Drug Interaction:
Interactions summary-
+ clonidine
Beta blockers + clonidine
reversal of antihypertensive activity and potentially life-threatening increases in blood pressure have occured
Clondine + Levodopa
reversal of antihypertensive effect .
Prazosin + clonidine
antihypertensive effect of clonidine may be decreased
Tricyclic antidepressants + clonidine
tricylic antidepress block antihypertensive effects of clonidine with possibly life threatening elevation in blood pressure.
Verapramil + clonidine
synergistic pharmacologic and toxic effects
Indication:
FIXED DOSE COMBINATIONS APPROVED BY DCG(I)
FROM JANUARY 1961 TILL NOVEMBER 2014
Name of Drug Indication Date of Approval
1.Clonidine Hcl 0.1mg/0.2mg+ Dec -1977
Chlorthalidone 15mg/15mg tablet
2.Clonidine Hcl 100mcg+ Jul 1975
HCTZ 20mg Tablet/Capsule
Hypertension
Antiadrenergic Agents-
Centrally acting include-
Methyl Dopa, Clonidine, Guannfacine Hcl, Guanabenz Acetate,
Adverse Reaction:
Withdrawal symptoms could be life threatening (blood pressure, irritability, headache, flushing, insomnia, agitation, emotional lability, tremors, nausea, vomiting and psychotic features).
Bradycardia, disturbances in conduction(in individuals with pre-existing diseases of SA/AV nodes ,overdose or on digitalis).
Reduced GI mortility at times may cause paralytic ileus.
Dry mouth, drowsiness, bradycardia, fluid or electrolyte imbalance.
GI upset, orthosatic hypotension, weakness,
sedation, pruritus, myalgia, urticaria, nausea, sedation, urticaria, nausea, insomnia, arrhythmias, agitation.
Contra-Indications:
Disorders of cardiac pacemaker activity and conduction.
Special precautions:
Gradual withdrawal,machine operators and drivers.
Dosages/ Overdosage Etc:
Indications:
Hypertension
Dosage:
Individualise dose. Intial- 0.1mg twice daily.
Lower dose for elderly patients.
Maintenance dose- increments of of 0.1 or 0.2mg/day. Until desired response is acheived.. Maximum dose is 2.4mg/day.
Patient Information:
1. Allergies- Tell your doctor if you have ever had any unusual or allergic raections to clonidine or other related medicines. Also tell your doctor if youn are allergic to any other substances such as foods, preservatives or dyes.
2. Pregnancy- clonidine causes harmful effects in the fetus but not birth defects.
3. Breast feeding- although clonidine passes into breast milk it has not been reported to cause problems in nursing babies
4. Children- clonidine overdose has been reported when children accidentally took this medicine
5. Elderly- dizziness or fainting may be more likely to occur in the elderly.
6. Other medicines- tell your doctor if you are taking any of the following- beta blockers- these medicines may increase the risk of harmful effects when clonidine treatment is stopped tricyclic antidepressants- these medicines may decrease clonidines effect on blood pressure
7. Other medical problems- tell your doctor if you have any other medical problems- Heart or blood vessel disease- clonidine may make these conditions worse. Irritated or scrapped skin- effects of clonidine may be increased if the skin patch is placed on an area of scrapped or irritated skin because more medicine is absorbed into the body.
8. Dosing- Follow doctors instructions
9. Missed dose- If you miss a dose of this medicine take it as soon as possible. However if it is almost time for your next dose go back to your regular dosing schedule. Do not double doses.
10. Storage- Keep the medicines out of reach of children Store the medicines away heat and direct light Do not store tablets or capsules in the bath room, in damp places near the kitchen sink Heat and dampness will cause the medicines to break down Keep the medicine from freezing
Pharmacology/ Pharmacokinetics:
Antiadrenergic Agents-
Centrally acting include-
Methyl Dopa, Clonidine, Guannfacine Hcl, Guanabenz Acetate,
Pharmacology:
Clonidine, an imidazole derivative is a central alpha adrenergic stimulant that inhibits sympathtic cardioaccelrator and vasoconstrictor centers. Stimulation of alpha-adrenergic in brain stem results in reduced sympathetic outflow from the CNS and a decrease in peripheral resistence, renal vascular resistence, heart rate and blood pressure.
Pharmacokinetics:
Peak plasma level occurs in approximately 3 to 5 hours with a plasma half -life of 12 to 18 hours. About 50% of the absorbed dose is metabolised in the liver. In patients with impaired renal function, half-life increases to 30 to 40 hours. About 40 to 60% of the absorbed dose is recovered in the urine as unchanged drug in 24 hours.
Interaction with Food:
Take with or without food
Pregnancy and lactation:
Pregnancy:
Observe caution before administration.
Lactation:
Excercise caution when administering to a nusing woman.