Clonidine, Oral/Transdermal

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KEY POINTS

• This medicine is taken by mouth or applied to the skin to treat high blood pressure. Use it exactly as directed.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antihypertensive

Generic and brand names: clonidine, oral; clonidine, transdermal; Catapres; Catapres-TTS

What is this medicine used for?

This medicine is taken by mouth or applied to the skin to treat high blood pressure. It may be used alone or with other medicines.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A stroke or transient ischemic attack (TIA)
• Heart disease, blood vessel disease, or a heart attack
• Kidney or liver disease
• Low blood pressure or a history of fainting

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine comes as:

• Tablets that you take by mouth
• Patches that stick to your skin

Check with your healthcare provider before using this medicine in children under age 18 years.

Check the label on the medicine for directions about your specific dose. Take the tablets exactly as your healthcare provider prescribes. Take them regularly, even when you feel well. You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach. Take the medicine at the same time each day to help you remember to take it.

If you are using stick-on patches, read the information sheet that comes in the medicine package for how to properly use the patches. Ask your healthcare provider or pharmacist about anything you do not understand.

Wash your hands before and after using this medicine. Put the sticky side of the patch on clean, dry skin of your upper arm or chest. Avoid areas where bending or rubbing might happen. Choose a spot with no hair or broken skin. Do not put it where your clothing might rub it off. Make sure all the edges of the patch are firmly attached. If the patch becomes loose or falls off while you are wearing it, follow the directions on the information sheet in the medicine package for what to do.

Each week, before putting on a new patch, remove the old patch. Do not apply the new patch in the exact same place as the old patch. Your skin may become irritated. Remove the old patch and fold it in half with the sticky sides together. Throw it away in a place away from children or pets.

Do not stop taking this medicine without your healthcare provider's approval. You may need to reduce your dosage gradually.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: drowsiness, slow heartbeat, diarrhea, cold clammy skin, slow breathing, weakness, fainting, seizures, coma.

What should I watch out for?

If you develop extreme nervousness, shakiness, headache, or increased blood pressure after you stop taking this medicine, contact your healthcare provider right away.

If you are dehydrated (due to diarrhea or sweating heavily) or you have lost salt from your system, this medicine may cause low blood pressure (lightheadedness, dizziness, fainting). If you feel faint, lie down until the reaction passes. You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may lessen this effect. Talk with your healthcare provider if this happens often.

This medicine may increase the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines, such as cough or cold medicines, unless your healthcare provider approves.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

This medicine may cause dry eyes. Talk with your provider about this if you wear contact lenses.

This medicine may cause dry mouth. Sucking hard candy, taking sips of water, or chewing sugarless gum may help. Check with your healthcare provider or dentist if this problem does not go away or becomes severe.

You need frequent checks of your blood pressure and heart rate while taking this medicine. Talk with your healthcare provider about this.

Occasionally, this medicine may cause some sexual problems or make you feel tired or rundown for the first few weeks that you take it. Do not stop taking the medicine without talking with your healthcare provider.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine. The patch may need to be removed before certain tests or procedures such as MRIs.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Cold feeling in your hands or feet; depression; confusion; unexplained swelling; fast, slow, or pounding heartbeat; chest pain; trouble urinating; severe dizziness or fainting; severe drowsiness; severe rash, redness, burning, or blisters from the patch.

Other: Dry mouth, dry eyes, dizziness, drowsiness, nervousness, weakness, headache, decreased appetite, constipation, nausea, vomiting, trouble sleeping, abnormal dreams, mild rash or redness from the patch, change in sexual desire or ability.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), and prazosin (Minipress)
• Alzheimer’s disease medicines such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon)
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antianxiety medicines such as alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• Antidepressants such as amitriptyline, citalopram (Celexa), desipramine (Norpramin), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), mirtazapine (Remeron), nortriptyline (Pamelor), sertraline (Zoloft), and venlafaxine (Effexor)
• Antihistamines such as chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), and hydroxyzine (Vistaril)
• Antipsychotic medicines such as aripiprazole (Abilify), asenapine (Saphris), chlorpromazine, haloperidol (Haldol), iloperidone (Fanapt), olanzapine (Zyprexa), paliperidone (Invega), pimozide (Orap), quetiapine (Seroquel), risperidone (Risperdal), thioridazine, trifluoperazine, and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), felbamate (Felbatol), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), phenytoin (Dilantin, Phenytek), primidone (Mysoline), tiagabine (Gabitril), and topiramate (Qudexy, Topamax, Trokendi)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), betaxolol, bisoprolol (Zebeta), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Cancer medicines such as ceritinib (Zykadia), crizotinib (Xalkori), and obinutuzumab (Gazyva)
• Cyclosporine (Gengraf, Neoral, Sandimmune)
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Doxepin (Silenor)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• Fingolimod (Gilenya)
• Flibanserin (Addyi)
• Heart medicines such as amiodarone (Cordarone, Pacerone), digoxin (Lanoxin), dronedarone (Multaq), isosorbide (Dilatrate, Isordil, Monoket), nitroglycerin (Minitran, Nitro-Dur, Nitrostat), and propafenone (Rythmol)
• Levodopa/carbidopa (Duopa, Rytary, Sinemet)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Methyldopa
• Methylphenidate (Concerta, Daytrana, Metadate, Ritalin)
• Muscle relaxants such as baclofen (Gablofen, Lioresal), carisoprodol (Soma), cyclobenzaprine (Amrix), dantrolene (Dantrium), methocarbamol (Robaxin), and tizanidine (Zanaflex)
• Natural remedies such as bayberry, black cohosh, blue cohosh, California poppy, dong quai, ephedra, ginger, ginseng, goldenseal, gotu kola, hawthorn, kava, licorice, shepherd’s purse, St. John's wort, valerian, and yohimbe
• Nausea medicines such as prochlorperazine (Compro) and promethazine
• Other medicines that contain clonidine (Kapvay)
• Pain medicines such as codeine, fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone (Hysingla, Zohydro), meperidine (Demerol), oxycodone (OxyContin, Roxicodone), oxycodone/acetaminophen (Percocet, Roxicet), pentazocine (Talwin), tapentadol (Nucynta), and tramadol (ConZip, Ultram)
• Parkinson's disease medicines such as pramipexole (Mirapex) and rasagiline (Azilect)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Sleeping pills such as temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo)
• Topiramate (Qudexy, Topamax, Trokendi)

Do not drink alcohol while taking this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.