Centrally acting imidazoline I1 agonist
Moxonidine
Brand names: Physiotens
Adult dose
Dose: 200 micrograms OD initially; max 600 micrograms/day in 1–2 divided doses
Route: PO
Frequency: OD-BD
Clinical pearls
- Hypertension when first-line agents not tolerated/effective
- Taper to discontinue
Contraindications
- Severe bradycardia
- Sick sinus syndrome
- 2nd/3rd degree AV block
- Severe heart failure
- Severe renal impairment
Side effects
- Dry mouth
- Drowsiness (less than clonidine)
- Dizziness
- Asthenia
- Rebound hypertension on abrupt withdrawal
Interactions
- β-blockers (rebound hypertension worse)
- CNS depressants
- TCAs (reduce effect)
Monitoring
- BP
- HR
Reference: BNF; NICE NG136; https://bnf.nice.org.uk/drugs/moxonidine/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines