Catapres (Clonidine Hydrochloride)

(kloe' ni deen)

Transdermal clonidine is used alone or in combination with other medications to treat high blood pressure. Clonidine is in a class of medications called centrally acting alpha-agonist hypotensive agents. It works by decreasing your heart rate and relaxing the blood vessels so that blood can flow more easily through the body.

Transdermal clonidine comes as a patch to apply to the skin. It is usually applied to the skin every 7 days. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use the clonidine patch exactly as directed. Do not apply it more or less often than prescribed by your doctor. Apply clonidine patches to clean, dry skin on a hairless area on the upper, outer arm or upper chest. Choose an area where it will not be rubbed by tight clothing. Do not apply patches to skin that has wrinkles or folds or to skin that is cut, scraped, irritated, scarred or recently shaved. You may bathe, swim, or shower while you are wearing a clonidine patch. If the clonidine patch loosens while wearing it, apply the adhesive cover that comes with the patch. The adhesive cover will help to keep the clonidine patch on until it is time for the patch to be replaced. If the clonidine patch significantly loosens or falls off, replace it with a new one in a different area. Replace the new patch on your next scheduled patch change day. Your doctor may start you on a low dose of clonidine patch and gradually increase your dose, not more than once every week. Clonidine patch controls high blood pressure but does not cure it. It may take 2-3 days before the full benefit of clonidine patch is seen in your blood pressure readings. Continue to use clonidine patch even if you feel well. Do not stop using clonidine patch without talking to your doctor. If you suddenly stop using clonidine patch, it can cause a rapid rise in blood pressure and symptoms such as nervousness, headache, and confusion. Your doctor will probably decrease your dose gradually over 2 to 4 days. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient and read it carefully. To apply the patch, follow the directions in the patient instructions. Be sure to ask your pharmacist or doctor if you have any questions about how to use this medication.

Before using clonidine patch,
• tell your doctor and pharmacist if you are allergic to clonidine, any of the ingredients in clonidine patch, or any other medications. Ask your pharmacist for a list of the ingredients in clonidine patch.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants; beta blockers such as acebutolol (Sectral), atenolol (Tenormin, in Tenoretic), betaxolol (Kerlone), bisoprolol (Zebeta, in Ziac), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard, in Corzide), pindolol, propranolol (Inderal, Innopran XL, in Inderide), sotalol (Betapace, Sorine), and timolol (Blocadren, in Timolide); calcium channel blockers such as amlodipine (Norvasc, in Caduet and Lotrel), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil, in Lexxel), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan, others); digoxin (Digitek, Lanoxicaps, Lanoxin); medications for anxiety, mental illness, or seizures; sedatives; sleeping pills; tranquilizers; and tricyclic antidepressants such as amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), maprotiline, nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had a stroke, a recent heart attack, or heart or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using clonidine patch, call your doctor.
• talk to your doctor about the risks and benefits of using clonidine patch if you are 65 years of age or older. Older adults should not usually use clonidine patch because it is not as safe as other medications that can be used to treat the same condition.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using clonidine patch.
• you should know that clonidine patch may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how this medication affects you.
• ask your doctor about the safe use of alcohol while you are using clonidine patch. Alcohol can make the side effects from clonidine patch worse.
• you should know that clonidine patch may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start using clonidine patch. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
• you should know that clonidine patch can cause burns on your skin if you are having magnetic resonance imaging (MRI; a radiology technique designed to show the images of body structures). Tell your doctor that you are using clonidine patch if you are to have an MRI scan.

Your doctor may prescribe a low-salt or low-sodium diet. Follow these directions carefully.

Remove the old patch and apply a new patch to a different spot as soon as you remember it. Replace the new patch on your next scheduled patch change day. Do not apply two patches to make up for a missed dose.

Clonidine patch may cause side effects. Tell your doctor if any of these symptoms or those listed in the SPECIAL PRECAUTIONS section, are severe or do not go away:

• redness, burning, swelling, or itching in the place where you applied a patch
• change in skin color in the place where you applied a patch
• dry mouth or throat
• change in taste
• constipation
• nausea
• tiredness
• headache
• nervousness
• decreased sexual ability
• difficulty falling asleep or staying asleep

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• rash anywhere on the body
• blisters or inflammation in the place where you applied a patch
• hives
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• difficulty swallowing or breathing
• hoarseness

Clonidine patch may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Dispose of any patches that are outdated or no longer needed by opening the pouch and folding each patch in half with the sticky sides together. Dispose of the folded patch carefully, making sure that it is out of the reach of children and pets. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

If someone applies extra clonidine patches, remove the patches from the skin. Then call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Keep all appointments with your doctor. Your blood pressure should be checked regularly to determine your response to the clonidine patch. Your doctor may ask you to check your pulse (heart rate) daily and will tell you how rapid it should be. Ask your doctor or pharmacist to teach you how to take your pulse. If your pulse is slower or faster than it should be, call your doctor. Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.