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Clonidine (Epidural route)

Pronunciation:

KLOE-ni-deen

Brand Names:

  • Duraclon

Dosage Forms:

  • Solution
  • Injectable

Warnings:

Epidural route(Solution)

The 500-mcg/mL strength product should be diluted prior to use in an appropriate solution. Epidural clonidine is not recommended for obstetrical, postpartum, or perioperative pain management. The risk of hemodynamic instability, especially hypotension and bradycardia, from epidural clonidine may be unacceptable in these patients. However, in a rare obstetrical, postpartum or perioperative patient, potential benefits may outweigh the possible risks .

Classifications:

Therapeutic—

Analgesic

Pharmacologic—

Alpha-2 Adrenergic Agonist

Uses of This Medicine:

Clonidine injection is used with injected pain medicine to treat pain in cancer patients.

Clonidine is to be started under the immediate supervision of your doctor. After your doctor has seen how you respond to clonidine, you may be able to receive this medicine at home.

This medicine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, clonidine is used in certain patients with the following medical conditions:

  • Post-operative shivering (to prevent or treat shivering that occurs after an operation or anesthesia)

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Although there is no specific information comparing use of clonidine in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults. This medicine is usually used in children only when the pain is severe and other pain medicines did not help.

Older adults—

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of clonidine in the elderly with use in other age groups.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acebutolol
  • Amitriptyline
  • Amoxapine
  • Atenolol
  • Betaxolol
  • Bevantolol
  • Bisoprolol
  • Carteolol
  • Celiprolol
  • Clomipramine
  • Crizotinib
  • Desipramine
  • Dilevalol
  • Diltiazem
  • Dothiepin
  • Doxepin
  • Esmolol
  • Imipramine
  • Levobunolol
  • Lofepramine
  • Metipranolol
  • Metoprolol
  • Mirtazapine
  • Nadolol
  • Nebivolol
  • Nortriptyline
  • Oxprenolol
  • Penbutolol
  • Pindolol
  • Propranolol
  • Protriptyline
  • Sotalol
  • Tertatolol
  • Timolol
  • Trimipramine
  • Verapamil

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cyclosporine
  • Fluphenazine
  • Mepivacaine
  • Naloxone
  • Yohimbine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Anticoagulant therapy or
  • Bleeding problems—Bleeding into the area around the spinal cord is possible
  • Heart or blood vessel disease—Clonidine may make these conditions worse
  • Infection at the place of injection or catheter (tube)—The risk of developing meningitis or an abscess is increased
  • Kidney disease—Effects of clonidine may be increased because of slower removal of clonidine from the body
  • Pain associated with surgery or
  • Pain during or following childbirth—The ability to tolerate some of the potential side effects of clonidine may be decreased

Proper Use of This Medicine:

Clonidine is given continuously as an epidural infusion (run around the spinal cord) using an infusion pump. The pump and its tube should be checked regularly to make sure the clonidine flow has not stopped accidentally. The injection or catheter site should also be checked regularly for signs of infection.

If you are using this medicine at home, make sure you understand exactly how to use it.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form:
    • For pain:
      • Adults—30 mcg per hour given as a continuous infusion.
      • Children—Dosage is based on body weight and must be determined by your doctor.

Missed dose—

Call your doctor or pharmacist for instructions.

Tell your doctor immediately if you think the clonidine has stopped for any reason.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

This medicine should not be stopped without the doctor's supervision. Serious side effects may occur if clonidine is stopped suddenly.

This medicine may add to the effects of alcohol and other CNS depressants (medicine that may make you drowsy or less alert). Check with your doctor before taking any such depressants while you are using this medicine.

Dizziness, light-headedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help.

This medicine may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common
Dizziness, light-headedness, or fainting
slow heartbeat
Less common
Chest pain
extremely shallow or slow breathing
fast heartbeat
fever
hallucinations (seeing, feeling, or hearing things that are not there)
mental depression
sleepiness (excessive)
vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Anxiety
confusion
dry mouth
nausea
sleepiness
Less common
Constipation
ringing, buzzing, or other unexplained noises in the ears
sweating, unusual
weakness

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Agitation
headache
nervousness
pounding heartbeat
shaking or trembling

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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