8 Clonidine Side Effects and How to Manage Them

Clonidine (Nexiclon XR, Catapres-TTS) was FDA approved over 40 years ago to manage hypertension (high blood pressure). Since then, it’s also been approved to treat ADHD in children and pain related to cancer. It’s used off-label for other conditions, too, such as restless leg syndrome, tics, and migraines.

This versatile medication is an alpha agonist. It reduces blood pressure by slowing your heart rate and relaxing your blood vessels. 

Clonidine comes in several forms, such as an immediate-release (IR) tablet, an extended-release (ER) tablet, and a topical patch. It also comes as an eye drop and an injection.

Promotion disclosure

Clonidine

Avg retail price

$1.64(Save Free%)

GoodRx discount

$1.64

See all discounts

How it works

Use GoodRx to find medications, pharmacies, and discounts.

GoodRx discounts can help you pay less for your prescription.

Bring your free coupon or savings card to the pharmacy.

Although clonidine offers several benefits, it generally isn’t a first-choice medication. It’s typically only recommended when other options haven’t worked well on their own or as combination treatment. This is due to its risk of side effects. Let’s discuss these in more depth. 

Clonidine side effects at a glance

Some clonidine side effects are mild, while others are more serious.

Relatively common and mild clonidine side effects include:

• Dry mouth

• Drowsiness

• Low energy

• Dizziness

• Constipation

• Rash

• Headache

More serious side effects of clonidine include:

• Depression or mood changes

• Sexual side effects

• Withdrawal effects

• Rebound hypertension 

The side effects you may experience from clonidine depend on the form of the medication you take.

EXPERT PICKS: WHAT TO READ NEXT

• Fighting off side effects: A dry mouth is clonidine’s most common side effect. Here are the best tips for managing it. 

• Optimizing your prescription: The best way to take clonidine depends on many factors. Determine which clonidine dosage is best for you.

• Avoiding medication interactions: Clonidine can interact with other medications, leading to extra side effects. Here’s how to steer clear of them.
  
  

Here’s what to know about eight notable clonidine side effects.

1. Dry mouth

Dry mouth is the most common side effect of clonidine. During clinical trials, about 40% of people taking the tablets and 25% of people using the patch had dry mouth. 

Dry mouth can occur for a variety of reasons. Fortunately, there are many over-the-counter (OTC) products and at-home remedies that can be used to manage it, including:

• Sugar-free gum: Chewing sugar-free gum promotes saliva production. An alternative to gum is sugar-free hard candy.

• Cool liquids: Drinking cool liquids, such as water or unsweetened beverages, can help combat dry mouth. Drink plenty of water each day and avoid caffeinated beverages.

• Saliva substitutes, such as Biotene: These OTC products provide fluids, proteins, and nutrients to the saliva to help relieve dry mouth. Pick one based on your preference — research doesn’t indicate which is best.  

Dry mouth isn’t a serious condition, especially when it’s short-lived. But it can lead to dental decay and infections over time. It’s recommended to brush your teeth two times per day with a toothpaste with fluoride, floss, and use an alcohol-free mouthwash. Be sure to see a dentist for regular checkups and cleanings as well.

If at-home remedies and OTC products aren’t working, talk to your healthcare professional (HCP). There are prescription products that can help as well. 

2. Drowsiness

If you feel more tired after you start taking clonidine, you’re not alone. The good news is that this feeling should subside as your body gets used to the medication. But make sure you can be fully awake before doing activities that require you to be alert, like driving.

In the meantime, there are many ways to manage drowsiness. Taking your dose of clonidine closer to bedtime is one way to combat feeling sleepy from the medication. If you’re taking the IR version, ask your HCP if you can take a larger portion of the dose before bed to curtail some of the drowsiness you feel. Trying the patch version, which is changed once weekly, may be another good option to try.

Maintaining a healthy diet and ensuring you’re getting adequate rest at night can also help with feeling tired. Try to avoid alcohol as well as other substances that can worsen drowsiness, too.

3. Dizziness

Dizziness is another common side effect of many medications, including clonidine. It can affect your daily routine and increase your risk of falls. So it’s recommended to take your medication in a safe, still place until you know how it affects you.

If you do become dizzy from taking clonidine, find a place to sit or lie down. Avoid any sudden movements. Drinking water or eating some food may help relieve some of the dizziness. But talk to your HCP if your dizziness seems severe or long-lasting.

4. Constipation

Constipation is another common complaint with clonidine. It occurs more frequently with the tablets than the patches.

You can prevent constipation by making some minor lifestyle changes. Make sure you’re drinking enough water every day and eating a fiber-rich diet. Getting regular exercise can help as well.

There are also many OTC products that help treat constipation if you end up needing some extra support. Examples include docusate sodium (Colace), psyllium (Metamucil), and bisacodyl (Dulcolax). Your pharmacist can help you narrow down your options.

5. Depression

Although rare, clonidine can cause or contribute to depression when taken long term. Depression symptoms may not appear right away, so your HCP will likely be monitoring you for it throughout treatment.

Listen to your body and be honest about how you’re feeling. Report any signs or symptoms of depression to your HCP. These may include:

• Feeling sad, hopeless, or disconnected from daily life

• Losing enjoyment or interest in activities

• Noticing changes in sleeping and/or eating patterns

• Having trouble concentrating or feeling motivated

• Feeling guilty or worthless

For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line. 

6. Skin-related side effects

Skin-related side effects can occur with clonidine — especially if you’re using the patch. Most often, these include skin redness or itching. They typically happen at the site of the patch, which is usually placed on the upper outer arm or chest. 

Rarer skin-related side effects include allergic skin reactions, hyperpigmentation (skin darkening), and swelling. Burning, throbbing, and rash can also occur.   

Fortunately, there are many options for managing a skin-related side effect from clonidine, including:

• Cold compresses: Applying an ice pack to the affected area for 5 to 10 minutes, several times per day, may relieve redness, inflammation, and itching.

• Cooling agents: Using products that contain menthol or camphor around the affected area can help reduce itchiness.

• Topical steroids: Low-dose topical steroids, such as hydrocortisone, are effective anti-itch agents that can be used once or twice daily for up to 2 weeks. 

Before using topical treatments to help with skin side effects, make sure you’re not applying the treatment on top of or underneath a clonidine patch. This could change the amount of medication you’re getting from the patch. 

Avoid scratching the skin, too. This could cause the area to become more irritated and inflamed. You can also rotate the site where you place a new patch to allow for your skin to heal.

7. Sexual changes

Clonidine may occasionally contribute to sexual problems such as loss of sexual ability, interest, or performance. Clonidine isn’t the only medication with this side effect, though. Many medications can cause sexual changes, including other blood pressure medications.

There are a few things you can do to help improve sexual changes caused by medication. First, talk to your HCP. Your prescriber may recommend a clonidine dose adjustment. They may also prescribe another medication to help address these symptoms, such as sildenafil (Viagra) or tadalafil (Cialis), which treat erectile dysfunction. In some cases, they may suggest switching to a different blood pressure medication that doesn’t cause as many sexual problems.

8. Sudden withdrawal risks

You should never stop taking clonidine without talking to your HCP first. Doing so can be dangerous. This is the main reason why clonidine isn’t typically prescribed as a first-choice option for high blood pressure. 

Abruptly stopping it can lead to rebound hypertension — a rapid and dangerous increase in blood pressure. Serious problems, including an increased risk of heart disease, stroke, and damage to the kidneys, can occur if high blood pressure remains untreated. 

You may also have withdrawal symptoms if you stop taking clonidine abruptly. These symptoms can include agitation, tremor, and confusion. These sudden withdrawal risks are caused by a “surge” of stress hormones. 

You can safely stop taking clonidine by decreasing your dose slowly over time. Talk to your HCP to come up with a plan to effectively stop taking it. 

Why trust our experts?

Written by:

Cassandra Pardini, PharmD, MS

Cassandra Pardini has been a freelance medical writer for 7 years. In that time, she has concentrated on publishing articles on medication-related information for healthcare professionals and patients.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Our editorial standards

Meet our experts