Clonidine Hydrochloride interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

  What to do: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

  8 sources

  1. Sternbach H "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol 11 (1991): 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med 101 (1984): 498-9
  3. Feder R "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry 52 (1991): 139
  4. Ellison JM, Milofsky JE, Ely E "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry 51 (1990): 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit 23 (2001): 435-40
  6. Cerner Multum, Inc. "Australian Product Information." O 0
  7. Pacher P, Kecskemeti V "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des 10 (2004): 2463-75
  8. Andrews C, Pinner G "Postural hypotension induced by paroxetine." BMJ 316 (1998): 595

Conditions

Conditions in which Clonidine Hydrochloride needs care, as documented in this source.

• Bradycardia

  Moderate

  Central alpha-2 adrenoreceptor agonists reduce sympathetic outflow from the central nervous system. Heart rate is decreased, which may lead to or exacerbate sinus bradycardia and atrioventricular block. Therapy with central alpha-2 adrenoreceptor agonists should be administered cautiously in patients with conduction disturbances such as sinus node dysfunction or AV nodal disease.

  7 sources

  1. Byrd BF, Collins HW, Primm RK "Risk factors for severe bradycardia during oral clonidine therapy for hypertension." Arch Intern Med 148 (1988): 729-33
  2. van Zwieten PA, Thoolen MJ, Timmermans PB "The hypotensive activity and side effects of methyldopa, clonidine, and guanfacine." Hypertension 6 (1984): 28-33
  3. Schwartz E, Friedman E, Mouallem M, Farfel Z "Sinus arrest associated with clonidine therapy." Clin Cardiol 11 (1988): 53-4
  4. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories (2001):
  5. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories (2001):
  6. Golusinski LL, Blount BW "Clonidine-induced bradycardia." J Fam Pract 41 (1995): 399-401
  7. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim (2001):

• Depressive Disorder

  Moderate

  Central alpha-2 adrenoreceptor agonists may occasionally cause mental depression and should be used cautiously in patients with a history of depression.

  5 sources

  1. Kostis JB, Rosen RC, Holzer BC, et al. "CNS side effects of centrally-active antihypertensive agents: a prospective, placebo-controlled study of sleep, mood state, and cognitive and sexual function in hypertensive males." Psychopharmacology (Berl) 102 (1990): 163-70
  2. Prasad A, Shotliff K "Depression and chronic clonidine therapy." Postgrad Med J 69 (1993): 327-8
  3. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories (2001):
  4. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories (2001):
  5. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim (2001):

• Hypotension

  Moderate

  Central alpha-2 adrenoreceptor agonists reduce sympathetic outflow from the central nervous system, resulting in decreases in heart rate, peripheral and renovascular resistance, and blood pressure. Therapy with these agents should be administered cautiously in patients with hypotension or conditions that may be exacerbated by decreased blood pressure and perfusion, such as coronary insufficiency, peripheral vascular disease (e.g., Raynaud's syndrome), cerebrovascular disease, or recent myocardial infarction.

  12 sources

  1. Anavekar SN, Jarrott B, Toscano M, Louis WJ "Pharmacokinetic and pharmacodynamic studies of oral clonidine in normotensive subjects." Eur J Clin Pharmacol 23 (1982): 1-5
  2. Fruncillo RJ, Gibbons WJ, Vlasses PH, Ferguson RK "Severe hypotension associated with concurrent clonidine and antipsychotic medication." Am J Psychiatry 142 (1985): 274
  3. Bosanac P, Dubb J, Walker B, et al. "Renal effects of guanabenz: a new antihypertensive." J Clin Pharmacol Nov-Dec (1976): 631-6
  4. Bauer JH "Effects of guanabenz therapy on renal function and body fluid composition." Arch Intern Med 143 (1983): 1163-7
  5. Dziedzic SW, Elijovich F, Felton K, et al. "Effect of guanabenz on blood pressure responses to posture and exercise." Clin Pharmacol Ther 33 (1983): 151-5
  6. Mosley C, O'Connor DT, Taylor A, et al. "Comparative effects of antihypertensive therapy with guanabenz and propranolol on renal vascular resistance and left ventricular mass." J Cardiovasc Pharmacol 6 (1984): s757-61
  7. Greene CS, Gretler DD, Cervenka K, et al. "Cerebral blood flow during the acute therapy of severe hypertension with oral clonidine." Am J Emerg Med 8 (1990): 293-6
  8. Given BD, Taylor T, Lilly LS, Dzau VJ "Symptomatic hypotension following the clonidine suppression test for pheochromocytoma." Arch Intern Med 143 (1983): 2195-6

  Show all 12 sourcesShow fewer sources

  9. van Zwieten PA, Thoolen MJ, Timmermans PB "The hypotensive activity and side effects of methyldopa, clonidine, and guanfacine." Hypertension 6 (1984): 28-33
  10. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories (2001):
  11. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories (2001):
  12. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim (2001):

• Kidney Diseases

  Moderate

  Clonidine is primarily eliminated unchanged by the kidney. The serum concentrations and half-life of clonidine may be increased in patients with impaired renal function, so patients may benefit from a lower initial dose. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment. Only a minimal amount of clonidine is removed during routine hemodialysis, and there is no need to give supplemental clonidine following dialysis.

  4 sources

  1. Hulter HN, Licht JH, Ilnicki LP, Singh S "Clinical efficacy and pharmacokinetics of clonidine in hemodialysis and renal insufficiency." J Lab Clin Med 94 (1979): 223-31
  2. Lowenthal DT, Affrime MB, Meyer A, et al. "Pharmacokinetics and pharmacodynamics of clonidine in varying states of renal function." Chest 83 (1983): 386-90
  3. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim (2002):
  4. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim (2001):

Therapeutic duplication

Drug classes that overlap with Clonidine Hydrochloride, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• centrally acting antihypertensiv

  The recommended maximum number of medicines in the 'centrally acting antihypertensives' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'centrally acting antihypertensives' category.

  Example product in the source data (US market): Hydrochlorothiazide/methyldopa