In the U.S.—

• Analgesic

Clonidine (KLOE-ni-deen) injection is used with injected pain medicine to treat pain in cancer patients.

Clonidine is to be started under the immediate supervision of your doctor. After your doctor has seen how you respond to clonidine, you may be able to receive this medicine at home.

This medicine is available only with your doctor's prescription, in the following dosage form(s):

Parenteral
• Injection (U.S.)

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For clonidine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to clonidine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies on birth defects with clonidine have not been done in pregnant women. However, it crosses the placenta. Clonidine has not been shown to cause birth defects in animal studies but may cause other problems. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding—Clonidine passes into the breast milk. Because this medicine may cause serious side effects, breast-feeding is generally not recommended while you are using it.

Children—Although there is no specific information comparing use of clonidine in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults. This medicine is usually used in children only when the pain is severe and other pain medicines did not help.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of clonidine in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking clonidine, it is especially important that your health care professional know if you are taking any of the following:

• Beta-adrenergic blocking agents (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], bisoprolol [e.g., Zebeta], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne], metoprolol [e.g., Lopressor, Toprol–XL], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal, Inderal LA], sotalol [e.g., Betapace], timolol [e.g., Blocadren])—These medicines may increase the risk of harmful effects when clonidine treatment is stopped suddenly

• Anticoagulant therapy or
• Bleeding problems—Bleeding into the area around the spinal cord is possible

• Heart or blood vessel disease—Clonidine may make these conditions worse

• Infection at the place of injection or catheter (tube)—The risk of developing meningitis or an abscess is increased

• Kidney disease—Effects of clonidine may be increased because of slower removal of clonidine from the body

• Pain associated with surgery or
• Pain during or following childbirth—The ability to tolerate some of the potential side effects of clonidine may be decreased

Clonidine is given continuously as an epidural infusion (run around the spinal cord) using an infusion pump. The pump and its tube should be checked regularly to make sure the clonidine flow has not stopped accidentally. The injection or catheter site should also be checked regularly for signs of infection.

If you are using this medicine at home, make sure you understand exactly how to use it.

Dosing—

The dose of clonidine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of clonidine. If your dose is different, do not change it unless your doctor tells you to do so.

• For injection dosage form:
  • For pain:
    • Adults—30 mcg per hour given as a continuous infusion.
    • Children—Dosage is based on body weight and must be determined by your doctor.

Missed dose—

Tell your doctor immediately if you think the clonidine has stopped for any reason.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing. Do not refrigerate.
• Discard any unused portion of medicine.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

This medicine should not be stopped without the doctor's supervision. Serious side effects may occur if clonidine is stopped suddenly.

This medicine may add to the effects of alcohol and other CNS depressants (medicine that may make you drowsy or less alert). Check with your doctor before taking any such depressants while you are using this medicine.

Dizziness, light-headedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help.

This medicine may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Dizziness, light-headedness, or fainting;  slow heartbeat 
  
  

• Less common
  • Chest pain;  extremely shallow or slow breathing;  fast heartbeat;  fever;  hallucinations (seeing, feeling, or hearing things that are not there);  mental depression;  sleepiness (excessive);  vomiting 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common
  • Anxiety;  confusion;  dry mouth;  nausea;  sleepiness  
  
  

• Less common
  • Constipation;  ringing, buzzing, or other unexplained noises in the ears;  sweating, unusual ;  weakness 
  
  

If clonidine use is suddenly stopped, check with your doctor immediately. If you notice any of the following symptoms, report them to your doctor:

• Agitation;  headache;  nervousness;  pounding heartbeat;  shaking or trembling 

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, clonidine is used in certain patients with the following medical conditions:

• Post-operative shivering (to prevent or treat shivering that occurs after an operation or anesthesia)