

"Pharmacology of drugs used to treat attention deficit hyperactivity disorder in children and adolescents"
UpToDate.com

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Last Editorial Review: 6/5/2017

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