Key takeaways
Prazosin (Minipress) and clonidine (Catapres-TTS, Nexiclon XR) are both medications used to treat high blood pressure, but they work differently and have distinct characteristics. Prazosin is an alpha blocker that relaxes blood vessels to help blood flow more easily, while clonidine is an alpha agonist that works in the brain to lower stress hormones, slowing down your heart rate and relaxing blood vessels. Prazosin is taken orally 2 to 3 times a day, whereas clonidine is available in multiple forms, including a once-weekly patch, immediate-release tablets, and extended-release tablets. Clonidine can cause "rebound hypertension" if stopped suddenly, making it risky to discontinue without medical guidance, while prazosin does not have this issue. Both medications can cause dizziness and drowsiness, but clonidine has a higher risk of causing dry mouth and constipation. Additionally, older adults are at a higher risk of having side effects when taking prazosin, while clonidine is also not recommended for older adults due to the increased risk of falls. Both medications are available as lower-cost generics, but clonidine's extended-release tablet form, Nexiclon XR, is only available as a brand-name product.
