Neonatal Drug Therapy Manual


Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Catapres, Catapres-TTS
Alpha-Adrenergic Agonist
Original Date: 
December 2008
Revised Date: 
August 2016
  • Neonatal narcotic abstinence syndrome
  • Prophylaxis for narcotic and sedative withdrawal syndrome
  • PO: administer with feedings or water to decrease GI upset
  • PR: can be used when PO route not available
  • PO/PR
    • Initial: 0.5 - 1 mcg/kg/dose every 6 hours. Increase incrementally over several days
    • Range: 0.5 - 4 mcg/kg/dose every 6 hours. Use the lowest effective dose
  • NOTE: Withhold or reduce dose for excessive bradycardia, hypotension.   


Wean clonidine gradually over 1 - 2 weeks to avoid rebound hypertension. One suggested regimen is to decrease by 0.5 - 1 mcg/kg/dose daily until 1 mcg/kg/dose then decrease interval from Q6H to Q8H to Q12H to Q24H as tolerated.  Gradually eliminate daytime dose and then wean to hs dose and then discontinue.

Side Effects: 
  • Cardiovascular: arrythmia, atrioventricular block, bradycardia, hypotension
  • Dermatologic: rash
  • GI: GI upset
Parameters to Monitor: 
  • BP
  • HR
Reconstitution and Stability: 





Severe rebound hypertension may occur if chronic therapy is abruptly discontinued.  Slowly tapering of clonidine dose is always recommended.


-Basker S, Singh G, Jacob R.  Clonidine In Pediatrics - A Review.  Indian J Anaesth 2009; 53: 270-80

Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 22th Edition. Hudson: Lexi-Comp Inc.; 2015

-Deutsh ES, Nadkarni VM. Clonidine Prophylaxis for Narcotic and Sedative Withdrawal Syndrome Following Laryngotracheal Reconstruction. Arch Otalaryngol head neck surg. 1996 Nov; 22: 1234-38

-Zenck KE, Sills JH, Koeppel RM. Neonatal Medications & Nutrition, 3rd edition. Santa Rosa, California; NICU INK Book Publishers, USA, 2003

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.