For patients taking this medicine for high blood pressure:

• In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.
• Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
• Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to use it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

For patients using the transdermal system (skin patch) :

• Use this medicine exactly as directed by your doctor. It will work only if applied correctly. This medicine usually comes with patient instructions. Read them carefully before using.
• Do not try to trim or cut the adhesive patch to adjust the dosage. Check with your doctor if you think the medicine is not working as it should.
• Apply the patch to a clean, dry area of skin on your upper arm or chest. Choose an area with little or no hair and free of scars, cuts, or irritation.
• The system should stay in place even during showering, bathing, or swimming. If the patch becomes loose, cover it with the extra adhesive overlay provided. Apply a new patch if the first one becomes too loose or falls off.
• Each dose is best applied to a different area of skin to prevent skin problems or other irritation.
• After removing a used patch, fold the patch in half with the sticky sides together. Make sure to dispose of it out of the reach of children.

To help you remember to use your medicine, try to get into the habit of using it at regular times. If you are taking the tablets, take them at the same time each day. If you are using the transdermal system (skin patch), try to change it at the same time and day of the week.

Dosing

The dose of clonidine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of clonidine used for the treatment of high blood pressure. If your dose is different, do not change it unless your doctor tells you to do so:

• For oral dosage form (tablets):
  • For high blood pressure:
    • Adults 100 mcg (0.1 mg) two times a day. Your doctor may increase your dose up to 200 mcg (0.2 mg) to 600 mcg (0.6 mg) a day taken in divided doses.
    • Children Use and dose must be determined by your doctor.
• For transdermal dosage form (skin patch):
  • For high blood pressure:
    • Adults One transdermal dosage system (skin patch) applied once a week.
    • Children Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of this medicine, take it or use it as soon as possible. Then go back to your regular dosing schedule. If you miss two or more doses of the tablets in a row or if you miss changing the transdermal patch for 3 or more days, check with your doctor right away. If your body goes without this medicine for too long, your blood pressure may go up to a dangerously high level and some unpleasant effects may occur.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For clonidine, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to clonidine. Also tell your health care professional if you are allergic to any other substance, such as foods, preservatives, or dyes.

Pregnancy Clonidine has not been studied in pregnant women. However, studies in animals have shown that clonidine causes harmful effects in the fetus, but not birth defects.

Breast-feeding Although clonidine passes into breast milk, it has not been reported to cause problems in nursing babies.

Children Children may be more sensitive than adults to clonidine. Clonidine overdose has been reported when children accidentally took this medicine.

Older adults Dizziness or faintness may be more likely to occur in the elderly, who are more sensitive than younger adults to the effects of clonidine.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking clonidine, it is especially important that your health care professional know if you are taking any of the following:

• Beta-blockers (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Sotacor], timolol [e.g., Blocadren]) These medicines may increase the risk of harmful effects when clonidine treatment is stopped suddenly

• Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) These medicines may decrease clonidine's effects on blood pressure

• Heart or blood vessel disease Clonidine may make these conditions worse

• Irritated or scraped skin (with transdermal system [skin patch] only) The effects of clonidine may be increased if the skin patch is placed on an area of scraped or irritated skin because more medicine is absorbed into the body

• Kidney disease Effects of clonidine may be increased because of slower removal of clonidine from the body

• Mental depression (history of) or
• Raynaud's syndrome Clonidine may make these conditions worse

• Polyarteritis nodosa or
• Scleroderma or
• Systemic lupus erythematosus (SLE) (with transdermal system [skin patch] only) Effects of clonidine may be decreased because absorption of this medicine into the body is blocked