α2 adrenergic agonist

Lofexidine hydrochloride

Brand names: BritLofex

Lofexidine hydrochloride is a centrally acting alpha-2 adrenergic agonist used to manage the symptoms of opioid withdrawal during detoxification.

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

By stimulating central alpha-2 adrenoceptors it reduces sympathetic (noradrenergic) overactivity, easing the autonomic symptoms associated with opioid withdrawal.

Prescribing in practice

It can cause hypotension, bradycardia and QT-interval prolongation, so blood pressure and pulse should be monitored and it should be used with caution in cardiovascular disease.
Doses should be reduced gradually at the end of treatment, as abrupt withdrawal may cause rebound hypertension.
Use with caution in patients with renal impairment or a history of QT prolongation.

Monitoring

Monitor blood pressure and heart rate during treatment and on withdrawal, with attention to symptoms of hypotension and bradycardia.

Counselling the patient

Explain that the medicine relieves withdrawal symptoms but is not an opioid substitute.
Rise slowly from sitting or lying because of the risk of dizziness.
Report fainting, slow heartbeat or palpitations.

Evidence & guidelines

Lofexidine is an established option for managing opioid withdrawal symptoms and is supported by NICE guidance on drug misuse and detoxification.

Reference: NICE CG52; 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).

Curated clinical cross-links plus same-class fallbacks.

Pathways