Clonidine

The Basics

What is Clonidine?

Used to treat high blood pressure, attention deficit hyperactivity disorder, drug withdrawal, menopausal flushing, diarrhea, and certain pain conditions.

Brand names for Clonidine

Catapres

How Clonidine is classified

Antihypertensive Agents, Adrenergic alpha-2 Receptor Agonists

Clonidine During Pregnancy

Clonidine pregnancy category

Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Clonidine while pregnant

Reproduction studies performed in rabbits at doses up to approximately 3 times the oral maximum recommended daily human dose (MRDHD) of Catapres® (clonidine hydrochloride, USP) tablets produced no evidence of a teratogenic or embryotoxic potential in rabbits. In rats, however, doses as low as 1/3 the oral MRDHD (1/15 the MRDHD on a mg/m² basis) of clonidine were associated with increased resorptions in a study in which dams were treated continuously from 2 months prior to mating. Increased resorptions were not associated with treatment at the same time or at higher dose levels (up to 3 times the oral MRDHD) when the dams were treated on gestation days 6 to 15. Increases in resorption were observed at much higher dose levels (40 times the oral MRDHD on a mg/kg basis; 4 to 8 times the MRDHD on a mg/m² basis) in mice and rats treated on gestation days 1 to 14 (lowest dose employed in the study was 500 μg/kg). No adequate, well-controlled studies have been conducted in pregnant women. Clonidine crosses the placental barrier (see CLINICAL PHARMACOLOGY, Pharmacokinetics). Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Taking Clonidine While Breastfeeding

What are recommendations for lactation if you're taking Clonidine?

Because of the high serum levels found in breastfed infants, possible infant side effects, and the possible negative effects on lactation, other antihypertensive agents are preferred, especially while nursing a newborn or preterm infant.[1] Clonidine used as a single postpartum dose as a neuraxial analgesia adjunct probably has not been studied, but it may reduce the need for other medications or their dosages, and appears unlikely to affect breastfeeding.[2]

Maternal / infant drug levels

Because of the high serum levels found in breastfed infants, possible infant side effects, and the possible negative effects on lactation, other antihypertensive agents are preferred, especially while nursing a newborn or preterm infant.[1] Clonidine used as a single postpartum dose as a neuraxial analgesia adjunct probably has not been studied, but it may reduce the need for other medications or their dosages, and appears unlikely to affect breastfeeding.[2]

Possible effects of Clonidine on milk supply

Clonidine has complex, dose-related actions on both oxytocin and prolactin secretion. The net effect of the drug on nursing mothers has not been well studied. A case of hyperprolactinemia and gynecomastia occurred in a 6-year-old boy taking clonidine for hyperactivity and valproic acid for a seizure disorder. Galactorrhea ceased within 3 weeks of discontinuing clonidine.[7] A case of clonidine-induced postpartum galactorrhea has also been reported.[8] The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Possible alternatives to Clonidine

(Hypertension) Enalapril, Hydrochlorothiazide, Methyldopa, Propranolol.