Clonidine Dosages for Adults: Your GoodRx Guide

Clonidine (Catapres-TTS, Nexiclon XR) is a medication that’s FDA approved to treat high blood pressure (hypertension). It’s also used off-label for several other conditions, such as migraines and restless leg syndrome.

In this guide, we’ll review common clonidine dosages. Your dose will depend on which clonidine product you’re using and your blood pressure goal. Make sure to follow your healthcare provider’s instructions for how to use clonidine, even if your prescribed dose is different from what’s discussed below.

Good to know: There’s a generic clonidine 0.1 mg ER tablet that’s only approved to treat ADHD (attention-deficit hyperactivity disorder). But in this article, we’ll focus only on the oral dosage forms that treat hypertension in adults.

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What’s the typical clonidine dosage for adults?

The best clonidine dosage for hypertension depends on the form of clonidine you’re using and how your blood pressure responds after starting clonidine. This target blood pressure goal may be different for each person, but a typical goal is 130/80 mmHg or less.

Clonidine comes in several oral tablet and patch dosage forms. 

Good to know: Although clonidine is FDA approved for high blood pressure, it’s typically avoided unless other medications aren’t working. This is because clonidine can cause troublesome side effects, such as low blood pressure, drowsiness, and dizziness. Other medications — including angiotensin-converting enzyme (ACE) inhibitors or thiazide diuretics (water pills) — are typically first-choice medications for high blood pressure.

Clonidine IR tablets

The typical starting dosage is 0.1 mg twice daily. If your blood pressure remains high, your healthcare provider may increase your dose on a weekly basis. The maximum daily dose is 2.4 mg, but most people won’t need this much. Generic clonidine IR tablets are available as 0.1 mg, 0.2 mg, and 0.3 mg tablets.

If your total daily dose can’t be evenly split between two doses, your prescriber may recommend taking the larger of your two daily doses at bedtime. This lowers your chances of experiencing side effects during the day, including drowsiness.

Clonidine ER tablets

The typical starting dosage is 0.17 mg once daily. Your provider may increase your dose on a weekly basis, if needed. The maximum dose is 0.52 mg per day. It’s best to take the ER forms of clonidine at bedtime. 

Brand-name (Nexiclon XR) and generic ER clonidine tablets are available as 0.17 mg and 0.26 mg tablets. They can be split in half if needed to make your prescribed dose. 

Clonidine skin patches

Most people start with one 0.1 mg patch. You’ll apply the patch to your skin and replace it once a week at the same time. Your dose may be increased every 1 to 2 weeks. The maximum dose is two 0.3 mg patches applied once a week. Brand-name (Catapres-TTS) and generic ER skin patches come as 0.1 mg, 0.2 mg, and 0.3 mg patches

Your patch should be applied to a hairless spot on the upper outer arm or chest area. Make sure the area is clean, dry, and free from any cuts or sores. Apply your patch to a different site each week. If your patch starts to loosen before it’s time to be replaced, secure it with the “adhesive cover” included with your clonidine patches. But if the patch is significantly loosened or falling off, you’ll need to replace it with a new one.

Can you switch between different forms of clonidine?

In some cases, your healthcare provider may suggest switching from one form of clonidine to another.

Clonidine IR tablets to clonidine ER tablets

One benefit of clonidine ER tablets is they only have to be taken once a day. If your healthcare provider recommends switching from the clonidine IR to clonidine ER, they’ll help you make the switch safely.

Your new dose of clonidine ER may be slightly less than your daily dose of clonidine IR. For example, if you’re taking 0.1 mg clonidine IR two times daily, then your provider will likely switch you to 0.17 mg Nexiclon XR once daily.

Clonidine IR tablets to the clonidine patch

You may also switch from clonidine IR tablets to the clonidine skin patch. The patches are applied once a week, which may be more preferable to you than taking tablets twice a day.

To make the switch, your provider may slowly lower your current dose of clonidine IR once you apply the skin patch for the first time. This is because it can take a few days for the skin patch to start working. Your skin patch dose may need to be adjusted every 1 to 2 weeks if your blood pressure remains too high. To help determine how well the skin patch is working, your provider may ask you to monitor your blood pressure at home. It can take a few weeks to find the best dosage for you.

Do some people need lower clonidine dosages?

Yes. If you’re over 65 years old, you may be more likely to experience clonidine side effects, such as dizziness, drowsiness, and low blood pressure. Side effects are most likely to occur just after starting clonidine or after your dose is increased. To minimize this risk, your healthcare provider may prescribe you a lower clonidine dose. They may increase your dose more slowly as well.

People with kidney problems may also need a lower starting dose. This is because clonidine is removed from the body by the kidneys. If your kidneys aren’t working properly, clonidine may build up in your body. This increases your risk of experiencing side effects.

What if you want to stop taking clonidine?

You shouldn’t stop taking clonidine without talking to your healthcare provider first. There are two main reasons this is a bad idea:

1. Your blood pressure can rapidly increase. This is called “rebound hypertension.” If left untreated, high blood pressure can have serious consequences for your health, including an increased risk of stroke and heart disease.

2. Stopping clonidine abruptly can cause bothersome withdrawal symptoms. These include agitation and tremor.

If it’s appropriate for you to stop clonidine, your healthcare provider or pharmacist can help you come up with a plan to lower your dose slowly.

What happens if you miss a dose of clonidine?

It’s important to take clonidine as directed. But if you miss a clonidine dose, your next steps depend on what product you’re taking.

• IR tablets: If you miss a dose of clonidine IR, take it as soon as you remember. But if it’s close to your next scheduled dose, skip the missed dose altogether. And then, take your next dose at your usual time. 

• ER tablets: If you miss a dose of clonidine ER, skip the missed dose and take your next dose at its usual time.

• Skin patch: If you forget to wear or change your patch, apply a new patch as soon as you remember and then return to your usual schedule. But if it’s close to when you usually replace your patch, skip the missed dose and wait until then to change your patch. 

Never take two doses at one time or apply an extra patch to make up for a missed dose. This increases your risk of side effects.

Good to know: Missing too many clonidine doses can cause withdrawal symptoms and raise your blood pressure. If you miss several clonidine doses in a row, let your healthcare provider know right away.

What should you do if you take too much clonidine?

Taking too much clonidine can lead to serious health concerns, including severely low heart rate and blood pressure. Seizures, coma, and irregular heartbeat are also possible.

If you think you took too much clonidine, call Poison Control at 1-800-222-1222. If you’re experiencing severe symptoms, such as trouble breathing, extreme dizziness or drowsiness, or weakness, seek immediate medical care by calling 911.

How to save on clonidine

GoodRx can help you save on various clonidine products. With a free GoodRx discount, you may be able to save:

• Over 40% off generic clonidine IR tablets, which may cost as low as $3.70

• Over 80% off generic clonidine patch, which may cost as low as $32.67

• Over 70% off generic clonidine ER 0.17 mg tablets, which may cost as low as $183.72

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Written by:

Makaela Premont, PharmD

Makaela Premont, PharmD, is a pharmacist and the founder of uniquelymickie.com, a website dedicated to helping pharmacy students and pharmacists create a life that they enjoy. She received her Doctorate of Pharmacy from the University of South Carolina and is a licensed pharmacist in North Carolina.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

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