Effects Of Oral Clonidine On Heart Rate Changes After Neostigmine
Staff Physician, Department of Anesthesia, Iwaki Kyoritsu General Hospital.
Associate Professor of Anesthesia, Akita University.
Professor of Anesthesia, Akita University.
Tetsu Kimura, Makoto Tanaka, Toshiaki Nishikawa Effects of Oral Clonidine on Heart Rate Changes after Neostigmine-Atropine Administration . Anesthesiology 1998 88:15071510 doi:
Clonidine reduces heart rate responses to atropine, whereas neostigmine causes bradycardia. This study was designed to determine whether clonidine premedication would reduce tachycardia after neostigmine-atropine administration.
Fifty adult patients without cardiovascular disorders who were scheduled for elective surgeries were randomly assigned to receive approximately 5 microg/kg or no clonidine 90 min before induction of general anesthesia. After tracheal intubation, anesthesia was maintained with N2O and 12% isoflurane in oxygen while patients were paralyzed with vecuronium and mechanically ventilated. When surgeries were completed, adequate spontaneous respiration, responses to verbal commands, and sustained tetanus by stimulating the ulnar nerve were confirmed, and patients’ tracheas were extubated. Then a mixture of 0.05 mg/kg neostigmine and 0.02 mg/kg atropine was administered intravenously over 20 s under stable hemodynamic condition , and blood pressure and HR were measured noninvasively at 1-min intervals for 10 min.
Precautions When Taking Clonidine
If you have a history of low blood pressure, you may be more likely to feel dizzy, lightheaded, and nauseous while taking clonidine.
Many people forget to take their medication. If you miss a dose of clonidine, don’t take a double dose. This could lower your blood pressure too much.
It’s important that you don’t stop taking clonidine abruptly, as this may cause rebound high blood pressure. Instead, your dose should be decreased gradually. Your doctor can give you advice on the best tapering schedule.
Clonidine may be unsafe for an unborn baby, and it can be found in breastmilk. Animal studies have also shown that clonidine may impair fertility in females and males. If you’re pregnant, breastfeeding, or planning to become pregnant, talk to your doctor. They can help you weigh the pros and cons of continuing with your medication.
More On Medical Detox
It takes about a week for the peak, intense withdrawal symptoms to finally subside. When someone is in active addiction, it can be almost impossible to be able to quit for this long to see the other side. Going through opioid detox alone will likely result in relapse, so it is very important to enter a treatment facility to help assist through this period of time.
In addition to Colidine to manage withdrawal symptoms, there are many other medications to help get through the detox period. These medications can not only help physical symptoms but emotional ones as well. Feeling new emotions after having opioids numb them for so long can be hard, so having medical assistance is comforting. There are also medications to help curb cravings, and even to block clients from getting high at all. Having these extra cushions can make all the difference in a persons long-term sobriety and recovery journey.
All clients are taken care of by the 24-hour medical staff, ready to assist at any time. Having this type of medical attention during detox is important, and is specifically trained to help manage symptoms associated with addiction and detox.
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Drugs That Increase Drowsiness
Dont combine these drugs with clonidine. Taking these drugs with clonidine might increase drowsiness:
- barbiturates such as:
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
This drug comes with several warnings.
When Is A Pulse Rate Considered Low
Your pulse rate is the number of pulsations in a minute that you can feel over one of your arteries. The pulsations are usually felt over the radial artery at your wrist or over the carotid artery in your neck. They are caused by your heartbeats and the pulse rate is usually the same as the heart rate. Sometimes not all of the heartbeats can be felt over the artery, causing the pulse rate to be lower than the heart rate.
A normal pulse rate is a range of values, which depends to a large extent on age. Children have higher pulse rates than adults. The normal pulse rate in adults ranges from 60 to 100 beats per minute. A pulse below 60 is considered low.
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How To Take Clonidine
Use Clonidine exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Clonidine is usually taken in the morning and at bedtime. If you take different doses of this medicine at each dosing time, it may be best to take the larger dose at bedtime.
Clonidine may be taken with or without food.
Swallow the extended-release tablet whole and do not crush, chew, or break it.
Tell your doctor if you have a planned surgery.
You may have withdrawal symptoms if you stop using clonidine suddenly. Ask your doctor before stopping the medicine.
Call your doctor if you are sick with vomiting. This is especially important for a child taking clonidine.
If you have high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms.
Store at room temperature away from moisture, heat, and light.
Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.
Can Clonidine Ir Oral Tablets Be Used To Treat Anxiety Sleep Problems And More
Yes, doctors will sometimes prescribe clonidine off-label for anxiety or sleep problems associated with certain conditions. Off-label drug use means using a drug for a purpose other than what the Food and Drug Administration has approved.
Clonidine IR oral tablets have only been approved by the FDA to treat hypertension . But this medication is also used off-label to treat several other conditions.
Examples of other off-label uses for clonidine IR oral tablets include:
When used for alcohol or opioid withdrawal, clonidine can help reduce withdrawal symptoms related to stopping these substances. These may include anxiety, agitation, nausea, diarrhea, and sleep problems.
However, clonidine doesnt reduce cravings for alcohol or opioids. Talk with your doctor if youre interested in using clonidine to help with alcohol or opioid withdrawal. They can determine if clonidine is the best treatment for you and what the right dose for withdrawal is for you.
Doctors sometimes recommend clonidine off-label to treat anxiety disorders other than PTSD, but theres not much evidence that its effective. If you have an anxiety disorder, your doctor will likely prescribe a medication other than clonidine. Examples may include benzodiazepines such as clonazepam and certain antidepressants such as citalopram .
Is clonidine a controlled substance?
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Pharmacist Tips For Catapres
Catapres is usually taken together with other medications for better blood pressure control
Many people notice drowsiness and dizziness, especially after they first start on Catapres . The patch usually causes fewer side effects.
Take the tablet at the same time every day and avoid skipping doses. If you are on the patch, pick a day of the week that helps you remember to change it every 7 days.
If you are prescribed the patch, make sure the area is clean and dry before applying. Apply it to a hairless area on the chest or upper arm, and make sure to change the location with each new patch every week.
Prices for Catapres start at just $4.00 with a GoodRx coupon. Theyâre fast, easy-to-use and free!
Clonidine As A Medication Choice For Adhd
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Catapres is a medication that was originally approved to treat people with high blood pressure. However, because of the calming effect it has on the body, clonidine has been found to help people with attention-deficit/hyperactivity disorder symptoms like hyperactivity, impulsivity, aggression, overarousal, and sleep difficulties.
The Food and Drug Administration has also approved Kapvay, the extended-release version of clonidine, as a medication for children with ADHD ages 6 and up. It can be taken alone or along with stimulant medication.
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Warnings For Certain Groups
For people with heart problems: This includes low blood pressure, low heart rate, and heart disease. This medication decreases blood pressure and heart rate. You may be at risk for more serious side effects if you already have low blood pressure or a low heart rate.
For people who get dizzy when standing: This condition is called orthostatic hypotension. Clonidine can make this condition worse. Dont stand up too quickly and make sure not to get dehydrated. These can increase your dizziness and risk of fainting.
For people with syncope : Clonidine can make this condition worse. Dont stand up too quickly and make sure not to get dehydrated. These can increase your dizziness and risk of fainting.
For people with eye problems: This includes dry eye syndrome and problems focusing your eyes. Clonidine may make these problems worse.
For pregnant women: Clonidine is a category C pregnancy drug. That means two things:
Speak with your doctor if youre pregnant or plan to become pregnant. Clonidine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
For seniors: This medication affects blood pressure, which may cause dizziness and increase your risk of falling.
What Is The Dosage Of Metoprolol Vs Clonidine
- Metoprolol should be taken before meals or at bedtime.
- The dose for treating hypertension is 100 to 450 mg daily in single or divided doses.
- Angina is treated with 100 to 400 mg daily in two divided doses.
- Heart attack is treated with three 5 mg injections administered 2 minutes apart followed by treatment with 50 mg oral metoprolol every 6 hours for 48 hours. After 48 hours, patients should receive 100 mg orally twice daily for at least 3 months.
- The dose for congestive heart failure is 25 mg/daily initially. Then the dose is increased every 2 weeks to reach a target dose of 200 mg/daily orally.
- Hyperthyroidism is treated with 25 to 30 mg by mouth every 6 hours.
Abnormal heart rhythms can occur with the combination of clonidine and verapamil.
Cyclosporine concentrations in the blood can increase when clonidine is begun. This interaction could result in kidney damage from the increased levels of cyclosporine.
Nonsteroidal anti-inflammatory drugs — for example, ibuprofen , naproxen , and nabumetone — can reduce the antihypertensive effects of clonidine.
Cocaine, pseudoephedrine, phenylephrine, and phenylpropanolamine also can reverse the blood pressure lowering effects of clonidine.
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Signs Of Addiction & Withdrawal
Addiction to clonidine is an effect of long-term use of the drug. Symptoms of clonidine addiction include:
- Uncontrollable use of the substance
- Becoming less accountable at home and/or work
- Increased tolerance
Individuals who have partaken in prolonged use of clonidine can become physically dependent on the substance. According to the Food and Drug Administration , withdrawal symptoms relating to clonidine include:
- Increased agitation
- Nervous behavior
Symptoms have become so severe in some cases that they have led to death, showing the seriousness of clonidine withdrawal. Those who witness these symptoms in an individual should contact medical professionals immediately.
Most of the mild long-term effects of clonidine use can be significantly diminished with therapy, but some effects can result in prolonged issues.
What Are The Approved Uses For Clonidine
- Clonidine is approved for the treatment of high blood pressure. It may be used alone or combined with other drugs used for the treatment of high blood pressure.
- Clonidine is also used off-label for the treatment of alcohol withdrawal, smoking cessation, restless leg syndrome, Tourettes syndrome, and opioid withdrawal.
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Clonidine Ir Oral Tablets And Other Medications
Below is a list of medications that can interact with clonidine IR oral tablets. This list does not contain all drugs that may interact with clonidine.
Before taking clonidine IR oral tablets, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Types of drugs that can interact with clonidine IR oral tablets include:
- Opioids. Taking clonidine with opioids can increase the risk of sleepiness. Examples of opioids include:
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What Is The Most Important Information I Should Know About Clonidine
You should not take this medicine if you are allergic to clonidine.
Tell your doctor if you have ever had:
- heart disease or severe coronary artery disease
- a heart rhythm disorder, slow heartbeats
- high or low blood pressure, or a history of fainting spells
- a heart attack or stroke
- kidney disease or
- if you have ever had an allergic reaction to a clonidine transdermal skin patch .
It is not known if clonidine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
If you are pregnant, your name may be listed on a pregnancy registry to track the effects of clonidine on the baby.
Clonidine may affect fertility in men or women. Pregnancy could be harder to achieve while either parent is using this medicine.
If you are breastfeeding, tell your doctor if you notice somnolence, tiredness, rapid breathing, and poor feeding in the nursing baby.
Catapres is not approved for use by anyone younger than 18 years old. Do not give Kapvay to a child younger than 6 years old.
When Is Bloodpressure Considered High
Your blood pressure is the force of blood as it pushes against the walls of your arteries. Blood pressure is usually measured in the upper arm or wrist with a blood pressure machine. It consists of two numbers: a higher number called the systolic pressure and a lower number called the diastolic pressure.
Like the pulse, normal blood pressure is a range that depends on age. Children have lower blood pressures than adults. Guidelines published jointly by the American Heart Association and American College of Cardiology in 2017 define high blood pressure in adults as a pressure of 130/80 or above.
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Is Weight Gain A Side Effect Of Clonidine Ir Oral Tablets
Weight gain has been reported in some people taking clonidine IR oral tablets. But these people may also have been taking other blood pressure medications, so its not known if clonidine caused the weight gain.
If you have unexplained weight gain while taking clonidine, talk with your doctor. They can help determine the possible cause of the weight gain and what your next steps should be.
More Common Side Effects
Mild side effects may go away within a few days or a couple of weeks. Talk to your doctor or pharmacist if theyre more severe or dont go away. The more common side effects that can occur with clonidine include:
- dry mouth and dry eyes
- slowed breathing or trouble breathing
- chest pain
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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I Have Had High Blood Pressure For The Last Year What Antihypertensive Medications Do Not Lower Heart Rate I Have Tried Several Different Medications And Have Had Episodes Of Severe Dizziness And Almost Fainting With Heavy Activity And Also Exposure To The Heat I Have Made Several Trips To The Er With These Episodes With A Low Heart Rate And Low Blood Pressure My Doctor Has Had No Success With Different Medications In Preventing These Episodes Can You Advise Us What To Do Next
Hx: Male 74 Very active and young for ageHypertensive50-70% block R carotidSlight narrowing aortic valveIrregular heart rate for many years with numerous tests and no significant problems when younger, even running.For past year has been on numerous different antihypertensives. Has had episodes of severe dizziness and almost fainting with heavy activity and also heat related.Several times to ER over past year via medics after these episodes. BP low and heart rate low with some dehydration do to heat and limiting fluids.Has had echocardiogram with no significant issues.What has been discussed with cardiologist is BP meds lower heart rate and exercise/exertion lowers BP.Last episode with HR 38 AND BP 119/50. To cardiologist and EKG done with HR 41. Took him off all BP meds.Lying to sitting/standing BP drops 20 points. After exercise or heavy exertion BP can drop up to 50 points. This is when he was on meds. Now off all meds 2 weeks and BP 202/88 to low of 124/68. Off meds he took a 20 min. walk and BP 198/84 prior to walk and 126/68 after walk.I am his wife and a RN. Went to reputable cardiologist, but now concerned with treatment. Dr. seems frustrated and does not know what to do next.PLEASE HELP us to proceed in the right direction.Thank You for your time.
Submitted by Lyndall from Charlotte, North Carolina on 09/09/2014