Centrally-acting α2-agonist

Clonidine hydrochloride

Brand names: Catapres, Dixarit

Adult dose

Dose: Hypertension: 50–100 micrograms TDS (max 1.2mg/day). Menopausal flushing: 50 micrograms BD. Migraine prophylaxis: 25–75 micrograms BD

Route: PO/IV

Frequency: BD-TDS

Paediatric dose

Dose: 1 micrograms/kg

Route: PO

Frequency: TDS-QDS

Max: 100 micrograms/dose

ADHD/sedation/withdrawal — initiate by specialist; range 1–5 micrograms/kg/dose

Paediatric weight-based calculator

Patient weight (kg)

ADHD/sedation/withdrawal — initiate by specialist; range 1–5 micrograms/kg/dose

Clinical pearls

Never stop abruptly — taper over ≥1 week to prevent rebound HT crisis
ICU sedation, opioid/alcohol withdrawal, ADHD specialist use, restless legs

Contraindications

Severe bradyarrhythmia
Sick sinus syndrome

Side effects

Sedation
Dry mouth
Bradycardia
Hypotension
Rebound hypertension on abrupt withdrawal
Depression

Interactions

β-blockers (additive bradycardia; rebound hypertension worse)
TCAs (reduced effect)
CNS depressants

Monitoring

Reference: BNFc; BNF; https://bnf.nice.org.uk/drugs/clonidine-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Pathways