Clonidine in Pregnancy and Breastfeeding

Risk Factor: CM
Class: Central nervous system drugs / Central analgesics

Contents of this page:
Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers

Fetal Risk Summary

No reports linking the use of clonidine with congenital defects have been located. The drug has been used during all trimesters, but experience during the 1st trimester is very limited. Adverse fetal effects attributable to clonidine have not been observed (1,2,3,4,5,6,7 and 8).

Reproduction studies in rats at doses as low as 1/3 the oral maximum recommended daily human dose [MRDHD] on a weight basis (1/15 times the MRDHD on a mg/m2 basis), started before gestation, resulted in increased resorptions (9). Decreased embryo/fetal survival was not observed when these doses were used on gestation days 615, but did occur in both mice and rats at doses 40 times the MRDHD based on weight or 4 to 8 times the MRDHD based on surface area. No embryo or fetal toxicity or teratogenicity was observed in rabbits given doses up to 3 times the MRDHD (weight basis) (9).

In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 59 newborns had been exposed to clonidine during the 1st trimester (F. Rosa, personal communication, FDA, 1993). Three (5.1%) major birth defects were observed (three expected), two of which were cardiovascular defects (0.6 expected). No anomalies were observed in five other categories of defects (oral clefts, spina bifida, polydactyly, limb reduction defects, and hypospadias) for which specific data were available. The number of exposures is too small to draw any conclusions.

The pharmacokinetics of clonidine during pregnancy have been reported (10). The mean maternal and cord serum concentrations in 10 women were 0.46 and 0.41 ng/mL, respectively, corresponding to a cord:maternal ratio of 0.89. The mean amniotic fluid concentration was 1.50 ng/mL. The mean maternal dose was 330 g/day. Results of neurologic examinations and limited blood chemistry tests in the exposed infants were similar to those in untreated controls. No neonatal hypotension was observed.

Breast Feeding Summary

Clonidine is secreted into breast milk (8,10). Following a 150-g oral dose, milk concentrations of 1.5 ng/mL may be achieved (milk:plasma ratio 1.5) (P.A. Bowers, personal communication, Boehringer Ingelheim, Ltd., 1981). In a study of nine nursing women taking mean daily doses of 391.7 g (postpartum days 15), 309.4 g (postpartum days 1014), and 241.7 g (postpartum days 4560), milk concentrations were approximately twice those in maternal serum (10). Mean milk levels were close to 2 ng/mL or higher during the three sampling periods. Hypotension was not observed in the nursing infants, although clonidine was found in the serum of the infants (mean levels less than maternal). The long-term significance of this exposure is not known.

References

  1. Turnbull AC, Ahmed S. Catapres in the treatment of hypertension in pregnancy, a preliminary study. In Catapres in Hypertension. Symposium of the Royal College of Surgeons. London, 1970:23745.
  2. Johnston CI, Aickin DR. The control of high blood pressure during labour with clonidine. Med J Aust 1971;2:132.
  3. Raftos J, Bauer GE, Lewis RG, Stokes GS, Mitchell AS, Young AA, Maclachlan I. Clonidine in the treatment of severe hypertension. Med J Aust 1973;1:78693.
  4. Horvath JS, Phippard A, Korda A, Henderson-Smart DJ, Child A, Tiller DJ. Clonidine hydrochloride a safe and effective antihypertensive agent in pregnancy. Obstet Gynecol 1985;66:6348.
  5. Horvath JS, Korda A, Child A, Henderson-Smart D, Phippard A, Duggin GC, Hall BM, Tiller DJ. Hypertension in pregnancy: a study of 142 women presenting before 32 weeks' gestation. Med J Aust 1985;143:1921.
  6. NG Wingtin L, Frelon JH, Beaute Y, Pellerin M, Guillaumin JP. Clonidine et traitement de l'hypertension arterielle de la femme enceinte. Cah Anesthesiol 1986;34:38993.
  7. Ng-Wing Tin L, Frelon JH, Beaute Y, Pellerin M, Guillaumin JP, Bazin C. Clonidine et traitement de l'hypertension arterielle de la femme enceinte. Rev Franc Gynecol Obstet 1986;81:5636.
  8. Wing-Tin LNG, Frelon JH, Hardy F, Bazin C. Clonidine et traitement des urgences hypertensives de la femme enceinte. Rev Franc Gynecol Obstet 1987;82:51922.
  9. Product information. Catapres. Boehringer Ingelheim Pharmaceuticals, 2000.
  10. Hartikainen-Sorri A-L, Heikkinen JE, Koivisto M. Pharmacokinetics of clonidine during pregnancy and nursing. Obstet Gynecol 1987;69:598600.

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Questions and Answers

clonidine ?, ok my friend hes a big drugy he wants to know if he snort clonidine if he will get high now this isnt for me i have done drugs yess but i stop

If your friend snorts clonidine he won't get high, he'll be lying low when his bloodpressure is non existant and you are calling 911

Can anyone tell me their experiances with clonidine for Percocet withdrawels?, I am ready to stop Percocet and my DR suggested clonidine. Can anyone share their experiances?

I had used clonidine for hydrocodone withdrawals once. I did not make it with the clonidine I still had to much withdrawal for my comfort. I ended up using a med called suboxone. That worked perfect as there were no withdrawals and I was off the hydrocodone instantly and the suboxone within two weeks. The only thing with the suboxone is that you have to see a Dr. that has a certain license in order to precribe. Im not saying that the clonidine won't help you as everybody reacts to meds differently, im just saying it was not that great for me. Long story short if the clonidine don't work I would ask about the suboxone because if you are serious and can't stand the withdrawals that is the most comfortable way to go. Give the clonodine a try though because if you can make it with the clonidine you won't have to replace an opiate with an opiate. Also if you do go the suboxone route they do ween you off the suboxone and there is no withdrawal. Kind of long winded I hope this helps though. I wish you the best.

What should I expect from the medication CLONIDINE?, Ive been prescribed Adderall XR for a little bit now, and all of the sudden my doctor prescribes me "clonidine." I researched it online and such (yet still unsure), but my question exactly is, if i take one of these 0.1 mg. pills, what will i feel like PHYSICALLY? Tired, drunkenly, wired, twitchy, happy? none of the above? I don't like to be surprised with things like this. Anybody know?

Drowsiness and dizziness is pretty common. You might also develop headache, diarrhea, cotton mouth, fatigue, etc.

how can i get prescription with out a doctor for clonidine?, I have no insurance currently and not under physicians care been paying out of the pocket for my medicine for my high blood pressure, prescription I have Clonidine has to be approved by a doctor and I need this medicine what do I do?

Clonidine is a medicine that requires a physician's prescription, there's no way around that. If you're worried about cost of a visit, find a free / discounted clinic in your area and implore the doctor there to prescribe it for you.

How long should I wait to start taking clonidine after quitting methadone?, I have been on 90 mg's/d for 6 months, but have gradually decreased to 20 mg's/d.

You should speak to your doctor about this. It all depends on the patient. If your doctor recommended that you take clonidine. Then you should wait approximately 3 months with Methadone blood tests every 3 weeks. You should directly speak to your doctor about this.

Do you know of any contraindications between clonidine and ativan?, Is it dangerous to take both of these drugs simultaneously?

No, you shouldn't have any problems. Clonidine is a beta blocker that lowers your blood pressure, and ativan is an anti-anxiety drug.

It says clonidine for adhd She told me High blood pressure?, I went on internet and they say its for alot of things anybody been on it. Iam tense and sleepy on it and more depressed.

Clonidine is for high blood pressure. i give it all the time.

Does clonidine hurt your eyes in any way?, I had read somewhere before about it and i can't find it now. If anyone could help me i would appreciate it. Thank you so much.

Catapres side effects


Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Catapres.


Side effects may include:
Agitation, constipation, dizziness, drowsiness, dry mouth, fatigue, impotence, loss of sex drive, nausea, nervousness, sedation (calm), vomiting, weakness

if i stop taking clonidine would that cause a sudden weight gain?, i have been taking clonidine for 2 years and i stopped taking it about 3 months ago. i have noticed a weight gain of 20 pounds since then.

consult your doctor

Has anyone used the Clonidine Transdermal Patch for high blood pressure?, Directions say doesn't work for 2-3 days...do you take oral Clonidine for that 2-3 days? Did you have any problems or adverse side effects?

Clonidine TD will enter your skin at a slow rate. It may not have full effectiveness for the initial 2-3 days but it will likely have some lesser effectiveness. I would not take oral Clonidine in the mean time. It is a very potent bp medication and the oral version is relatively short acting. As a result you are likely to cause your blood pressure to yo-yo if you take oral Clonidine. A few days of suboptimally controlled blood pressure is not usually a horrible thing. Keep track of it. Call your doctor (or go to the ED) if the top number exceeds 205 and if the bottom number exceeds 105. or if you are feeling symptoms associated with high blood pressure.

Good luck.