- 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
- 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.
- Cardiovascular: arrythmia, atrioventricular block, bradycardia, hypotension
- Dermatologic: rash
- GI: GI upset
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