Clonidine is a medication that is commonly used to reduce high blood pressure and sometimes used to treat opioid use disorder (OUD), among other uses.
In 2020, American doctors wrote about 9 million prescriptions for clonidine.[1] In addition to managing blood pressure, clonidine is approved to treat Tourette’s syndrome tics, symptoms of ADHD in children and cancer-related pain.
Many people use clonidine off-label to help them with opioid withdrawal symptoms. It may also be used off-label to treat alcohol withdrawal symptoms, restless leg syndrome and smoking cessation.[2]
Clonidine is a prescription medication that belongs to the antihypertensive medication class. These drugs relax blood vessels, allowing the blood to move freely through the body and lowering blood pressure.
Clonidine is sold as a tablet, patch, or injection. Multiple brand formulations of the drug exist, along with many generic versions.
Clonidine was developed more than 40 years ago, and it’s been reviewed by the U.S. Food and Drug Administration (FDA) multiple times.
Clonidine is FDA approved as a therapy for the following conditions:[2]
Doctors also use clonidine on an off-label basis to manage withdrawal from multiple drugs, including these:[2]
Doctors may also use clonidine to address anxiety, insomnia and hyperarousal seen with disorders like post-traumatic stress disorder (PTSD). Interestingly, these are some of the same symptoms some people have when quitting opioids, alcohol and benzodiazepines. Although this is an off-label use of clonidine, many people benefit from taking this medication to ease withdrawal as they begin or transition off Suboxone or methadone after long-term use.
Clonidine is categorized as an antihypertensive medication. It works in the brain to alter nerve impulses, and these changes cause blood vessels to relax. Once the blood vessels relax like this, blood can flow more easily, and this reduces blood pressure.[2]
Clonidine may also reduce pain signals from the spinal cord to the brain’s higher centers by releasing norepinephrine. Since this hormone plays a vital role in the regulation of arousal and stress reactions, it can result in an overall feeling of relaxation and decreased pain.[7]
Many uncomfortable and painful symptoms experienced during opioid withdrawal result from an overactive nervous system. Clonidine helps to reduce this hyperactivity, minimizing withdrawal symptoms. As a result, people experience fewer symptoms, including hot flashes, sweating, muscle aches, runny nose, anxiety and irritability.
Clonidine is typically prescribed to ease acute withdrawal symptoms.[2] While it might help you stop taking drugs, it isn’t approved as a long term treatment for managing opioid use disorder. Medication for Addiction Treatment (MAT) refers to drugs like Suboxone, which can help you get sober and stay that way.
Your doctor might use clonidine to do the following:
Since clonidine doesn’t bind to the brain’s opioid receptors, it is not primarily used to ease cravings and help maintain sobriety. It’s not considered a long-term MAT therapy, but it could be part of your overall treatment plan.
Clonidine is a safe and effective medication, and since it requires a prescription, your doctor manages your dose carefully. But there are issues you should discuss with your team before you start using this therapy.
You should talk with your team about the following:[2]
Talk with your doctor if you are concerned or have any underlying conditions that might contribute to medication reactions, such as these:
Allergic reactions to clonidine are rare, but they can cause serious problems. If you develop hives, a rash, trouble breathing or swallowing, serious itching, or swelling in the face, mouth, or throat, call 911 immediately.
People who take Clonidine on a long-term basis at high doses might develop physical dependence, which can lead to withdrawal symptoms if they suddenly stop taking it.[4]
Do not attempt to stop taking clonidine suddenly on your own if you’ve been taking it for a while. Consult your doctor before lessening or stopping use.
Stopping use can result in rebound symptoms, such as high blood pressure, and intense withdrawal symptoms. This could result in a dangerous situation, so medical supervision is required.
Although clonidine is a beneficial medication, it can cause some side effects.[3] Common side effects include the following:
Short-term use of clonidine should not lead to too many side effects or adverse reactions. Risks compound with long-term use.
If you suddenly stop taking the drug, you may experience withdrawal. The main symptom is rebound high blood pressure. For people taking clonidine off label, this can feel like a pounding heart, fatigue, insomnia or anxiety.
These are other withdrawal symptoms:[8]
Clonidine is only available with a prescription, even if you are given it for off-label use. Health insurance, including Medicare, will cover clonidine prescriptions, but off-label use can be difficult to navigate.[5]
Fortunately, since clonidine is a generic drug, it does not cost much without insurance.[6] Oral tablets cost, on average, $10.31 for eight tablets at 0.1 mg and $14.22 for 30 pills at 0.3 mg in the United States. The extended-release transdermal film at 0.1 mg (which lasts for 24 hours) can cost $62.55 for four films, but this is four days of doses, which can be enough to ease acute withdrawal from opioids.
There are also patient rebate programs and coupons available that can help you save money on clonidine. Ask your physician or pharmacy about these options.
Bicycle Health is dedicated to helping people get off and stay off opioids. To learn more about the success rates and safety of Bicycle Health’s telemedicine addiction treatment compared to other common treatment options, call us at (844) 943-2514 or schedule an appointment here.
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role of the brain dopamine system in substance use disorders and in aging. He also studies brain function in obesity and eating disorders.
