Section 03 · Monograph
Clonidine
Reviewed Nov 2026FDA label
Catapres / KapvayAlpha-2 agonist
- Forms
- Tab: 0.1, 0.2, 0.3mg | ER tab: 0.1, 0.2mg | Patch: 0.1, 0.2, 0.3mg/24h
- Dose
- Tics (off-label): start 0.05mg qHS, increase to 0.1-0.3mg/day divided
- MOA
- Central α2 agonism, ↓sympathetic outflow
Indications
- HypertensionFDA-labeled
- ADHD (extended-release, Kapvay)FDA-labeled
- Epidural use for severe cancer pain (injection)FDA-labeled
Off-Label Uses
- Tic disorders including Tourette's syndromeOff-label
- Opioid and alcohol withdrawal symptoms; neurogenic orthostatic and other autonomic usesOff-label
Mechanism of Action
- Central alpha-2 adrenergic agonist reducing sympathetic outflow; may reduce tics through noradrenergic modulation of frontostriatal circuits
Full Dosing
Adult / usual
- Tics (off-label): start 0.05mg at bedtime; increase gradually to 0.1-0.3mg/day in 2-3 divided doses (or patch/ER form)
- Do not stop abruptly; taper over 2-4 days to avoid rebound hypertension and agitation
Contraindications
- Known hypersensitivity to clonidine
- Epidural use in obstetric, postpartum or perioperative pain (injection)
Drug Interactions
- Beta-blockers: increased rebound hypertension and bradycardia risk with withdrawal
- Tricyclic antidepressants may blunt the effect
- Additive sedation with CNS depressants
Adverse Effects
- Sedation, dry mouth, dizziness
- Hypotension and bradycardia
- Rebound hypertension on abrupt withdrawal
- Constipation, depression (uncommon)
Monitoring Parameters
- Blood pressure and heart rate
- Sedation
- Withdrawal symptoms on dose changes
Pregnancy & Lactation
- Limited data; use if benefit justifies risk
- Present in milk; monitor infants for sedation