Key takeaways:
Clonidine (Nexiclon XR, Catapres-TTS, Duraclon) is a prescription medication that’s FDA approved to manage high blood pressure, ADHD among children, and cancer-related pain.
Clonidine isn't typically prescribed as a first-choice medication due to its risk of side effects.
Common clonidine side effects include dry mouth, drowsiness, and dizziness. Rare but serious clonidine side effects include depression, sexual changes, and dangerously high blood pressure.
To avoid withdrawal symptoms, never stop taking clonidine abruptly or without talking to your prescriber first. Contact your prescriber about any serious side effects or symptoms that don’t improve or worsen over time.
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Clonidine (Nexiclon XR, Catapres-TTS, Duraclon) is an older medication that’s FDA approved to manage hypertension (high blood pressure), alongside a couple other uses. It belongs to a class of drugs called alpha agonists. It works by lowering the level of a chemical messenger in your brain called norepinephrine. Too much norepinephrine in your body can cause stress and high blood pressure. So lowering the amount slows your heart rate and helps lower blood pressure.
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. This is due to its risk of side effects.
If you've been prescribed clonidine, it’s important to understand the possible side effects and how to manage them. Some clonidine side effects are mild and may improve over time, but others can be more serious.
Clonidine side effects at a glance
Below are lists of both common and rare clonidine side effects. Keep in mind this isn’t a complete list and other side effects may occur.
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
Here, we’ll discuss 10 clonidine side effects and how to manage them.
Keep in mind: 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 injection and ER suspension (liquid). It’s important to note that side effects may vary depending on the form used because each delivers the medication differently.
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.
Fortunately, there are many over-the-counter (OTC) products and at-home remedies that can be used to manage dry mouth, including:
Sugar-free gum: Chewing sugar-free gum promotes saliva production. An alternative to gum is sucking on sugar-free hard candy.
Cool liquids: Drinking plenty of cool liquids, such as water or unsweetened beverages, can help combat dry mouth. And be sure to avoid caffeinated beverages, since they can dehydrate you more.
Saliva substitutes, such as Biotène: These OTC products provide fluids, proteins, and nutrients to saliva to help relieve dry mouth. They are available as liquids, gels, sprays, and lozenges. Some saliva substitutes may work better than others for lasting relief. But you’ll likely need to try different products before you find what works best for you.
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 at least 2 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 a healthcare professional. 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 feel fully awake before doing activities that require you to be alert, such as driving.
In the meantime, there are ways to manage drowsiness. Taking your dose of clonidine closer to bedtime is one way to combat sleepiness. If you’re taking the IR version twice a day, ask your prescriber if you can take a larger portion of the dose before bed to lower your chance of daytime tiredness. Trying the once-weekly patch may be another good option to try.
Maintaining a nutritious diet and ensuring you’re getting enough rest at night can also help improve your energy levels. 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 raise 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 feel dizzy after 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. Speak with your prescriber if your dizziness seems severe or long-lasting.
4. Constipation
Constipation is another common complaint with clonidine. It occurs more frequently with the tablets.
You can prevent constipation by making some minor lifestyle changes. Be sure to drink enough water every day and eat a fiber-rich diet. Getting regular exercise can help too.
There are many OTC products that help relieve constipation if you end up needing some extra support. Examples include docusate sodium (Colace), psyllium (Metamucil), and bisacodyl (Dulcolax). Your pharmacist can help find an option that would likely work well for you.
5. Nausea
Clonidine may also cause nausea. It often improves as your body gets used to the medication.
You can take clonidine with or without food, but taking it with food may help ease nausea. You can also consider eating smaller but more frequent meals, staying hydrated, and avoiding spicy or fried foods to help manage symptoms.
Your prescriber may also give you a lower dose of clondine at first, then gradually raise your dose to help prevent stomach problems.
6. Headache
Headache is another possible side effect of clonidine. Some people may notice headaches soon after starting clonidine, but they may improve over time as your body adjusts to the medication.
If you’re experiencing headaches while taking clonidine, an OTC pain reliever like acetaminophen (Tylenol) is generally safe to take. But check with your prescriber before trying a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (Advil, Motrin) or naproxen (Aleve). These options may raise your blood pressure.
Staying hydrated, exercising, and getting enough sleep may also help relieve a headache.
7. Depression
Although rare, clonidine can cause or contribute to depression when taken long term. Depression symptoms may not appear right away, so your prescriber will likely be monitoring your mood throughout your treatment with clonidine.
Listen to your body and be honest about how you’re feeling. Report any signs or symptoms of depression to your healthcare team. 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 988 Suicide & Crisis Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
8. 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, itching, or blisters. They typically happen where the patch is applied, 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.
Thankfully, there are many options for managing skin-related side effects 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.
9. Sexual changes
Clonidine may occasionally contribute to sexual problems such as loss of sexual ability, interest, or performance. But clonidine isn’t the only medication with this side effect. Many medications can cause sexual changes, including other blood pressure medications.
Fortunately, there are a few things you can do to help improve sexual changes caused by medication.
First, talk to your prescriber. They may recommend a clonidine dose adjustment. They may also prescribe another medication to help address these symptoms, such as sildenafil (Viagra), which treats erectile dysfunction. And other medications, such as Addyi (flibanserin) can help with women experiencing a drop in sex drive.
In some cases, your prescriber may suggest switching to a different blood pressure medication that doesn’t cause as many sexual problems.
10. Sudden withdrawal risks
You should never stop taking clonidine without talking to a healthcare professional first. Suddenly stopping clonidine can cause a surge in norepinephrine. This may lead to withdrawal symptoms such as agitation, tremor, and confusion.
Abruptly stopping clonidine can also cause rebound hypertension — a rapid and dangerous increase in blood pressure. If your blood pressure stays too high, it can raise the risk of serious problems such as heart disease, stroke, or kidney damage.
If you need to stop taking clonidine, your prescriber can help you do so safely. This usually involves slowly lowering your dose over time to lower the risk of withdrawal symptoms and rebound high blood pressure.
Frequently asked questions
Yes, clonidine lowers your heart rate. Clonidine is an alpha agonist, so it works by calming certain signals in your brain to make your heart beat slower. This helps relax your blood vessels and lower your blood pressure too.
Typically not. Studies suggest that people taking clonidine may experience weight gain, but it’s not very common. If you notice weight gain while taking clonidine, talk to your prescriber. It may be a sign of another underlying health issue that needs attention.
Not usually. Clonidine isn’t known to cause water retention. If you notice swelling in your hands, feet, or ankles, speak with your prescriber. Sometimes fluid retention or swelling can be a sign of another issue, such as an allergic reaction or kidney problems.
Clonidine side effects usually get better over time as your body adjusts to the medication. Mild side effects may improve within a few days to a couple of weeks. If your side effects don’t go away or get worse at any point, speak with your prescriber.
Yes, clonidine lowers your heart rate. Clonidine is an alpha agonist, so it works by calming certain signals in your brain to make your heart beat slower. This helps relax your blood vessels and lower your blood pressure too.
Typically not. Studies suggest that people taking clonidine may experience weight gain, but it’s not very common. If you notice weight gain while taking clonidine, talk to your prescriber. It may be a sign of another underlying health issue that needs attention.
Not usually. Clonidine isn’t known to cause water retention. If you notice swelling in your hands, feet, or ankles, speak with your prescriber. Sometimes fluid retention or swelling can be a sign of another issue, such as an allergic reaction or kidney problems.
Clonidine side effects usually get better over time as your body adjusts to the medication. Mild side effects may improve within a few days to a couple of weeks. If your side effects don’t go away or get worse at any point, speak with your prescriber.
The bottom line
Clonidine (Nexiclon XR, Catapres-TTS, Duraclon) is a blood pressure medication that treats many health conditions. But, it’s not typically used as a first-choice medication due to its risk of side effects. Mild clonidine side effects include dry mouth, drowsiness, and dizziness. Depression, sexual changes, and withdrawal symptoms are more serious clonidine side effects. Talk to a healthcare professional to learn more about the benefits and risks of clonidine.
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References
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