クロニジン塩酸塩

id: clonidine
brandNames:
  US:
    - Kapvay
    - Catapres
  CN: []
  EU:
    - Catapres
  JP: []
  UK:
    - Catapres
  AU:
    - Catapres
  CA:
    - Catapres
genericName:
  en: clonidine hydrochloride
  zh: 盐酸可乐定
  ja: クロニジン塩酸塩
manufacturers:
  - name: Concordia Pharmaceuticals
    region: US
    product: Kapvay
  - name: Boehringer Ingelheim
    region: US
    product: Catapres
chemicalStructure:
  smiles: ClC1=CC=CC(Cl)=C1NC1=NCCN1
  pubchemCid: 2803
  molecularFormula: C9H9Cl2N3
  imageUrl: https://pubchem.ncbi.nlm.nih.gov/rest/pug/compound/cid/2803/PNG
  wikipediaUrl: https://en.wikipedia.org/wiki/File:Clonidine.svg
drugClass: non-stimulant
drugClassLabel:
  en: Non-Stimulant
  zh: 非兴奋剂
  ja: 非中枢刺激薬
category: alpha-2 adrenergic agonist
categoryLabel:
  en: Alpha-2 Adrenergic Agonist
  zh: α-2肾上腺素能激动剂
  ja: α2アドレナリン受容体作動薬
controlledSubstance: false
schedule:
  US: Not scheduled
  CN: Not approved for ADHD
  EU: Not scheduled (not ADHD indication)
  JP: Not approved for ADHD
  UK: Not scheduled
activeIngredient:
  en: clonidine hydrochloride
  zh: 盐酸可乐定
  ja: クロニジン塩酸塩
mechanismOfAction:
  en: Alpha-2 adrenergic receptor agonist. Stimulates presynaptic alpha-2 receptors in the brain, reducing sympathetic outflow and norepinephrine release. In ADHD, thought to improve prefrontal cortex function, reduce hyperactivity, and improve impulse control.
  zh: α-2肾上腺素能受体激动剂。刺激脑内突触前α-2受体，减少交感神经传出和去甲肾上腺素释放。在ADHD中，被认为可改善前额叶皮层功能，减少多动，改善冲动控制。
  ja: α2アドレナリン受容体作動薬。脳内のシナプス前α2受容体を刺激し、交感神経出力とノルエピネフリン放出を減少させます。ADHDでは、前頭前皮質機能を改善し、多動性を軽減し、衝動制御を改善すると考えられています。
neurotransmittersAffected:
  - norepinephrine
forms:
  - type: tablet
    typeLabel:
      en: Tablet
      zh: 片剂
      ja: 錠剤
    releaseType: extended
    releaseTypeLabel:
      en: Extended Release
      zh: 缓释
      ja: 徐放性
    brandName: Kapvay
    strengths:
      - 0.1mg
      - 0.2mg
    durationHours: 12
    notes:
      en: FDA-approved for ADHD; twice daily dosing
      zh: FDA批准用于ADHD；每日两次给药
      ja: ADHDにFDA承認；1日2回投与
  - type: tablet
    typeLabel:
      en: Tablet
      zh: 片剂
      ja: 錠剤
    releaseType: immediate
    releaseTypeLabel:
      en: Immediate Release
      zh: 速释
      ja: 即放性
    brandName: Catapres
    strengths:
      - 0.1mg
      - 0.2mg
      - 0.3mg
    durationHours: 6-8
    notes:
      en: Approved for hypertension; used off-label for ADHD
      zh: 批准用于高血压；用于ADHD为超说明书使用
      ja: 高血圧に承認；ADHDには適応外使用
  - type: patch
    typeLabel:
      en: Transdermal Patch
      zh: 透皮贴剂
      ja: 経皮パッチ
    releaseType: extended
    releaseTypeLabel:
      en: Extended Release
      zh: 缓释
      ja: 徐放性
    brandName: Catapres-TTS
    strengths:
      - 0.1mg/day
      - 0.2mg/day
      - 0.3mg/day
    durationHours: 168
    notes:
      en: Transdermal patch; change weekly; off-label for ADHD
      zh: 透皮贴剂；每周更换；用于ADHD为超说明书使用
      ja: 経皮パッチ；毎週交換；ADHDには適応外使用
onsetMinutes:
peakEffectHours: 2-4
durationHours: 6-12
sideEffects:
  common:
    - name:
        en: somnolence/drowsiness
        zh: 嗜睡/困倦
        ja: 傾眠/眠気
      frequency: 30-40%
    - name:
        en: fatigue
        zh: 疲劳
        ja: 疲労
      frequency: 20-30%
    - name:
        en: headache
        zh: 头痛
        ja: 頭痛
      frequency: 15-20%
    - name:
        en: dry mouth
        zh: 口干
        ja: 口渇
      frequency: 10-20%
    - name:
        en: dizziness
        zh: 头晕
        ja: めまい
      frequency: 10-15%
    - name:
        en: irritability
        zh: 易怒
        ja: 易刺激性
      frequency: 10%
    - name:
        en: upper respiratory infection
        zh: 上呼吸道感染
        ja: 上気道感染
      frequency: 10%
  uncommon:
    - name:
        en: hypotension
        zh: 低血压
        ja: 低血圧
      frequency: 5-10%
    - name:
        en: bradycardia
        zh: 心动过缓
        ja: 徐脈
      frequency: 5%
    - name:
        en: constipation
        zh: 便秘
        ja: 便秘
      frequency: 5%
    - name:
        en: nausea
        zh: 恶心
        ja: 悪心
      frequency: 5%
    - name:
        en: skin reactions (patch)
        zh: 皮肤反应（贴剂）
        ja: 皮膚反応（パッチ）
      frequency: 5-15%
  serious:
    - name:
        en: hypotension
        zh: 低血压
        ja: 低血圧
      notes:
        en: Significant drops in blood pressure possible
        zh: 可能出现明显血压下降
        ja: 血圧の著しい低下の可能性
    - name:
        en: bradycardia
        zh: 心动过缓
        ja: 徐脈
      notes:
        en: Can slow heart rate significantly
        zh: 可能显著减慢心率
        ja: 心拍数を著しく低下させる可能性
    - name:
        en: rebound hypertension
        zh: 反跳性高血压
        ja: リバウンド高血圧
      notes:
        en: Severe if stopped abruptly; MUST taper
        zh: 突然停药时严重；必须逐渐减量
        ja: 急に中止すると重度；必ず漸減すること
    - name:
        en: sedation
        zh: 镇静
        ja: 鎮静
      notes:
        en: Can be profound, especially early in treatment
        zh: 可能很严重，尤其是治疗初期
        ja: 特に治療初期は重度になる可能性
    - name:
        en: AV block
        zh: 房室传导阻滞
        ja: 房室ブロック
      notes:
        en: Rare cardiac conduction abnormalities
        zh: 罕见的心脏传导异常
        ja: まれな心臓伝導異常
contraindications:
  en:
    - Hypersensitivity to clonidine
    - Severe bradyarrhythmia
    - "Patch: skin irritation at application site"
  zh:
    - 对可乐定过敏
    - 严重缓慢性心律失常
    - 贴剂：贴敷部位皮肤刺激
  ja:
    - クロニジンに対する過敏症
    - 重度の徐脈性不整脈
    - パッチ：貼付部位の皮膚刺激
drugInteractions:
  - drug:
      en: Beta-blockers
      zh: β受体阻滞剂
      ja: β遮断薬
    severity: major
    effect:
      en: Enhanced bradycardia, rebound hypertension risk if clonidine stopped
      zh: 心动过缓增强，停用可乐定时有反跳性高血压风险
      ja: 徐脈の増強、クロニジン中止時のリバウンド高血圧リスク
  - drug:
      en: Tricyclic antidepressants
      zh: 三环类抗抑郁药
      ja: 三環系抗うつ薬
    severity: moderate
    effect:
      en: May reduce clonidine effectiveness
      zh: 可能降低可乐定疗效
      ja: クロニジンの効果を低下させる可能性
  - drug:
      en: CNS depressants
      zh: 中枢神经抑制剂
      ja: 中枢神経抑制剤
    severity: moderate
    effect:
      en: Enhanced sedation
      zh: 镇静作用增强
      ja: 鎮静作用の増強
  - drug:
      en: Antihypertensives
      zh: 降压药
      ja: 降圧薬
    severity: moderate
    effect:
      en: Additive hypotensive effect
      zh: 降压作用叠加
      ja: 降圧作用の相加
  - drug:
      en: Digoxin
      zh: 地高辛
      ja: ジゴキシン
    severity: moderate
    effect:
      en: Enhanced AV block risk
      zh: 房室传导阻滞风险增加
      ja: 房室ブロックリスクの増加
blackBoxWarnings:
  en: []
  zh: []
  ja: []
pregnancyCategory: C
foodInteractions:
  en: Can be taken with or without food
  zh: 可随餐或空腹服用
  ja: 食事の有無にかかわらず服用可能
typicalDosing:
  children:
    startingDose: 0.1mg at bedtime
    maxDose: 0.4mg/day (divided twice daily)
    notes:
      en: Increase by 0.1mg weekly; Kapvay is twice daily (morning and bedtime)
      zh: 每周增加0.1mg；Kapvay为每日两次（早晨和睡前）
      ja: 毎週0.1mgずつ増量；Kapvayは1日2回（朝と就寝時）
  adults:
    startingDose: 0.1mg twice daily
    maxDose: 0.4mg/day
    notes:
      en: Off-label for adult ADHD
      zh: 用于成人ADHD为超说明书使用
      ja: 成人ADHDには適応外使用
costEstimate:
  US:
    brand: $200-300/month (Kapvay)
    generic: $20-50/month
  CN:
    brand: Not available for ADHD
    generic: Not available for ADHD
storageRequirements:
  en: Room temperature (25°C), protect from light
  zh: 室温保存（25°C），避光
  ja: 室温（25°C）で保存、光を避ける
approvals:
  - region: US
    agency: FDA
    year: 2010
    approvedAges:
      en: 6-17 years
      zh: 6-17岁
      ja: 6〜17歳
    indications:
      en:
        - ADHD
      zh:
        - 注意缺陷多动障碍
      ja:
        - ADHD
    available: true
    notes:
      en: Kapvay (ER) approved for ADHD; can be used alone or with stimulants
      zh: Kapvay（缓释）批准用于ADHD；可单独使用或与兴奋剂联用
      ja: Kapvay（徐放）がADHDに承認；単独または刺激薬との併用が可能
  - region: CN
    agency: NMPA
    year:
    approvedAges:
      en: ""
      zh: ""
      ja: ""
    indications:
      en: []
      zh: []
      ja: []
    available: false
    notes:
      en: Not approved for ADHD
      zh: 未批准用于ADHD
      ja: ADHDには未承認
  - region: EU
    agency: EMA
    year:
    approvedAges:
      en: ""
      zh: ""
      ja: ""
    indications:
      en: []
      zh: []
      ja: []
    available: false
    notes:
      en: Not specifically approved for ADHD; used off-label
      zh: 未专门批准用于ADHD；为超说明书使用
      ja: ADHDに特定の承認なし；適応外使用
  - region: JP
    agency: PMDA
    year:
    approvedAges:
      en: ""
      zh: ""
      ja: ""
    indications:
      en: []
      zh: []
      ja: []
    available: false
    notes:
      en: Not approved for ADHD
      zh: 未批准用于ADHD
      ja: ADHDには未承認
  - region: UK
    agency: MHRA
    year:
    approvedAges:
      en: ""
      zh: ""
      ja: ""
    indications:
      en: []
      zh: []
      ja: []
    available: false
    notes:
      en: Not specifically approved for ADHD; sometimes used off-label
      zh: 未专门批准用于ADHD；有时超说明书使用
      ja: ADHDに特定の承認なし；適応外使用されることがある
specialConsiderations:
  cardiacRisk:
    en: Significant cardiovascular effects; monitor BP and HR closely
    zh: 心血管影响显著；需密切监测血压和心率
    ja: 心血管への影響が大きい；血圧と心拍数を注意深くモニタリング
  abuseRisk:
    en: No abuse potential; not a controlled substance
    zh: 无滥用风险；非管制药物
    ja: 乱用の可能性なし；規制物質ではない
  withdrawalNotes:
    en: "CRITICAL: Must taper slowly. Abrupt discontinuation can cause severe rebound hypertension, agitation, and other serious effects"
    zh: 重要：必须缓慢减量。突然停药可导致严重的反跳性高血压、激动和其他严重后果
    ja: 重要：必ずゆっくりと漸減すること。急な中止は重度のリバウンド高血圧、興奮、その他の重篤な影響を引き起こす可能性
  monitoringRequired:
    en: Blood pressure and heart rate at each visit; ECG if cardiac concerns
    zh: 每次就诊时监测血压和心率；如有心脏问题需做心电图
    ja: 毎回の診察時に血圧と心拍数；心臓に懸念がある場合はECG
travelRules:
  generalAdvice:
    en: "Clonidine is NOT a controlled substance, making travel straightforward. Note: Only approved for ADHD in the US (Kapvay). Other regions use it off-label for ADHD."
    zh: 可乐定不是管制药物，旅行较为简单。注意：仅在美国获批用于ADHD（Kapvay）。其他地区用于ADHD为超说明书使用。
    ja: クロニジンは規制物質ではないため、旅行は簡単です。注意：ADHDへの承認は米国（Kapvay）のみ。他の地域ではADHDへの適応外使用です。
  requiredDocumentation:
    - type: prescription
      typeLabel:
        en: Valid prescription
        zh: 有效处方
        ja: 有効な処方箋
      notes:
        en: Recommended for longer trips
        zh: 长途旅行建议携带
        ja: 長期旅行の場合は推奨
  maxPersonalSupply:
    default: 90 days
  crossBorderRules:
    - fromRegion: US
      toRegion: JP
      status: allowed
      statusLabel:
        en: Allowed
        zh: 允许
        ja: 許可
      requirements:
        en:
          - Carry prescription copy
          - Keep in original packaging
        zh:
          - 携带处方副本
          - 保持原包装
        ja:
          - 処方箋のコピーを携帯
          - 元のパッケージを維持
      maxSupply: 90 days
      notes:
        en: Clonidine is available in Japan (for hypertension). Not a controlled substance.
        zh: 可乐定在日本可用（用于高血压）。不是管制药物。
        ja: クロニジンは日本で入手可能（高血圧用）。規制物質ではありません。
    - fromRegion: US
      toRegion: CN
      status: allowed
      statusLabel:
        en: Allowed
        zh: 允许
        ja: 許可
      requirements:
        en:
          - Carry prescription copy
          - Keep in original packaging
        zh:
          - 携带处方副本
          - 保持原包装
        ja:
          - 処方箋のコピーを携帯
          - 元のパッケージを維持
      maxSupply: 90 days
      notes:
        en: Clonidine is available in China (for hypertension). Personal use quantities allowed.
        zh: 可乐定在中国可用（用于高血压）。允许个人使用量。
        ja: クロニジンは中国で入手可能（高血圧用）。個人使用量は許可されています。
    - fromRegion: US
      toRegion: EU
      status: allowed
      statusLabel:
        en: Allowed
        zh: 允许
        ja: 許可
      requirements:
        en:
          - Carry prescription copy
        zh:
          - 携带处方副本
        ja:
          - 処方箋のコピーを携帯
      maxSupply: 90 days
      notes:
        en: Clonidine is available in EU. No special import requirements.
        zh: 可乐定在欧盟可用。无特殊进口要求。
        ja: クロニジンはEUで入手可能です。特別な輸入要件はありません。
rxnormData:
  ingredientRxcui: "2599"
  ingredientName: clonidine
  rxcuiMappings:
    - rxcui: "2599"
      name: clonidine
      tty: IN
      description: Base ingredient
    - rxcui: "1013931"
      name: Kapvay
      tty: BN
      description: Brand name
    - rxcui: "1050312"
      name: Nexiclon
      tty: BN
      description: Brand name
    - rxcui: "202941"
      name: Catapres
      tty: BN
      description: Brand name
    - rxcui: "216099"
      name: Clorpres
      tty: BN
      description: Brand name
    - rxcui: "216778"
      name: Duraclon
      tty: BN
      description: Brand name
    - rxcui: "2690729"
      name: Onyda
      tty: BN
      description: Brand name
    - rxcui: "2725555"
      name: Javadin
      tty: BN
      description: Brand name
    - rxcui: "142432"
      name: clonidine hydrochloride
      tty: PIN
      description: Precise ingredient (includes salt form)
    - rxcui: "1013934"
      name: 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet [Kapvay]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "1050338"
      name: 24 HR clonidine 0.17 MG Extended Release Oral Tablet [Nexiclon]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "2690735"
      name: 24 HR clonidine hydrochloride 0.1 MG/ML Extended Release Suspension [Onyda]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "2725561"
      name: clonidine hydrochloride 0.02 MG/ML Oral Solution [Javadin]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "884196"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.1 MG Oral Tablet [Clorpres]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "884202"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.2 MG Oral Tablet [Clorpres]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "884207"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.3 MG Oral Tablet [Clorpres]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "884223"
      name: 10 ML clonidine hydrochloride 0.1 MG/ML Injection [Duraclon]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "998673"
      name: 168 HR clonidine 0.00417 MG/HR Transdermal System [Catapres]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "998677"
      name: 168 HR clonidine 0.00833 MG/HR Transdermal System [Catapres]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "998681"
      name: 168 HR clonidine 0.0125 MG/HR Transdermal System [Catapres]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "1013933"
      name: clonidine Extended Release Oral Tablet [Kapvay]
      tty: SBDF
      description: Branded ingredient + dose form
    - rxcui: "1050333"
      name: clonidine Extended Release Oral Tablet [Nexiclon]
      tty: SBDF
      description: Branded ingredient + dose form
    - rxcui: "1732372"
      name: clonidine Injection [Duraclon]
      tty: SBDF
      description: Branded ingredient + dose form
    - rxcui: "2268636"
      name: clonidine Transdermal System [Catapres]
      tty: SBDF
      description: Branded ingredient + dose form
    - rxcui: "2690733"
      name: clonidine Extended Release Suspension [Onyda]
      tty: SBDF
      description: Branded ingredient + dose form
    - rxcui: "2725559"
      name: clonidine Oral Solution [Javadin]
      tty: SBDF
      description: Branded ingredient + dose form
    - rxcui: "884195"
      name: chlorthalidone / clonidine Oral Tablet [Clorpres]
      tty: SBDF
      description: Branded ingredient + dose form
    - rxcui: "1013930"
      name: 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "2690727"
      name: 24 HR clonidine hydrochloride 0.1 MG/ML Extended Release Suspension
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "2725554"
      name: clonidine hydrochloride 0.02 MG/ML Oral Solution
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "884173"
      name: clonidine hydrochloride 0.1 MG Oral Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "884185"
      name: clonidine hydrochloride 0.2 MG Oral Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "884189"
      name: clonidine hydrochloride 0.3 MG Oral Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "884192"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.1 MG Oral Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "884198"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.2 MG Oral Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "884203"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.3 MG Oral Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "884221"
      name: 10 ML clonidine hydrochloride 0.1 MG/ML Injection
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "884225"
      name: 10 ML clonidine hydrochloride 0.5 MG/ML Injection
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "885880"
      name: 24 HR clonidine 0.17 MG Extended Release Oral Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "892791"
      name: clonidine hydrochloride 0.025 MG Oral Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "892793"
      name: clonidine hydrochloride 0.15 MG/ML Injectable Solution
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "892795"
      name: clonidine hydrochloride 0.25 MG Extended Release Oral Capsule
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "998671"
      name: 168 HR clonidine 0.00417 MG/HR Transdermal System
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "998675"
      name: 168 HR clonidine 0.00833 MG/HR Transdermal System
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "998679"
      name: 168 HR clonidine 0.0125 MG/HR Transdermal System
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "1732370"
      name: clonidine Injection
      tty: SCDF
      description: Ingredient + dose form
    - rxcui: "1806253"
      name: clonidine Transdermal System
      tty: SCDF
      description: Ingredient + dose form
    - rxcui: "2725552"
      name: clonidine Oral Solution
      tty: SCDF
      description: Ingredient + dose form
    - rxcui: "371580"
      name: chlorthalidone / clonidine Oral Tablet
      tty: SCDF
      description: Ingredient + dose form
    - rxcui: "371581"
      name: clonidine Extended Release Oral Capsule
      tty: SCDF
      description: Ingredient + dose form
    - rxcui: "371582"
      name: clonidine Injectable Solution
      tty: SCDF
      description: Ingredient + dose form
    - rxcui: "371583"
      name: clonidine Oral Tablet
      tty: SCDF
      description: Ingredient + dose form
    - rxcui: "885790"
      name: clonidine Extended Release Suspension
      tty: SCDF
      description: Ingredient + dose form
    - rxcui: "885794"
      name: clonidine Extended Release Oral Tablet
      tty: SCDF
      description: Ingredient + dose form
  brandMappings:
    - brandName: Kapvay
      rxcui: "1013931"
      region: US
    - brandName: Nexiclon
      rxcui: "1050312"
      region: US
    - brandName: Catapres
      rxcui: "202941"
      region: US
    - brandName: Clorpres
      rxcui: "216099"
      region: US
    - brandName: Duraclon
      rxcui: "216778"
      region: US
    - brandName: Onyda
      rxcui: "2690729"
      region: US
    - brandName: Javadin
      rxcui: "2725555"
      region: US
  synonyms:
    - name: clonidine hydrochloride
      type: chemical
      source: RxNorm
    - name: Kapvay
      type: brand
      source: RxNorm
    - name: Nexiclon
      type: brand
      source: RxNorm
    - name: Catapres
      type: brand
      source: RxNorm
    - name: Clorpres
      type: brand
      source: RxNorm
    - name: Duraclon
      type: brand
      source: RxNorm
    - name: Onyda
      type: brand
      source: RxNorm
    - name: Javadin
      type: brand
      source: RxNorm
    - name: clonidine
      type: generic
      source: RxNorm
  relatedDrugs:
    - rxcui: "1013930"
      name: 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "2690727"
      name: 24 HR clonidine hydrochloride 0.1 MG/ML Extended Release Suspension
      tty: SCD
      relationship: clinical_drug
    - rxcui: "2725554"
      name: clonidine hydrochloride 0.02 MG/ML Oral Solution
      tty: SCD
      relationship: clinical_drug
    - rxcui: "884173"
      name: clonidine hydrochloride 0.1 MG Oral Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "884185"
      name: clonidine hydrochloride 0.2 MG Oral Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "884189"
      name: clonidine hydrochloride 0.3 MG Oral Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "884192"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.1 MG Oral Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "884198"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.2 MG Oral Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "884203"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.3 MG Oral Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "884221"
      name: 10 ML clonidine hydrochloride 0.1 MG/ML Injection
      tty: SCD
      relationship: clinical_drug
    - rxcui: "884225"
      name: 10 ML clonidine hydrochloride 0.5 MG/ML Injection
      tty: SCD
      relationship: clinical_drug
    - rxcui: "885880"
      name: 24 HR clonidine 0.17 MG Extended Release Oral Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "892791"
      name: clonidine hydrochloride 0.025 MG Oral Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "892793"
      name: clonidine hydrochloride 0.15 MG/ML Injectable Solution
      tty: SCD
      relationship: clinical_drug
    - rxcui: "892795"
      name: clonidine hydrochloride 0.25 MG Extended Release Oral Capsule
      tty: SCD
      relationship: clinical_drug
    - rxcui: "998671"
      name: 168 HR clonidine 0.00417 MG/HR Transdermal System
      tty: SCD
      relationship: clinical_drug
    - rxcui: "998675"
      name: 168 HR clonidine 0.00833 MG/HR Transdermal System
      tty: SCD
      relationship: clinical_drug
    - rxcui: "998679"
      name: 168 HR clonidine 0.0125 MG/HR Transdermal System
      tty: SCD
      relationship: clinical_drug
    - rxcui: "1013934"
      name: 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet [Kapvay]
      tty: SBD
      relationship: branded_drug
    - rxcui: "1050338"
      name: 24 HR clonidine 0.17 MG Extended Release Oral Tablet [Nexiclon]
      tty: SBD
      relationship: branded_drug
    - rxcui: "2690735"
      name: 24 HR clonidine hydrochloride 0.1 MG/ML Extended Release Suspension [Onyda]
      tty: SBD
      relationship: branded_drug
    - rxcui: "2725561"
      name: clonidine hydrochloride 0.02 MG/ML Oral Solution [Javadin]
      tty: SBD
      relationship: branded_drug
    - rxcui: "884196"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.1 MG Oral Tablet [Clorpres]
      tty: SBD
      relationship: branded_drug
    - rxcui: "884202"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.2 MG Oral Tablet [Clorpres]
      tty: SBD
      relationship: branded_drug
    - rxcui: "884207"
      name: chlorthalidone 15 MG / clonidine hydrochloride 0.3 MG Oral Tablet [Clorpres]
      tty: SBD
      relationship: branded_drug
    - rxcui: "884223"
      name: 10 ML clonidine hydrochloride 0.1 MG/ML Injection [Duraclon]
      tty: SBD
      relationship: branded_drug
    - rxcui: "998673"
      name: 168 HR clonidine 0.00417 MG/HR Transdermal System [Catapres]
      tty: SBD
      relationship: branded_drug
    - rxcui: "998677"
      name: 168 HR clonidine 0.00833 MG/HR Transdermal System [Catapres]
      tty: SBD
      relationship: branded_drug
    - rxcui: "998681"
      name: 168 HR clonidine 0.0125 MG/HR Transdermal System [Catapres]
      tty: SBD
      relationship: branded_drug
    - rxcui: "1732370"
      name: clonidine Injection
      tty: SCDF
      relationship: drug_form
  lastUpdated: 2025-12-04
instructions:
  indicationsAndUsage:
    en: |
      Clonidine extended-release (Kapvay) is an alpha2-adrenergic agonist indicated for the treatment of:
      - Attention Deficit Hyperactivity Disorder (ADHD) in patients 6-17 years of age as monotherapy or adjunctive therapy to stimulants

      Note: Immediate-release clonidine (Catapres) is FDA-approved for hypertension, not ADHD. ADHD use of IR formulations is off-label. Clonidine patches are also for hypertension only.
  dosageAndAdministration:
    en: |
      ADHD (KAPVAY EXTENDED-RELEASE):
      - Starting dose: 0.1 mg at bedtime
      - Week 2: 0.1 mg twice daily (morning and bedtime)
      - Week 3: 0.1 mg in morning, 0.2 mg at bedtime
      - Week 4+: 0.2 mg twice daily
      - Maximum dose: 0.4 mg/day (0.2 mg twice daily)

      ADJUNCTIVE THERAPY WITH STIMULANTS:
      - Same dosing as monotherapy
      - Total daily dose can be given as twice daily

      General Instructions:
      - Take twice daily (morning and bedtime)
      - Equal or higher split dosage should be given at bedtime
      - May be taken with or without food
      - Swallow tablets whole; do NOT crush, chew, or break (extended-release)

      DISCONTINUATION:
      - CRITICAL: Taper gradually over 3-7 days
      - Reduce dose by no more than 0.1 mg every 3-7 days
      - Abrupt discontinuation can cause severe rebound hypertension

      OFF-LABEL IR DOSING (CATAPRES):
      - Typically 0.05-0.1 mg 2-4 times daily
      - Often used at bedtime for sleep issues
      - Must also be tapered when discontinuing
  dosageForms:
    en: |
      Extended-Release Tablets (Kapvay): 0.1 mg, 0.2 mg (FDA-approved for ADHD)
      Immediate-Release Tablets (Catapres): 0.1 mg, 0.2 mg, 0.3 mg (off-label for ADHD)
      Transdermal Patch (Catapres-TTS): 0.1 mg/day, 0.2 mg/day, 0.3 mg/day (hypertension only)
  contraindications:
    en: |
      Clonidine is contraindicated in patients with:
      - Known hypersensitivity to clonidine or any components of the formulation

      CAUTIONS (Use with Extreme Care):
      - Patients with severe cardiovascular disease
      - History of syncope
      - Conditions predisposing to syncope (hypotension, dehydration)
      - Patients on other antihypertensives or drugs affecting blood pressure
  warningsAndPrecautions:
    en: |
      HYPOTENSION AND BRADYCARDIA:
      - Can cause dose-dependent decreases in blood pressure and heart rate
      - Syncope has been reported
      - Measure blood pressure and heart rate before initiation and periodically during treatment
      - Titrate slowly and monitor during dose adjustments

      SEDATION AND SOMNOLENCE:
      - Common adverse reaction
      - Patients should avoid activities requiring mental alertness until effects are known
      - May be more pronounced when combined with CNS depressants

      REBOUND HYPERTENSION (CRITICAL):
      - Sudden discontinuation can cause nervous system hyperactivity resulting in:
        • Rapid rise in blood pressure
        • Headache
        • Agitation
        • Tremor
        • Confusion
      - Always taper dose gradually
      - If switching from patch to oral: overlap for 1-2 days

      CARDIAC CONDUCTION ABNORMALITIES:
      - Use caution in patients with conduction disturbances
      - May worsen sinus node dysfunction and AV block
      - Caution with other drugs affecting heart rate/rhythm

      ALLERGIC REACTIONS:
      - Patches may cause localized skin reactions and rarely systemic allergic reactions
  adverseReactions:
    en: |
      Most Common Adverse Reactions (≥5%):
      - Somnolence (31-38%)
      - Fatigue (16%)
      - Irritability (9%)
      - Insomnia (less common with bedtime dosing)
      - Nightmares
      - Emotional disorder
      - Constipation
      - Dry mouth
      - Upper abdominal pain

      Other Notable Adverse Reactions:
      - Hypotension
      - Bradycardia
      - Dizziness
      - Headache
      - Nausea
      - Decreased appetite

      Patch-Specific (Transdermal):
      - Localized skin reactions (erythema, pruritus)
      - Contact dermatitis
  drugInteractions:
    en: |
      USE WITH CAUTION:
      - Antihypertensives: Additive hypotensive effects
      - CNS Depressants (sedatives, hypnotics, alcohol): Enhanced CNS depression
      - Tricyclic Antidepressants: May reduce clonidine's antihypertensive effect
      - Beta-blockers: Additive bradycardia; if stopping both, taper beta-blocker first, then clonidine
      - Digitalis: Additive effects on AV conduction and heart rate
      - Calcium channel blockers: Additive bradycardia and hypotension
      - Drugs affecting renal function: May affect clonidine elimination

      IMPORTANT:
      - Abrupt withdrawal of beta-blockers while on clonidine can cause severe hypertension
      - Always discontinue beta-blockers several days before clonidine taper
  useInSpecificPopulations:
    en: |
      PREGNANCY:
      - Category C. Use only if potential benefit justifies risk to fetus.
      - Crosses placenta

      LACTATION:
      - Clonidine is excreted in human milk
      - Consider benefits of breastfeeding vs. potential risks

      PEDIATRIC USE:
      - Kapvay: Safety and efficacy established for patients 6-17 years
      - Not recommended for children under 6 years

      GERIATRIC USE:
      - Clinical studies did not include sufficient patients 65 and older
      - May be more sensitive to hypotensive effects

      RENAL IMPAIRMENT:
      - Clonidine is primarily renally excreted
      - Consider dose reduction; monitor closely
      - Adjust dose according to renal function
  overdosage:
    en: |
      SIGNS AND SYMPTOMS:
      - Hypotension
      - Bradycardia
      - Lethargy/drowsiness
      - Diminished or absent reflexes
      - Weakness, irritability
      - Miosis (constricted pupils)
      - Hypothermia
      - Respiratory depression (large doses)
      - Reversible cardiac conduction abnormalities/arrhythmias
      - Apnea, seizures (rarely, in children)

      TREATMENT:
      - Supportive treatment as primary therapy
      - Monitor cardiac and respiratory function
      - Atropine for symptomatic bradycardia
      - Intravenous fluids and/or vasopressors for hypotension
      - Tolazoline has been used to treat clonidine overdose
      - Dialysis is not effective
  clinicalPharmacology:
    en: |
      MECHANISM OF ACTION:
      Clonidine is a centrally acting alpha2-adrenergic agonist. It works by:
      - Stimulating alpha2-adrenergic receptors in the brain stem
      - Reducing sympathetic outflow from the CNS
      - Decreasing peripheral resistance, heart rate, and blood pressure
      - In ADHD: thought to improve prefrontal cortex function and reduce hyperactivity/impulsivity

      Unlike guanfacine, clonidine is less selective for alpha2A receptors, which may explain its more pronounced sedative effects.

      PHARMACOKINETICS:
      - Absorption: Well absorbed; bioavailability ~70%
      - Peak concentration: 7-8 hours (extended-release); 1-3 hours (immediate-release)
      - Distribution: Widely distributed; crosses blood-brain barrier
      - Metabolism: Hepatic (minor); 50% excreted unchanged
      - Half-life: 12-16 hours (allows twice-daily dosing for ER)
      - Excretion: 72% renal (50% unchanged); 22% fecal
  howSupplied:
    en: |
      STORAGE AND HANDLING:
      - Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F)
      - Protect from light

      Not a Controlled Substance - No DEA Schedule
  patientCounselingInfo:
    en: |
      IMPORTANT PATIENT INFORMATION:

      1. DO NOT STOP SUDDENLY (CRITICAL): Stopping this medication abruptly can cause dangerous spikes in blood pressure. Always taper gradually as directed by your doctor.

      2. DROWSINESS: This medication causes significant drowsiness, especially at first. Avoid driving or operating machinery until you know how it affects you.

      3. DOSING: Take twice daily. Take the larger dose at bedtime. Swallow extended-release tablets whole.

      4. LOW BLOOD PRESSURE: Rise slowly from sitting or lying positions to avoid dizziness.

      5. AVOID ALCOHOL: Alcohol increases drowsiness and may worsen blood pressure effects.

      6. MISSED DOSES: If you miss two or more doses, contact your doctor before restarting - you may need to restart at a lower dose.

      7. SURGERY: Tell your surgeon you take this medication. It may interact with anesthesia.

      8. HEAT EXPOSURE: If using the patch, be aware that heat can increase drug absorption.

      9. NOT A STIMULANT: This is a non-stimulant medication. It may take several weeks to see full effect.

      10. MONITORING: Blood pressure and heart rate will be checked regularly during treatment.
lastUpdated: 2025-12-04
sources:
  - https://www.goodrx.com/conditions/adhd/non-stimulant-adhd-meds
  - https://www.additudemag.com/adhd-medications-list-chart-stimulants-nonstimulants/
notes:
  en: "Less selective than guanfacine; more sedating. Only FDA-approved for ADHD in US (Kapvay). Helpful for hyperactivity, impulsivity, and sleep issues. Often used as adjunct to stimulants. CRITICAL: Never stop abruptly due to rebound hypertension risk."
  zh: 选择性低于胍法辛；镇静作用更强。在美国仅Kapvay获FDA批准用于ADHD。对多动、冲动和睡眠问题有帮助。常作为兴奋剂的辅助用药。重要：由于反跳性高血压风险，切勿突然停药。
  ja: グアンファシンより選択性が低い；鎮静作用が強い。米国ではKapvayのみがADHDにFDA承認。多動性、衝動性、睡眠の問題に有用。刺激薬の補助としてよく使用される。重要：リバウンド高血圧リスクのため、急な中止は禁忌。