clonidine

Adult Dosing .

Dosage forms:  TAB: 0.1 mg, 0.2 mg, 0.3 mg; INJ: various

HTN

[0.1-0.4 mg PO bid]

Start: 0.1 mg PO bid, may incr. by 0.1 mg/day qwk; Max: 2.4 mg/day; Info: consider lower start dose in elderly patients; taper dose over 2-4 days to D/C

severe cancer pain, adjunct tx

[individualize dose epidurally]

Start: 30 mcg/h epidurally; Info: taper dose over 2-4 days to D/C

Tourette syndrome (off-label)

[0.1-0.3 mg/day PO divided bid-qid]

Start: 0.025-0.05 mg PO qd, then may titrate slowly; Max: 0.6 mg/day; Info: taper dose over 2-4 days to D/C

opioid withdrawal (off-label)

[0.1-0.3 mg PO tid-qid]

Start: 0.1-0.2 mg PO bid-qid; Max: 1.2 mg/day; Info: adjust dose based on clinical response and adverse effects; hold tx if BP <90/60; taper dose gradually to D/C approximately 7-10 days after opioid cessation

renal dosing

[see below]

renal impairment: consider decr. usual start dose, titrate slowly

HD: consider decr. usual start dose, titrate slowly; no supplement after dialysis; PD: consider decr. usual start dose, titrate slowly; no supplement

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  TAB: 0.1 mg, 0.2 mg, 0.3 mg; ER TAB: 0.1 mg; INJ: various

Special Note

[equivalency or interchangeability info]

Info: clonidine ER products not interchangeable; do not substitute on a mg to mg basis; retitrate if switching between products

severe intractable cancer pain, adjunct tx

[individualize dose epidurally]

Start: 0.5 mcg/kg/h epidurally; Info: taper dose over 2-4 days to D/C

ADHD

[extended-release form, 6-17 yo]

Dose: 0.1-0.4 mg/day ER PO divided qd-bid; Start: 0.1 mg ER PO qhs, may incr. by 0.1 mg/day qwk; Max: 0.4 mg/day ER; Info: divide dose bid if >0.2 mg/day, and give either equal or higher split dose at bedtime; do not cut/crush/chew ER tab; taper dose by no more than 0.1 mg/day q3-7 days to D/C

[immediate-release form, 27-40.5 kg (off-label)]

Dose: 0.003-0.005 mg/kg/day PO divided tid-qid; Start: 0.05 mg PO qhs, then may incr. by 0.05 mg/day q3-7 days; Max: 0.05 mg/dose up to 0.2 mg/day; Info: taper dose over 2-4 days to D/C

[immediate-release form, 40.5-45 kg (off-label)]

Dose: 0.003-0.005 mg/kg/day PO divided tid-qid; Start: 0.05 mg PO qhs, then may incr. by 0.05 mg/day q3-7 days; Max: 0.1 mg/dose up to 0.3 mg/day; Info: taper dose over 2-4 days to D/C

[immediate-release form, >45 kg (off-label)]

Dose: 0.003-0.005 mg/kg/day PO divided tid-qid; Start: 0.1 mg PO qhs, then may incr. by 0.1 mg/day q3-7 days; Max: 0.1 mg/dose up to 0.4 mg/day; Info: taper dose over 2-4 days to D/C

HTN (off-label)

[12 yo and older]

Dose: 0.2-0.8 mg/day PO divided bid; Start: 0.2 mg/day PO divided bid, may incr. by 0.1 mg/day qwk; Max: 2.4 mg/day; Info: taper dose over 2-4 days to D/C

HTN, acute severe (off-label)

[0.05-0.1 mg PO q1h prn]

Max: 0.8 mg/total dose; 8h; Info: for patients w/ non-life-threatening symptoms

Tourette syndrome (off-label)

[7 yo and older]

Dose: 0.1-0.3 mg/day PO divided bid-qid; Start: 0.025-0.05 mg PO qd, then may titrate slowly; Max: 0.4 mg/day; Info: taper dose over 2-4 days to D/C

neonatal opioid withdrawal syndrome, adjunct tx (off-label)

[0.5-1 mcg/kg/dose PO q3-6h]

Max: 8 mcg/kg/day; Info: refer to institutional protocol

renal dosing

[see below]

renal impairment: consider decr. usual start dose, titrate slowly

HD: consider decr. usual start dose, titrate slowly; no supplement after dialysis; PD: consider decr. usual start dose, titrate slowly; no supplement

hepatic dosing

[not defined]