Clonidine is one of the medications recommended by addiction experts to help treat withdrawal symptoms from opioids. Although it’s not FDA-approved for use in opioid withdrawal, clonidine has been used for decades and has been found to be effective for treating withdrawal symptoms.

What Is Clonidine?

Clonidine is a common prescription medication that is available as both tablets and skin patches. Skin patches and short-acting clonidine tablets are FDA-approved for treating high blood pressure, and long-acting clonidine tablets are FDA-approved for treating attention-deficit hyperactivity disorder. Typically, the short-acting and patch forms of clonidine are prescribed off-label to treat opioid withdrawal symptoms. The drug can also be used to help treat alcohol withdrawal syndrome. Unlike some other medications used for medication-assisted treatment (MAT) during opioid detox, clonidine is not a controlled substance.

Doctors believe that clonidine works on withdrawal symptoms because of its mechanism of action in the brain. During opioid withdrawal, there is often an increase in the noradrenergic neurotransmitters that excite the brain, which causes withdrawal symptoms. Clonidine belongs to a class of drugs known as alpha-2 adrenergic agonists. It works on the neurons that produce the noradrenergic neurotransmitters, preventing them from releasing the noradrenergic chemicals into the brain. By blocking these chemicals that would otherwise cause withdrawal symptoms, clonidine helps to prevent and treat withdrawal.

Dosage and Administration

Experts recommend that when taken to prevent withdrawal symptoms, clonidine short-acting tablets should be taken at the dose of 0.1 mg to 0.3 mg every six to eight hours as needed, with a max dose of 1.2 mg daily.

Clonidine can be taken alongside other non-opioid medications to prevent opioid withdrawal symptoms, but it should not be combined with methadone or buprenorphine-based drugs for MAT.

Side Effects

Clonidine’s side effects are generally mild. The most common side effects are:

  • Dry mouth
  • Drowsiness
  • Dizziness
  • Constipation
  • Fatigue

Other side effects include:

  • Dry throat
  • Headache
  • Insomnia
  • Sexual dysfunction
  • Nausea
  • Change in taste
  • Anxiety

Notably, when used for opioid withdrawal, low blood pressure is an additional clonidine side effect that often limits the dose a person can take.

Drug Interactions

Like all drugs, clonidine has some drug interactions. Drugs that should be used cautiously or avoided with clonidine include:

  • Central nervous system depressants: Clonidine may intensify the side effects of sedating drugs like alcohol, opioids, benzodiazepines and barbiturates.
  • Antipsychotics: Clonidine shares side effects like low blood pressure, dizziness and fatigue with antipsychotic drugs. Combining the medications may exacerbate these side effects.
  • Some cardiac medications: Heart and blood pressure medications that impact heart rate may dangerously slow the heart when combined with clonidine. These drugs include digitalis, calcium channel blockers like verapamil and diltiazem and beta blockers like metoprolol.

Risks of Clonidine Treatment

Clonidine can be used safely in many people. However, one of the biggest risks of clonidine is that it should not be suddenly discontinued. Stopping the drug cold turkey can have serious health consequences, including a rapid rise in blood pressure that can cause a stroke or death. You may also experience symptoms like agitation, tremor or confusion.

If you need to stop taking clonidine, you should only do so while being closely monitored by your doctor. Generally, your doctor will reduce your dose over the course of several days to safely wean you off the drug.

Abuse Potential

Although clonidine is not a controlled substance, experts believe it does have abuse potential. Some people may begin to psychologically rely on clonidine while getting treatment for opioid addiction, associating clonidine with the relief of opioid withdrawal symptoms. Other times, people who struggle with central nervous system depressants like opioids may intentionally take clonidine in an attempt to enhance their high.

Clonidine Use and Recovery Statistics

Clonidine is one of the most common medications prescribed in the United States and was the 79th most commonly prescribed drug in 2017. Further, it is generally affordable — the average out-of-pocket prescription price is under $5. However, studies have shown it is not as effective as buprenorphine, methadone or opioid tapers in preventing opioid withdrawal symptoms. Regardless, it may be useful when a person is not a good candidate for taking methadone or buprenorphine to manage their opioid withdrawal symptoms.

If you or a loved one struggle with clonidine addiction, or if you are considering opioid addiction treatment and wondering if clonidine is right for you, The Recovery Village at Baptist Health can help. Contact us today to learn more about treatment programs that can suit your specific situation.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.