General Toxicity Notes
Blood pressure is the best guide to dose and interval.
Half-Life (Normalesrd) Hours
12-16/39-42
Plasma Protein Binding %
20
Volume Of Distribution L/Kg
2.5-3.7
Dose For Normal Renal Function
0.1-0.6 mg bid
Adjustment For Renal Failure Method
I
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
q12h [B]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
q12-24h [B]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
q24h [B]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Dose after dialysis, [B]
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10, [B]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50,titrate, [D]
References
Byrd BF 3rd, Collins HW, Primm RK. Risk factors for severe bradycardia during oral clonidine therapy for hypertension. Arch Intern Med. 1988; 148: 729-33. [PMID: 3341873] / Hulter HN, Licht JH, Ilnicki LP, Singh S. Clinical efficacy and pharmacokinetics of clonidine in hemodialysis and renal insufficiency. J Lab Clin Med. 1979; 94: 223-31. [PMID: 458242] / Langley MS, Heel RC. Transdermal clonidine. A preliminary review of its pharmacodynamic properties and therapeutic efficacy. Drugs. 1988; 35: 123-42. [PMID: 3281820] / Lowenthal DT, Matzek KM, MacGregor TR. Clinical pharmacokinetics of clonidine. Clin Pharmacokinet. 1988; 14: 287-310. [PMID: 3293868]
Toxicity Notes
Increased risk of bradycardia in renal patients. Rebound hypertension if drug is abruptly withdrawn. Tricyclic antidepressants decrease efficacy. Potentiates CNS depressant effects of alcohol, sedatives. Start with prolonged dose interval and titrate. For transdermal dosing, start with 0.1 mg and increase as needed.