Amitriptyline
Adverse Effect: decreased antihypertensive effectiveness Clinical Management: Blood pressure should be monitored for an appropriate clinical response.
Amoxapine
Adverse Effect: decreased antihypertensive effectiveness Clinical Management: Blood pressure should be monitored for an appropriate clinical response.
Atenolol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: When clonidine is to be withdrawn from concomitant therapy with a beta blocker, discontinue the beta blocker first, and monitor blood pressure carefully. Labetalol (alph/beta blocker) or alpha blockers (eg, prazosin, doxazosin) may prevent rebound hypertension.
Betaxolol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: Patients to be withdrawn from clonidine who are concomitantly receiving Betaxolol should be monitored carefully for hypertension. Withdraw Betaxolol several days before a gradual lowering of clonidine doses. Alternatively, substitute labetalol (an alpha/beta blocker) for clonidine.
Bisoprolol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: When clonidine is to be withdrawn from concomitant therapy with a beta blocker, discontinue the beta blocker first, and monitor blood pressure carefully. Labetalol (alph/beta blocker) or alpha blockers (eg, prazosin, doxazosin) may prevent rebound hypertension.
Carvedilol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: Patients to be withdrawn from clonidine who are concomitantly receiving a beta blocking agent should be monitored carefully for hypertension. Withdraw the beta blocker several days before a gradual lowering of clonidine doses. Alternatively, substitute labetalol (an alpha/beta blocker) for clonidine.
Celiprolol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: When clonidine is to be withdrawn from concomitant therapy with a beta blocker, discontinue the beta blocker first, and monitor blood pressure carefully. Labetalol (alph/beta blocker) or alpha blockers (eg, prazosin, doxazosin) may prevent rebound hypertension.
Chlordiazepoxide
Adverse Effect: Decreased antihypertensive effectiveness Clinical Management: Blood pressure should be monitored for an appropriate clinical response. Higher doses of clonidine may be required. An alternative class of antihypertensive agents or an alternative class of antidepressants might be considered.
Clomipramine
Adverse Effect: decreased antihypertensive effectiveness Clinical Management: Blood pressure should be monitored for an appropriate clinical response.
Dothiepin
Adverse Effect: decreased antihypertensive effectiveness Clinical Management: Blood pressure should be monitored for an appropriate clinical response. Higher doses of clonidine may be required. An alternative class of antihypertensive agents or an alternative class of antidepressants might be considered.
Doxepin
Adverse Effect: decreased antihypertensive effectiveness Clinical Management: Blood pressure should be monitored for an appropriate clinical response. Higher doses of clonidine may be required.
Fluphenazine
Adverse Effect: An increased risk of dementia Clinical Management: Monitor patients receiving both fluphenazine and clonidine for signs of acute organic brain syndrome (aggressiveness, agitation, anxiety, hallucinations).
Imipramine
Adverse Effect: decreased antihypertensive effectiveness Clinical Management: Blood pressure should be monitored for an appropriate clinical response. Higher doses of clonidine may be required.
Labetalol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: Patients to be withdrawn from clonidine who are concomitantly receiving a beta blocking agent should be monitored carefully for hypertension. Withdraw the beta blocker several days before a gradual lowering of clonidine doses. Alternatively, substitute labetalol (an alpha/beta blocker) for clonidine.
Levobunolol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: Patients to be withdrawn from clonidine who are concomitantly receiving Levobunolol should be monitored carefully for hypertension. Withdraw Levobunolol several days before a gradual lowering of clonidine doses. Alternatively, substitute labetalol (an alpha/beta blocker) for clonidine.
Lignocaine
Adverse Effect: Reduced lidocaine absorption following combined epidural administration Clinical Management: Combined use of clonidine plus lidocaine for epidural anesthesia provides for prolonged pain relief with a lower potential for adverse reactions due to excessive lidocaine serum levels.
Metoprolol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: When clonidine is to be withdrawn from concomitant therapy with a beta blocker, discontinue the beta blocker first, and monitor blood pressure carefully. Labetalol (alph/beta blocker) or alpha blockers (eg, prazosin, doxazosin) may prevent rebound hypertension.
Naloxone
Adverse Effect: hypertension
Nortriptyline
Adverse Effect: decreased antihypertensive effectiveness Clinical Management: Blood pressure should be monitored for an appropriate clinical response. Higher doses of clonidine may be required.
Oxprenolol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: When clonidine is to be withdrawn from concomitant therapy with a beta blocker, discontinue the beta blocker first, and monitor blood pressure carefully. Labetalol (alph/beta blocker) or alpha blockers (eg, prazosin, doxazosin) may prevent rebound hypertension.
Pindolol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: When clonidine is to be withdrawn from concomitant therapy with a beta blocker, discontinue the beta blocker first, and monitor blood pressure carefully. Labetalol (alph/beta blocker) or alpha blockers (eg, prazosin, doxazosin) may prevent rebound hypertension.
Propranolol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: When clonidine is to be withdrawn from concomitant therapy with a beta blocker, discontinue the beta blocker first, and monitor blood pressure carefully. Labetalol (alph/beta blocker) or alpha blockers (eg, prazosin, doxazosin) may prevent rebound hypertension.
Sotalol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: Patients to be withdrawn from clonidine who are concomitantly receiving a beta blocking agent should be monitored carefully for hypertension. Withdraw the beta blocker several days before a gradual lowering of clonidine doses. Alternatively, substitute labetalol (an alpha/beta blocker) for clonidine. Labetalol (800 to 1200 mg) should be titrated to individual patient needs based on blood pressure monitoring. In case of hypertensive crisis, alpha adrenergic blocking agents, such as phentolamine and prazosin, may be used.
Timolol
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: When clonidine is to be withdrawn from concomitant therapy with Timolol , discontinue Timolol first, and monitor blood pressure carefully. Labetalol (alph/beta blocker) or alpha blockers (eg, prazosin, doxazosin) may prevent rebound hypertension.
Trimipramine
Adverse Effect: decreased antihypertensive effectiveness Clinical Management: Blood pressure should be monitored for an appropriate clinical response. Higher doses of clonidine may be required. |