Clonidine + Metoprolol TartrateContraindicated
Metoprolol may exacerbate rebound hypertension following clonidine withdrawal. Withdraw metoprolol several days before gradual clonidine withdrawal.
Source: NLP:metoprolol tartrate
Clonidine Interactions
Brand names: Clonidine
Central alpha-2 Adrenergic Agonist · Adrenergic alpha2-Agonists
Route: Oral
FDA Black Box Warning
The 500 mcg/mL strength product should be diluted prior to use in an appropriate solution. NOTE: Clonidine hydrochloride injection (epidural clonidine) is not recommended for obstetrical, post-partum, or peri-operative 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, post-partum or peri-operative patient, potential benefits may outweigh the possible risks.
Contraindications
4 CONTRAINDICATIONS History of a hypersensitivity reaction to clonidine. Reactions have included generalized rash, urticaria, angioedema.( 4 ) Clonidine hydrochloride extended-release tablets are contraindicated in patients with a history of a hypersensitivity reaction to clonidine. Reactions have included generalized rash, urticaria, and angioedema [see Adverse Reactions ( 6 )].
Pregnancy & Breastfeeding
8.1 Pregnancy Pregnancy Exposure Registry There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ADHD medications, including clonidine hydrochloride extended-release tablets, during pregnancy. Healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for ADHD Medications at 1-866-961-2388 or visiting https://womensmentalhealth.org/adhd-medications/. Risk Summary Prolonged experience with clonidine in pregnant women over several decades, based on published literature, including controlled trials, a retrospective cohort study and case reports, have not identified a drug associated risk of major birth defects, miscarriage, and adverse maternal or fetal outcomes. In animal embryofetal studies, increased resorptions were seen in rats and mice administered oral clonidine hydrochloride from implantation through organogenesis at 10 and 5 times, respectively, the maximum recommended human dose (MRHD) given to adolescents on a mg/m 2 basis. No developmental effects were seen in rabbits administered oral clonidine hydrochloride during organogenesis at doses up to 3 times the MRHD (see Data) . The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriages in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. Data Animal Data Oral administration of clonidine hydrochloride to pregnant rabbits during the period of embryo/fetal organogenesis at doses of up to 80 mcg/kg/day (approximately 3 times the oral maximum recommended daily dose [MRHD] of 0.4 mg/day given to adolescents on a mg/m 2 basis) produced no developmental effects. In pregnant rats, however, doses as low as 15 mcg/kg/day (1/3 the MRHD given to adolescents on a mg/m 2 basis) were assoc
52 interactions on record
Negative chronotrope. Potentiates electrophysiologic and hemodynamic effects resulting in bradycardia, sinus arrest, and AV block.
Source: NLP:amiodarone hydrochloride
Clonidine + AtenololMajor
Beta-blockers may exacerbate rebound hypertension following clonidine withdrawal; careful withdrawal timing required.
Source: NLP:atenolol
Beta-blockers may exacerbate rebound hypertension following clonidine withdrawal; beta-blocker should be withdrawn several days before gradual clonidine cessation.
Source: NLP:atenolol and chlorthalidone
Bisoprolol fumarate should be discontinued several days before clonidine withdrawal to avoid excessive sympathetic rebound.
Source: NLP:bisoprolol fumarate
Bisoprolol should be discontinued several days before clonidine withdrawal to avoid rebound hypertension and excessive sympathetic reduction.
Source: NLP:bisoprolol fumarate and hydrochlorothiazide
May cause hypotension and bradycardia; beta-blocker should be discontinued first when terminating concomitant therapy.
Source: NLP:carvedilol
Concomitant use may cause hypotension and bradycardia; beta-blocker should be discontinued first when stopping both drugs.
Source: NLP:carvedilol phosphate
Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported with clonidine and diltiazem concomitantly.
Source: NLP:clonidine
Sinus bradycardia resulting in hospitalization and pacemaker insertion reported with concurrent use. Heart rate monitoring required.
Source: NLP:diltiazem hydrochloride
Potentiates pressor effects of epinephrine.
Source: NLP:epinephrine
Beta blockers increase risk of clonidine-withdrawal rebound hypertension. If antihypertensive therapy must be interrupted, discontinue beta blocker first and gradually.
Source: NLP:esmolol hydrochloride
Increases bradycardia risk; beta-blockers may exacerbate rebound hypertension following clonidine withdrawal. Withdraw metoprolol several days before gradual clonidine withdrawal.
Source: NLP:metoprolol
Beta-blocker may exacerbate rebound hypertension following clonidine withdrawal. Withdraw metoprolol several days before gradual clonidine withdrawal, or delay metoprolol introduction for several days after stopping clonidine.
Source: NLP:metoprolol succinate
Beta-blocker may exacerbate rebound hypertension following clonidine withdrawal. Withdraw metoprolol several days before gradual clonidine withdrawal.
Source: NLP:metoprolol succinate er tablets
Beta-blocker withdrawal several days before clonidine withdrawal required to avoid exacerbating rebound hypertension; concomitant use also increases risk of bradycardia.
Source: NLP:metoprolol tartrate and hydrochlorothiazide
Discontinue nebivolol several days before gradual tapering of clonidine to avoid excessive reduction of sympathetic activity.
Source: NLP:nebivolol
May produce excessive reduction of sympathetic activity. Nebivolol must be discontinued several days before gradual tapering of clonidine.
Source: NLP:nebivolol hydrochloride
α-2 adrenergic agonist that increases the pressor effect of phenylephrine hydrochloride.
Source: NLP:phenylephrine hci
α-2 adrenergic agonist that increases the pressor effect of phenylephrine hydrochloride.
Source: NLP:phenylephrine hydrochloride
Alpha-2 adrenergic agonist increases pressor effect of phenylephrine hydrochloride.
Source: NLP:phenylephrine hydrochloride injection, solution
Beta-blockers may antagonize clonidine's antihypertensive effects and rebound hypertension may result if clonidine is withdrawn abruptly. Withdraw beta-blocker several days before clonidine withdrawal.
Source: NLP:propranolol hydrochloride
Concomitant use increases risk of bradycardia and rebound hypertension upon discontinuation. Withdraw sotalol several days before gradual clonidine withdrawal.
Source: NLP:sotalol hydrochloride
Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported with clonidine and verapamil concomitantly.
Source: NLP:clonidine
Sinus bradycardia resulting in hospitalization and pacemaker insertion reported. Monitor heart rate during concurrent use.
Source: NLP:verapamil hydrochloride
Clonidine + AlcoholModerate
Clonidine may potentiate the CNS-depressive effects of alcohol.
Source: NLP:clonidine
Clonidine + ApraclonidineModerate
Caution advised with simultaneous use of clonidine and other similar pharmacologic agents.
Source: NLP:apraclonidine
Clonidine + BarbituratesModerate
Clonidine may potentiate the CNS-depressive effects of barbiturates.
Source: NLP:clonidine
Monitor heart rate in patients receiving clonidine concomitantly with calcium channel blockers, which affect sinus node function or AV nodal conduction.
Source: NLP:clonidine
Tricyclic antidepressants may block the pharmacologic effects of clonidine.
Source: NLP:clomipramine hydrochloride
Tricyclic antidepressants including clomipramine may block the pharmacologic effects of clonidine.
Source: NLP:clomipramine hydrochloride capsules
Clonidine + Digitalis GlycosidesModerate
Monitor heart rate in patients receiving clonidine concomitantly with digitalis, which affects sinus node function or AV nodal conduction.
Source: NLP:clonidine
Clonidine + Ephedrine SulfateModerate
Augments pressor effect of ephedrine. Carefully monitor blood pressure.
Source: NLP:ephedrine sulfate
Potentiates the effects of epinephrine.
Source: NLP:epinephrine in sodium chloride
Clonidine + GlimepirideModerate
May lead to either potentiation or weakening of glimepiride's glucose-lowering effect. May also reduce signs of hypoglycemia.
Source: NLP:glimepiride
Clonidine + GlipizideModerate
May lead to either potentiation or weakening of glucose-lowering effect; may mask hypoglycemia signs.
Source: NLP:glipizide
May increase or decrease the blood glucose lowering effect and blunt signs/symptoms of hypoglycemia. Increased glucose monitoring required.
Source: NLP:insulin aspart
Clonidine + Insulin Aspart-SzjjModerate
May increase or decrease blood glucose lowering effect and blunt signs/symptoms of hypoglycemia. Increased glucose monitoring required.
Source: NLP:insulin aspart-szjj
Clonidine + Insulin DegludecModerate
May increase or decrease blood glucose lowering effect and blunt hypoglycemia signs/symptoms. Dosage adjustment and increased glucose monitoring may be required.
Source: NLP:insulin degludec
Clonidine + Insulin GlargineModerate
May increase or decrease blood glucose lowering effect and blunt signs/symptoms of hypoglycemia. Dosage adjustment and increased glucose monitoring required.
Source: NLP:insulin glargine
Clonidine + Insulin GlulisineModerate
May increase or decrease blood glucose lowering effect and may blunt signs/symptoms of hypoglycemia. Dose adjustment and increased glucose monitoring required.
Source: NLP:insulin glulisine
Clonidine + Insulin HumanModerate
May increase or decrease blood glucose effect and blunt hypoglycemia signs; increased glucose monitoring required.
Source: NLP:insulin human
Clonidine + Insulin LisproModerate
May increase or decrease blood glucose lowering effect and may blunt signs/symptoms of hypoglycemia; increased glucose monitoring required.
Source: NLP:insulin lispro
Clonidine + Insulin Lispro-AabcModerate
May increase or decrease blood glucose lowering effect and blunt signs/symptoms of hypoglycemia. Dose adjustment and increased glucose monitoring required.
Source: NLP:insulin lispro-aabc
Clonidine + Macimorelin AcetateModerate
May transiently elevate growth hormone concentrations and impact accuracy of MACRILEN diagnostic test. Avoid concomitant use.
Source: NLP:macimorelin acetate
Clonidine + NateglinideModerate
May blunt signs and symptoms of hypoglycemia. Increased frequency of glucose monitoring may be required.
Source: NLP:nateglinide
Concomitant use can potentiate electrophysiologic and hemodynamic effects, resulting in bradycardia, sinus arrest, and AV block.
Source: NLP:nexterone (amiodarone hci)
Monitor heart rate in patients receiving clonidine concomitantly with beta-blockers, which affect sinus node function or AV nodal conduction.
Source: NLP:clonidine
Clonidine + Timolol HemihydrateModerate
Oral beta-blockers may exacerbate rebound hypertension following clonidine withdrawal, though no reports with ophthalmic timolol.
Source: NLP:timolol hemihydrate
Clonidine + Timolol MaleateModerate
Oral beta-adrenergic blocking agents may exacerbate rebound hypertension following clonidine withdrawal, though no reports exist for ophthalmic timolol maleate.
Source: NLP:timolol maleate
Oral beta-adrenergic blocking agents may exacerbate rebound hypertension following clonidine withdrawal; no reports with ophthalmic timolol maleate.
Source: NLP:timolol maleate ophthalmic gel forming solution
Clonidine + AmitriptylineUnknown
Amitriptyline in combination with clonidine enhances the manifestation of corneal lesions in animal studies.
Source: NLP:clonidine