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Centrally acting imidazoline I1 agonist

Moxonidine

Brand names: Physiotens

Moxonidine is a centrally acting antihypertensive used for mild to moderate essential hypertension, often when other agents are unsuitable or insufficient.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is a selective agonist at central imidazoline I1 receptors (with some alpha-2 adrenoceptor activity) in the brainstem, reducing sympathetic outflow and thereby lowering peripheral vascular resistance and blood pressure.

Prescribing in practice

  • Treatment should not be stopped abruptly because of the risk of rebound hypertension; withdraw gradually, and if a concomitant beta-blocker is also being stopped, stop the beta-blocker first.
  • It is contraindicated in significant bradyarrhythmias and certain conduction disorders, and caution is needed in renal impairment as it is largely renally excreted.
  • Common effects include dry mouth, headache, fatigue and dizziness; consult the SPC for full cautions.

Monitoring

Monitor blood pressure and heart rate, with attention to renal function in those with impaired kidneys.

Counselling the patient

  • Tell the patient not to stop the medicine suddenly and to seek advice before discontinuing.
  • Warn that dry mouth and drowsiness are common, especially early in treatment, and that alcohol may add to sedation.

Evidence & guidelines

Moxonidine is an established centrally acting antihypertensive; refer to current prescribing references for its place in therapy.

Reference: NICE NG136; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways