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Caution in patients with cerebrovascular disease, ischemic heart disease including myocardial infarction, renal impairment, occlusive peripheral vascular disorders eg, Raynaud's disease or those with a history of depression.
Clonidine Discontinuation: Instruct patients not to discontinue clonidine therapy without consulting a physician. Abrupt withdrawal of clonidine treatment may result in symptoms eg, nervousness, agitation, headache and tremor followed by a rapid rise in blood pressure, and increase in plasma catecholamine concentration. Such occurrences have usually been associated with previous administration of high oral doses (exceeding 1,200 mcg/day) or with continuation of concomitant α-blocker therapy. Rare cases of hypertensive encephalopathy, cerebrovascular accidents and death have been reported after clonidine withdrawal. When discontinuing therapy, clonidine dose should be reduced gradually over 2-4 days to avoid withdrawal symptoms.
Use with caution in patients with severe coronary insufficiency, conduction disturbances, recent myocardial infarction or cerebrovascular disease and chronic renal failure.
Use in pregnancy & lactation: Pregnancy Category C: There are no adequate and well controlled studies in pregnant women. Use in pregnancy only if clearly needed.
Exercise caution when clonidine is administered to a breastfeeding woman as it can be excreted in human milk.
Use in children: Safety and effectiveness in pediatric patients <12 years have not been established.
