How to replace clonidine to lower blood pressure. Application and dosage

• 1 Release form of "Clonidine", its dosage and composition
• 2 Pharmacology medicine"Clonidine"
• 3 Indications for use
• 4 Brief summary and instructions for using “Clonidine” for blood pressure
• 5 Contraindications for use
• 6 Use during pregnancy
• 7 Can it be prescribed to children?
• 8 Interaction with alcohol
• 9 "Clonidine" and other drugs
• 10 Side effects on the body
• 11 Recommendations for use
• 12 Medicinal analogues

Clonidine is one of the widely used antihypertensive drugs. The use of Clonidine for the treatment of high blood pressure gained popularity at the end of the last century, and it is still often prescribed by doctors for high blood pressure. This medicine is used as during standard therapy arterial hypertension, and to relieve hypertensive crises.

Release form of "Clonidine", its dosage and composition

international generic name(INN) "Clonidine" and its active substance- clonidine. This substance belongs to the group of alpha2-adrenergic receptor stimulants (alpha-adrenergic agonists). Clonidine was first obtained in the middle of the last century and was used to treat the common cold. Later, its ability to reduce the level of blood pressure. IN present time This remedy is mainly prescribed for high blood pressure. This medicine also contains additional substances that are responsible for its appearance and safety. Clonidine is produced in the form of tablets and solution for injection.

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Pharmacology of the drug "Clonidine"

The mechanism of action of "Clonidine" is due to its active substance clonidine. This substance, as already mentioned, belongs to the group of alpha2-adrenergic agonists. This group of drugs acts on the adrenal receptors of the vascular center in the brain, stimulates them, thereby inhibiting the production of norepinephrine, as a result of which the resistance of the vascular walls decreases and cardiac output decreases. In addition, clonidine acts on imidazole receptors, which is why this drug helps reduce heart rate.

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Indications for use

A constant increase in blood pressure requires the use of antihypertensive drugs.

• complex therapy of arterial hypertension (hypertension);
• fight against hypertensive (hypertensive) crises;
• opiate drug addiction with withdrawal syndrome (as a component of complex therapy);
• primary glaucoma.

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Brief summary and instructions for using "Clonidine" for blood pressure

Instructions for use and method of administration of this drug depend on the type and severity of the pathology. Clonidine tablets are used for continuous treatment of arterial hypertension and reduction high pressure. The dose is always selected by the doctor individually. Start with a minimum dose of 0.075 mg. Take 2 tablets. 2−3 times a day. At the discretion of the doctor and based on the severity of the patient's condition, the dosage may be increased. Injections are prescribed intravenously, subcutaneously or intramuscularly. When administered intravenously, “Clonidine” is diluted with a physiological 0.9% solution and administered slowly. With subcutaneous or intramuscular method administration, the medicine is not diluted. Injectable liquid "Clonidine" is used to relieve crisis conditions. For glaucoma, it is instilled into the eye. For this, 0.5%, 0.25% or 0.125% solution concentrations are used. Use drops 2-4 times a day.

Despite the fact that a prescription for the purchase of Clonidine is optional, it is not recommended to use this drug alone without a doctor's prescription.

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Contraindications for use

A mental disorder is a contraindication to taking the drug "Clonidine".

The list of contraindications to the appointment of the drug "Clonidine" is as follows:

• individual sensitivity to the active substance or other components of the drug;
• arterial hypotension (low blood pressure);
• depressive disorders;
• cardiogenic shock;
• atherosclerosis of cerebral vessels;
• violation of the passage of excitation through the conductive structures of the heart (heart block);
• renal failure;
• Parkinson's disease.

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Use during pregnancy

"Clonidine" during pregnancy is not recommended for prescription and use, since the active substance of this drug is able to penetrate the placental barrier and can lead to the development of pathology in the fetus. During breastfeeding this tool is also contraindicated for use. If it becomes necessary to prescribe "Clonidine" during lactation, breastfeeding must be stopped.

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Can it be prescribed to children?

The use of the drug "Clonidine" in childhood contraindicated. In case of occurrence critical situation When a child is required to prescribe such a medicine, the decision on the appointment and appropriateness of use is made exclusively by a specialist doctor.

The hypotensive effect of clonidine (international non-proprietary name - clonidine) is due to stimulation of the central α 2A -adrenergic receptors of the brain stem, which is accompanied by a decrease in the tone of the sympathetic part of the autonomic nervous system. The decrease in the concentration of norepinephrine in the blood is directly correlated with the hypotensive effect of this drug.

Clonidine lowers blood pressure by affecting both cardiac output and total peripheral vascular resistance. A decrease in sympathetic influences on the heart leads to a decrease in the frequency and strength of heart contractions. Renal blood flow and glomerular filtration rate do not change.

When taking clonidine, salt and water may be retained, therefore, if necessary, a diuretic is additionally prescribed.

Application area

Clonidine is prescribed primarily for all forms of arterial hypertension, for the relief of hypertensive crises, in ophthalmology - in the treatment of certain forms of glaucoma. In addition, clonidine:

• facilitates the manifestations of alcohol, opioid and nicotine withdrawal syndromes, and also reduces cravings for these substances;
• has an antidiarrheal effect in diabetic autonomic neuropathy;
• reduces hot flashes during menopause;
• applied as aid at general anesthesia due to its analgesic and sedative properties;
• prescribed for attention deficit hyperactivity disorder and Gilles de la Tourette syndrome (multiple tics, including vocal tics, outbursts of aggression and coprolalia);
• is used for differential diagnosis between essential hypertension and pheochromocytoma (a hormonally active tumor that secretes catecholamines);
• effective in severe autonomic failure, which is characterized by severe orthostatic hypotension.

In patients with upper cervical injury spinal cord blood pressure after taking clonidine does not decrease.

In all cases, clonidine is used only on prescription!

For arterial hypertension, clonidine is usually combined with diuretics, but it can also be used as monotherapy. Due to its strong effect on the central nervous system, clonidine cannot be considered a drug of choice.– both as monotherapy and in combination with diuretics. Rebound syndrome occurs, as a rule, in patients taking high doses of clonidine, therefore, even with severe arterial hypertension, more than 0.3 mg of this drug should not be prescribed per day.

Side effect

Side effects of clonidine are rarely life-threatening, but are often poorly tolerated and lead to refusal of treatment. By at least, half of the patients during therapy with this drug experience drowsiness and dry mouth. After a few weeks, these effects may decrease, but almost every tenth patient refuses to take clonidine due to persistent drowsiness and dry mouth, as well as decreased potency, nausea or lightheadedness. Dry mouth may be accompanied by dry mucous membranes of the nose and eyes, swelling and soreness. parotid glands. When using clonidine patches, dry mouth and drowsiness occur less frequently than when taken orally (the maximum serum concentration may not reach such high values).

To more rare side effects the central nervous system includes colorful and nightmare dreams, anxiety and depression. Due to a decrease in sympathetic influences on the heart in sick sinus syndrome, a pronounced decrease in heart rate and even arrest of the sinus node is possible, and in case of disturbances of atrioventricular conduction or the simultaneous use of drugs with a negative dromotropic effect (slowing down atrioventricular conduction) - atrioventricular block. In approximately 15-20% of cases, clonidine patches cause contact dermatitis.

With abrupt withdrawal of clonidine, rebound syndrome is possible, manifested by headache, anxiety, tremor, abdominal pain, sweating and rapid heartbeat. Blood pressure may exceed the level that was noted before treatment, although rebound arterial hypertension doesn't always happen. The listed symptoms occur 18-36 hours after discontinuation of clonidine. They are caused by overexcitation sympathetic system, which is confirmed by an increase in the concentration of catecholamines in urine and plasma. The frequency of rebound syndrome is not known exactly, but it rarely occurs at a daily dose of the drug up to 0.3 mg and is much more common (and more severe) at higher doses. After discontinuation of the clonidine patch, rebound arterial hypertension also occurs.

Overdose

In case of an overdose of clonidine, depression of consciousness develops, blood pressure temporarily increases, then develops arterial hypotension, bradycardia and respiratory depression. The latter is accompanied by miosis (constriction of the pupils), which resembles opioid poisoning. Measures are taken to maintain breathing; for bradycardia, atropine or sympathomimetics (adrenaline) are indicated; infusion therapy, if necessary - dopamine or dobutamine.

Drug interactions

Undesirable interactions of clonidine with other drugs are rare. Diuretics increase its hypotensive effect, and this is quite predictable. Tricyclic antidepressants (amitriptyline) hypotensive effect drug; the mechanism is unknown. When taking clonidine simultaneously with neuroleptics (antipsychotic drugs), the sedative effect increases. Drinking alcohol while using clonidine is strictly prohibited! It should be remembered that the body's reaction to joint use clonidine with ethanol (narcotic sleep, amnesia, coma, death) is often used in the criminal world.

Release form

Clonidine is sold in the form of an injection solution of 0.01%, tablets of 75 and 150 mcg, extended-release film-coated tablets of 300 mcg, transdermal patches, as well as eye drops 0.125%, 0.25% and 0.5%.

Analogues

Structural analogues of clonidine, the active ingredient of which is also clonidine, include:

• Apo-Clonidine (Canada);
• Barclid (France);
• Hemiton (Germany);
• Catapresan (Germany);
• Clonidine-Darnitsa (Ukraine);
• Clofelin-M (Ukraine);
• Chlofazolin (Bulgaria), etc.

You should not choose clonidine substitutes on your own. Only the attending physician will be able to select the correct drug and take into account the release form and dosage. There are contraindications; consultation with a doctor is required.

Clonidine is one of the trade names a medicine called "". This is a medicine belonging to the group of imidazoline derivatives.

The medicine was synthesized in the sixties of the 20th century. Initially, this was supposed to be a remedy for the common cold; this prescription was due to its adrenergic stimulating effect and reduction of spasms. But, after a certain period of use, it was discovered that the drug significantly reduces blood pressure.

In the 20th century, clonidine was used as a blood pressure lowering agent; the main manufacturer was a plant called Organika.

Clonidine - characteristics

Externally it is a crystalline powder white, which dissolves well and instantly in water, is much more difficult to dissolve in alcohol.

Has a clear hypotensive effect (lowers blood pressure). The use of the drug makes the heart rate much lower, calms and normalizes the activity of the central nervous system, and intraocular pressure also noticeably decreases.

How does the powder work? The work of clonidine occurs due to the stimulating effect on postsynaptic alpha2-adrenergic receptors of the inhibitory parts of the brain, and also the sympathetic impulse to the heart and blood vessels decreases.

Clonidine (the same name Clonidine) acts as an antihypertensive agent, the main effect of which is on the neurogenic area of ​​vascular tone. The medicine provides a short-lived pressor effect. As the drug acts, the effect increases parasympathetic system on the heart, the release of norepinephrine through the nerve endings decreases, and the secretion of adrenaline slows down.

A distinctive feature of clonidine is that it has the ability to disqualify the somatovegetative manifestations of alcohol and opiate abstinence. As a result, the person experiences a lack of feelings of fear, feelings of excitement and frustration, and improves heartbeat, the person stops being nervous and worried. Experts have proven that this effect is achieved due to the fact that during the action of clonidine, central adrenergic activity noticeably decreases.

The medication has two forms of release:

1. In the form of tablets;
2. In the form of a solution for injection.

The main active ingredient is clonidine, excipients clonidine contains:

• Potato starch;
• Milk sugar;
• Magnesium stearate.

One tablet may contain 0.075 mg or 0.15 mg of the main active ingredient (clonidine). Sold in packs of ten or fifty.

One ampoule of injection solution contains 0.1 mg of clonidine. Sold in packs of ten ampoules.

It should be noted that the tablets can be stored for 4 years, and the injection solution for 3 years.

Indications for use

In what cases is a patient prescribed clonidine? So, the main medical indications to the use of clonidine are:

Contraindications

Every patient should know that before using any medicinal product it is necessary to obtain competent advice from a competent specialist, a doctor who prescribes drug treatment, based on the person’s medical history.

Clonidine has a number of contraindications, in the presence of which it is prohibited to take the drug even in small doses:

Side effects in overdose

In cases of overdose of the drug, as well as in the presence of allergic reactions or individual intolerance, the following may occur side effects from taking clonidine:

Elderly people and patients suffering from kidney problems should obtain additional medical advice, as this category may have a special sensitivity to the main active ingredient (clonidine), as well as too slow elimination of the drug.

Clonidine has many uses. It is used orally, administered intramuscularly and subcutaneously, and also in the form of eye drops. When a patient is treating hypertension, clonidine is prescribed orally or parenterally; for eye problems (high eye pressure) it is used as instillation.

Typically, a specialist prescribes treatment with clonidine orally in a volume of 0.075 mg 3-4 times a day. The duration of the course can range from a couple of weeks to a year, depending on the effectiveness of treatment, as well as on how the drug is tolerated by the body.

For intramuscular and subcutaneous administration use a dosage of 0.01 mg, 0.5 or 1.5 ml per ampoule, and for intravenous injections the same amount of solution must be diluted in 15 ml isotonic solution sodium chloride, then inject very slowly into a vein (approximately 7-11 minutes). Parenteral clonidine can only be used in hospitals or by emergency medical technicians.

Clonidine and alcohol - use for criminal purposes

Clonidine has become widespread in the criminal world; every ordinary person hears this name and knows that the drug has a strong hypnotic effect.

An overdose of the active substance clonidine in combination with alcohol intake instantly leads to a hypnotic effect, which is necessarily accompanied by loss of consciousness for a long period of time. This is extremely dangerous, as the probability of death is high.

Criminals often use this tool to carry out their plans. If you add clonidine to alcohol, the effect occurs instantly, and during this time the lawbreaker will have time to do his business (carry out a robbery, for example).

Clonidine is an effective antihypertensive tablet. It has long been used in the treatment of hypertension, hypertensive crisis, and periodic rises in blood pressure. They provide a hypotensive, sedative and analgesic effect. Even small doses of the drug when administered intravenously almost immediately reduce blood pressure. This phenomenon is called “at the tip of the needle.”

Handle the medicine carefully! As required by the instructions for use, otherwise death is possible. Its price is low. However, to buy the drug, you need a prescription.

Effect of the drug

The active substance of the drug is clonidine. Auxiliary elements – lactose, magnesium stearate, starch.

Release forms:

• solution for injection in ampoules 0.01%;
• tablets 0.15 mg, 0.075 mg (can be purchased in blisters, glass and plastic bottles);
• powder substance;
• eye drops 0.125% (the drug is available in a dropper tube).

The active substance of the drug affects the neurogenic regulation of human vascular tone. The hypotensive effect after taking the tablet appears within an hour or two. Duration – 6-8 hours.

The clonidine solution acts immediately. This is due to its immediate absorption. Antihypertensive drug stimulates the vasomotor center medulla oblongata postsynaptic alpha-2 adrenergic receptors, reduces sympathetic pulsation to the heart and blood vessels.

If the solution is administered quickly, a short-term increase in blood pressure may occur. This is due to the activation of postsynaptic alpha-2 adrenergic receptors.

Eye drops are a drug from the group of antiglaucoma drugs.

Directions of action of clonidine:

1. The medicine reduces cardiac output and reduces cerebral blood flow.
2. At the same time, the drug reduces resistance in the peripheral vascular system. Including renal vessels. Blood flow increases in them.
3. Severe drowsiness appears. A calming effect is observed.
4. Minor pain goes away.
5. The feeling of fear decreases.
6. The heart rate gradually levels out and the headache stops.

Medicine drops are used to treat primary open-angle glaucoma: the solution is used to reduce intraocular pressure.

How is clonidine absorbed?

The tablets are well absorbed from the gastrointestinal tract.

1. The maximum concentration in blood plasma is after two to four hours.
2. The drug is 20-40% bound to albumin.
3. Approximately 50% of the absorbed substance is metabolized in the liver.
4. The half-life is 12-16 hours (with normally functioning kidneys), up to 40 hours (with kidney dysfunction).
5. Up to 60% of the active substance is excreted unchanged by the kidneys. About 20% - through the intestines.

The solution is absorbed faster:

• The maximum concentration after administration is within an hour and a half.
• Easily and quickly penetrates the placenta and into breast milk.

Appointments

To buy the drug, you need a special (on a certain form) prescription. There are also analogues prescription. Such precautions are due to the fact that criminal poisoning with clonidine is becoming increasingly common.

And the price of the product is minimal - anyone can buy it.

Indications for use:

• arterial hypertension;
• periodic increase in pressure;
• relief of hypertensive crisis;
• withdrawal syndrome for alcoholism and drug addiction (as part of complex treatment).

Contraindications

Absolute contraindications to taking clonidine:

• high sensitivity to the active substance,
• bright sinus bradycardia,
• atrioventricular block 2-3 degrees,
• SSS (sick sinus syndrome),
• pregnancy,
• lactation,
• alcohol intoxication,
• age up to fifteen years.

Relative contraindications (take the drug with caution):

• depressive state ( a sharp decline pressure may worsen the condition);
• coronary heart disease (especially after a recent heart attack);
• severe chronic heart failure;
• cerebrovascular pathologies;
• disorders of peripheral circulation, intracardiac conduction;
• constipation,
• diabetes mellitus (clonidine can mask the symptoms of hypoglycemia and interfere with insulin secretion);
• work requiring increased attention, fast response;
• taking tricyclic antidepressants.

If clonidine therapy is necessary during lactation, you should stop breastfeeding.

Directions for administration and dosage

The dose and treatment regimen are selected according to individually taking into account age, diagnosis, concomitant diseases in the anamnesis.

Instructions:

1. Antihypertensive tablets are initially prescribed at a minimum dosage of 0.075 mg 2-4 times a day.
2. If this dose is ineffective, add 0.0375 mg to a single dose every other day or two. A single dose is adjusted to 0.15-0.3 mg.
3. Usually daily dosage is 0.3-0.45 mg. Less often it is adjusted to 1.5 mg.
4. The maximum single dose is 0.3 mg. Per day – 1.5 mg.
5. If the maximum dosage of clonidine is ineffective, prescribed additional medications. These can be saluretics, vasodilators, prazonin tablets. Sometimes - beta-blockers (very carefully).
6. To relieve a hypertensive crisis – 1-2 tablets.
7. For adolescents over fifteen years of age weighing over 45 kg – 1 tablet 2-3 times a day.

Use of clonidine in elderly patients:

1. For older people, the dose is reduced due to decreased kidney function.
2. With atherosclerosis of cerebral vessels, hypersensitivity to clonidine may occur, resulting in hypotension and severe sedation. Therapy begins with 0.0375 mg.
3. The active substance of the drug may accumulate. Therefore, the interval between doses is extended, and the single dosage is reduced by a third or half.

The therapeutic course ranges from several weeks to a year or more.

Treatment with clonidine is characterized by withdrawal syndrome. Rising blood pressure, nervousness appears, headache. Therefore, at the end of the course, the dosage is gradually reduced until completely discontinued.

Features of treatment of withdrawal syndrome in alcoholism and drug addiction:

• the medicine is prescribed at 0.15-0.3 mg 3 times a day (in a hospital setting);
• interval between doses – 6-8 hours;
• duration – 5-7 days;
• if side effects occur, clonidine is discontinued gradually.

How to use the solution in ampoules? Instructions:

• To relieve a hypertensive crisis - 0.5-1.5 ml intramuscularly or subcutaneously.
• If this dose is not enough to reduce blood pressure, the solution is administered up to 3-4 times a day.
• For intravenous administration the solution (0.5-1.5 ml) is diluted in 10-20 ml of isotonic sodium chloride solution. It is injected very slowly into a person’s vein, over 3-5 minutes.

Side effects

From the heart and blood vessels:

• pronounced bradycardia,
• atrioventricular block,
• violation of fluid outflow,
• chilly fingers, pain, paleness (Raynaud's syndrome);
• orthostatic circulatory disorders.

Undesirable effects from the gastrointestinal tract:

• insufficient production of gastric secretions,
• feeling of dry mouth,
• constipation,
• poor appetite or lack thereof.

Undesirable effects from the central nervous system:

• fatigue,
• drowsiness,
• slow mental and motor response,
• dizziness,
• numbness of the limbs,
• nervousness.

Other effects:

• decreased libido, potency,
• skin itching, rashes (often local),
• nasal congestion.

An overdose of clonidine is much more pronounced.

Signs of overdose

The drug should be taken strictly in the dosage prescribed by the doctor. If the amount of the product is increased, the state of health worsens significantly. Moreover, the consequences can be dire.

Overdose is manifested by the following symptoms:

• headache,
• blurred vision,
• inhibited reactions
• loss of consciousness,
• severe weakness
• apnea and other signs of respiratory dysfunction,
• hypotension,
• arrhythmia,
• pale skin,
• disturbance of intestinal motility.

The lethal dosage has not been precisely established. Death associated with the state of human health. On average, an overdose occurs after a single dose

• 0.509 mg - for children,
• 2.096 mg - for an adult.

What to replace

Clonidine is one of the "oldest" drugs for the treatment of arterial hypertension. Today, prescriptions for it are not written out so often: doctors prefer to use modern substitutes. However, it is clonidine and its analogues that help many hypertensive patients, containing the same active substance in certain concentrations. And the price is such that even low-income people can afford it.

Analogues:

• hemitone (active substance – clonidine),
• Chlophazoline (active ingredient – ​​clonidine),
• catapresan,
• barklid,
• apo-clonidine,
• Clonidine hydrochloride.

All analogues contain clonidine. It is fast. But the effect does not last long. And the withdrawal syndrome can be very vivid.

Interaction with other drugs

Concomitant use of clonidine with the following groups of drugs is undesirable:

1. Antidepressants, because the hypotensive effect decreases.
2. Neuroleptics, which aggravate sedative effect and can lead to depression.
3. Benzodiazepines. Concomitant use may cause depression.
4. Nifedipine. The hypotensive effect of clonidine decreases.
5. Quinidine. This combination provokes bradycardia.
6. Diuretics, vasodilators (due to increased hypotensive effect).
7. Ethanol. Under the influence of clonidine, the drug depresses the central nervous system.
8. Narcotic analgesics (their effect is enhanced).
9. Non-steroidal anti-inflammatory drugs, under the influence of which blood pressure decreases worse.

Strictly prohibited simultaneous administration clonidine with adrenaline, aminazine, norepinephrine, hypoglycemic drugs.

Prices

You can buy clonidine and its analogs at any pharmacy. Because overdose can be fatal, a prescription is required.

• The maximum price in Moscow is 42 rubles.
• Minimum price - 31 rubles.
• The price of analogues ranges from 30-70 rubles.
• The average price for an injection is 40 rubles.

International name

Group affiliation

Dosage form

pharmachologic effect

A centrally acting antihypertensive drug, it stimulates postsynaptic alpha2-adrenergic receptors of the vasomotor center of the medulla oblongata and reduces the flow of sympathetic impulses to the vessels and heart at the presynaptic level. Reduces OPSS and IOC, reduces heart rate. With rapid intravenous administration, a short-term increase in blood pressure is possible due to stimulation of postsynaptic alpha1-adrenergic receptors of blood vessels. Increases renal blood flow; increasing cerebral vascular tone, reduces cerebral blood flow; has a pronounced sedative effect.

Duration therapeutic effect– 6-12 hours

Indications

Contraindications

Side effects

From the outside digestive system: dry mouth, loss of appetite, nausea, vomiting, constipation, decreased gastric secretion.

From the side of the nervous system: asthenia, drowsiness, slowing down of the rate of mental and motor reactions, anxiety, nervousness, depression, vivid or "nightmarish" dreams.

From the cardiovascular system: bradycardia, orthostatic hypotension; with intravenous administration – an increase in blood pressure (short-term).

From the outside genitourinary system: decreased potency and/or libido.

Allergic reactions: skin rash, itching.

Others: Raynaud's syndrome, Na + and water retention, manifested by swelling of the feet and ankles, nasal congestion; in case of sudden withdrawal – withdrawal syndrome, “hemitonic crisis”.

Application and dosage

Orally, regardless of food intake, at an initial dose of 0.075 mg 3 times a day. If necessary, the dose is gradually increased to an average daily dose of 0.9 mg. The maximum single dose is 0.3 mg; maximum daily dose– 2.4 mg.

Elderly patients, especially those with manifestations of cerebrovascular disease, are prescribed an initial dose of 0.0375 mg 3 times a day.

The drug is withdrawn gradually over 1-2 weeks.

As a means of preventing headaches of vascular origin: orally, 0.025 mg 2-4 times a day, if necessary, increase the dose to 0.05 mg 3 times a day.

For dysmenorrhea: orally, 0.025 mg 2 times a day for 14 days before and during menstruation.

As an auxiliary drug in treatment autonomic symptoms during menopause: orally, 0.025-0.075 mg 2 times a day.

To relieve a hypertensive crisis - sublingually (in the absence of severe dry mouth) or intravenously or intramuscularly at a dose of 0.15 mg.

For intravenous jet administration, 1 ml of solution is diluted in 10 ml of 0.9% NaCl solution and injected over 7-10 minutes.

For intravenous drip administration, 4 ml of solution is diluted in 500 ml of 5% dextrose solution and administered at an average speed of 20 drops/min. Maximum speed infusion – 120 drops/min.

special instructions

Currently, clonidine is being pushed out of widespread practice due to a sharp but short-term decrease in blood pressure followed by a phase of increased blood pressure ("hemitonic crises").

At acute heart attack myocardium, as well as for the treatment of vasomotor symptoms due to dysmenorrhea or menopause, withdrawal syndrome in drug addicts and labile arterial hypertension, its use is especially undesirable. In these cases, imidazoline receptor agonists are preferred.

With long-term parenteral administration of clonidine, intraocular pressure must be regularly monitored.

To prevent orthostatic hypotension during intravenous administration, the patient should be in horizontal position during and for 1.5-2 hours after injection.

The development of a weakly positive Coombs reaction is possible.

During the treatment period, care must be taken when driving vehicles and engaging in other potentially dangerous species activities requiring increased concentration attention and speed of psychomotor reactions.

Interaction

Strengthens the effect of drugs that depress the central nervous system and ethanol.

The effect is enhanced by other vasodilators, diuretics and antihistamines; weaken - tricyclic antidepressants, anorexigenic drugs (with the exception of fenfluramine - enhances), NSAIDs and sympathomimetics.

Beta-blockers and / or cardiac glycosides increase the risk of developing bradycardia and AV blockade.

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