clonidine ER

General information

• Class: Adjunctive therapy
• Common US brands: KAPVAY
• Typical dose range: Typically dosed twice daily; bedtime dosing is common early to reduce daytime sedation.
• Therapeutic drug monitoring not routinely recommended.
• Last reviewed: 2025-12-29

Dosing & forms

• Forms/strengths: Extended-release oral tablets (often dosed twice daily).
• Frequency: Typically dosed twice daily; bedtime dosing is common early to reduce daytime sedation.
• Typical range: Typically dosed twice daily; bedtime dosing is common early to reduce daytime sedation.

Mechanism (brief)

Alpha-2 adrenergic agonist (non-stimulant ADHD medication).

Metabolism & Half‑life

• Metabolism: Hepatic metabolism (multiple pathways)
• Half‑life: Single-dose mean 12 h; Single-dose range 6–20 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

Monitoring highlights

• Baseline and periodic blood pressure and heart rate, especially during titration.
• Sedation, dizziness, and orthostasis are monitored; dosing timing and titration speed can be adjusted as needed.
• Interacting medications (antihypertensives, CNS depressants, beta blockers) are reviewed when symptoms change.
• Taper planning in advance helps reduce rebound hypertension and irritability.

Sources

• Clonidine hydrochloride extended-release tablets prescribing information — DailyMed (2025)
• Attention deficit hyperactivity disorder (NICE guideline NG87) — NICE (2018)
• Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents — Pediatrics (2019)
• Comparative efficacy and tolerability of medications for ADHD (systematic review and network meta-analysis) — Lancet Psychiatry (2018)