Clonidine

Clonidine is a medicine used in children to help treat a range of different conditions. Some of these conditions include high blood pressure, dystonia, pain, tic disorders (i.e. Tourette syndrome), attention deficit hyperactivity disorder (ADHD) and sleep disorders. It can also help to reduce symptoms of substance withdrawal, post-traumatic stress disorder (PTSD) and agitation.

Clonidine works in the brain to send messages to the rest of the body to relax blood vessels and muscles and reduce the heart rate.

Your child’s doctor or nurse practitioner will prescribe a particular dose based on the condition being treated and your child’s symptoms. The dose may be given once a day or multiple times a day.

Clonidine is available as a tablet, a patch, and a vial. The vial is generally used for inpatients only. Your child’s doctor will work out the most suitable option for your child.

While using this medicine – Remember

Immediately call 000 for an ambulance if your child is very drowsy, difficult to wake up or has difficulty breathing.

• If a dose is missed, never give a double dose to make up the missed dose.
• If more than one person gives your child their medication, communicate or write down the times doses are given so that you don’t give extra doses by mistake.
• Avoid stopping this medicine abruptly as this may cause side effects such as headaches or agitation.
• Always follow the plan provided by your doctor or pharmacist when stopping clonidine and ensure you have enough stock and do not run out.
• Always store this medicine out of reach of children.

Giving my child clonidine

Your doctor will work out the amount (the dose) that is right for your child and the duration of use. If you think the dose is not right or the medicine is not working, talk to your doctor.

The effects of clonidine may not be seen straight away and depends on the condition being treated. Your doctor may decide to start at a low dose and gradually increase the dose over a few weeks so your child can get used to the medicine.

Clonidine tablets are measured in micrograms (microg) and come in two different strengths, 100 micrograms and 150 micrograms. These products look very similar so always check you have the right strength before giving it to your child.

Clonidine also come as a vial which is 150 microg/mL.

The patch is 100 microg and is designed to slowly release the dose consistently over one week. This product is not registered in Australia, therefore it can only be dispensed and collected from a Queensland Health hospital.

When and how should I give clonidine?

Depending on the reason for using clonidine, it may be given once a day, up to four times daily. Your child’s doctor will decide the correct dose for your child. Never give more clonidine than prescribed by the doctor.

Do not stop giving clonidine to your child suddenly. Always talk to a doctor or pharmacist before stopping clonidine.

If using tablets

Clonidine tablets can be swallowed with water, milk or juice and may be taken with or without food.

Clonidine tablets should be taken at the same time each day for the best effect. The tablet may be crushed and mixed with water and given via a feeding tube or crushed and mixed with soft food, yoghurt, honey, or jam and given via the mouth. Some patients may only require a portion of a tablet, crushed and mixed with water or soft food.

If using a patch

Wash and dry hands thoroughly before applying a patch. Apply the patch to clean, dry skin, in a place that is hairless (i.e. upper, outer arm or upper chest) and in a place that is difficult for the child to reach.

After one week, remove the old patch before applying a new one. Fold the old patch with the sticky sides together and discard it in the general waste (out of reach of children or animals).

Always rotate patch application site to reduce skin irritation. The clonidine patch can be worn in the shower but may need to be replaced after swimming or heavy sweating. The patch must not be cut as this can change the absorption rate of the medication.

Remove the patch before a magnetic resonance imaging scan as it may cause skin burns at the patch site.

What to do if a dose is missed or my child vomits

Never give a double dose of the medicine to catch up a missed dose. If several doses in a row are missed, contact your doctor or pharmacist for advice.

If you forget to give a dose, give the dose as soon as you remember as long as there is 6 hours before the next dose is due. If there is less than 6 hours before the next dose, skip the missed dose and give the medicine at normal times. Do not wake your child to give a missed dose.

If your child vomits within 15 minutes after having a dose of clonidine, give them the dose again. If they vomit more than 15 minutes after having a dose of clonidine, do not give them another dose. Instead, wait until the next normal dose.

What to do if I give too much clonidine

If you think your child has had too much clonidine, call the Poisons Information Centre on 13 11 26 even if your child shows no effects. In an emergency, such as if they have difficulty waking up, excessive drowsiness, a new rash or breathing issues, call 000 for an ambulance or take your child to the hospital straight away. Bring the medicine packaging with you, even if it is empty, as this information will be useful.

What about using other medicines with clonidine?

Clonidine can also interact with some other prescription or over-the-counter medicines. Speak to your doctor and pharmacist before starting your child on any new medicines, including herbal or complementary medicines

You can give your child medicines that contain paracetamol or ibuprofen (anti-inflammatories) to treat pain and fever, unless your doctor has told you not to.

Avoid alcohol-containing foods, beverages or non-prescription medicines (for example, cough syrup) while taking this medication.

Possible side effects – what other effects can occur?

Take your child to hospital or call 000 for an ambulance if your child has:

• Severe drowsiness (sleepiness), or fatigue
• Severe allergic reaction (anaphylaxis) – wheezing, difficulty breathing, chest tightness, rash, and/or swelling of their face, lips, tongue or throat
• Irregular heartbeat
• Fainting
• Decreased frequency of urination, swelling of the body (particularly the hands and feet)
• Severe nausea or vomiting
• Changes in mood, increased agitation or restlessness.

Other side effects to be aware of – Some side effects go away with time or after the dose has been changed.

Speak to your doctor if you are worried about any of the following or if they continue.

• Mild-moderate allergic reaction – skin hives, rashes or itching
• Day time sleepiness/fatigue – this is usually worse in the first 2-4 weeks after commencing the medication and can last for a few hours after a dose. However, if your child becomes difficult to rouse, please seek medical attention immediately.
• Dizziness/light-headedness – this may occur when a child standing up too quickly. Care must be taken when riding bikes/scooters, climbing or activities needing balance or for older children, driving or operating machinery.
• Headaches – these are usually mild and should wear off after being on the medication for a short period. If they do not resolve or become worse, please seek medical attention.
• Stomach pain
• Nausea and vomiting
• Dry mouth
• Constipation or diarrhoea
• Irritation/redness from clonidine patch

There may be other side effects not listed above. If you notice anything unusual and are concerned, contact your doctor.

General medicine advice

Only give this medicine to your child who was prescribed it. Never give it to anyone else, even if their condition appears to be the same, as this could do harm. Contact Poisons Information Centre on 13 11 26 if another person takes this medicine.

Always have a valid prescription and enough supply of clonidine. Clonidine tablets can be purchased with a valid prescription from any community pharmacy.

Store clonidine tablets and patches at room temperature, in a cool dry place away from heat, direct sunlight and moisture, below 25 oC.

Dispose of expired medicines or medicines you no longer need at your local pharmacy.

Store all medicines out of sight and where children cannot reach them. Always keep medicine in the container or box that it came in.

For more information

This fact sheet is about using this medicine in children and young people. Some information may be different from the manufacturer’s Consumer Medicine Information (CMI). Talk to your doctor, nurse or pharmacist if you have any questions or concerns.

Contact us

In an emergency, always contact 000 for immediate assistance

Pharmacy Department
Level 2, Queensland Children’s Hospital
501 Stanley Street, South Brisbane 4101
t: 07 3068 1901 (9am – 5pm Mon – Fri)
(9am – 12pm Sat – Sun/public holidays)

Updated: Jan 2023.

Endorsed by Queensland Children’s Hospital Medication Safety Committee and developed by Pharmacy with input from parents and carers.

Contact CHQMedicationSafety@health.qld.gov.au for sources used to create this Fact Sheet.

Disclaimer: We take great care to make sure the information in this Fact Sheet is correct, up-to-date and reflects current use in Australia. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something.

This Fact Sheet is to be used as an aid, rather than a substitute for a discussion with your doctor or pharmacist. Children’s Health Queensland Hospital and Health Service accepts no responsibility for any inaccuracies, omissions, reliance placed, or the success of any treatment regimens detailed in this Fact Sheet.