Clonidine - Transdermal

Clonidine is used on its own or together with other medicines to help keep your blood pressure under control.

Apply Clonidine patch on your skin exactly as directed by your doctor or according to the instructions on the label. Do not apply more or less than instructed by your doctor.

Do not apply the patch on broken skin. Do not cut the patch. The release pattern of the medicine will be affected if you cut the patch. Do not use it for a longer period than instructed by your doctor.

Instructions for application:

1. Remove the patch from the protective foil pouch and peel away half of the liner. Do not touch the sticky side with your fingers.
2. Apply the patch to a clean, dry, and hairless area. Apply the patch on your upper outer arm or chest. Make sure that the area of the skin is not oily, cut, blistered, or irritated. The skin should be free of any powder, creams, or lotions. If the area of skin is hairy, you should shave the area at least 3 days before applying the patch. Do not put the patch near the waistline or where your belt or clothes may rub against it.
3. Peel away the other half of the liner. Press firmly on the skin for a few seconds to ensure that the patch stays in place.
4. Apply the patch at around the same time and day every week.
5. Replace the patch every week. Change the site of application every week to avoid skin irritation. For example, if you put the patch on your right upper arm on the first week, put it on your left upper arm on the second week, and so on.
6. If the patch falls off, apply a new patch to a new area of skin and change the patch at the usual scheduled time. If the sides of the patch lift up, use plaster or bandage to secure it to your skin.
7. Throw away the used patch by folding the sticky sides together, put it back in the empty pouch, and place it in a rubbish bin. Do not throw it into the toilet bowl. Wash your hands after throwing the used patch.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the severity of your condition and your response to the medication.

Do not stop using Clonidine suddenly as it may worsen your condition. Your doctor will gradually reduce the dose before stopping it completely. Follow your doctor's instructions carefully.

Apply the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose to make up for a missed dose.

If you often forget to apply your medicine, let your doctor and pharmacist know.

Alert your doctor if you have a slow heart rate resulting from sick sinus syndrome (abnormal heart rhythms due to problems with your heart's natural pacemaker) or a 2nd- or 3rd-degree heart block as Clonidine may not be suitable for you.

Inform your doctor if you have the following conditions:

• disease of the blood vessels supplying the brain
• Raynaud's disease (poor blood circulation which makes the toes and fingers numb and pale when feeling cold or stressed)
• peripheral vascular disease (narrowing or blockage of the blood vessels outside of the heart and brain causing poor blood circulation to the arms and legs)
• other heart disease or problems e.g. heart failure (weakness and inability of the heart to pump blood), recent heart attack
• constipation
• polyneuropathy (multiple nerve damage that causes tingling, numbness, and pain usually in the hands and feet)
• history of depression
• kidney disease

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Clonidine to a child or the elderly. Children and elderly people may be more sensitive to the side effects.

If you are going to have certain blood tests, inform your doctor that you are using this medicine.

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

Your blood pressure may fall or rise to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.

What lifestyle changes can I make to improve my blood pressure?

Regular exercise and eating a healthy diet will help control your blood pressure and improve your overall health. Engage in physical activity like walking for at least 30 to 60 minutes on most days of the week. If you have not exercised for a long time, start with light exercises such as slow walks. Speak to your doctor about what type of exercise would be suitable for you. Follow a healthy diet plan by eating more fruits, vegetables, whole grains and low-fat dairy products and reduce your intake of foods high in saturated fat, cholesterol and sodium. Cutting down on deep-fried foods and using less salt when cooking can kick-start your healthy diet.

If you smoke, you should try to quit. Smoking is harmful to your blood pressure, heart and overall health. Speak to your doctor or pharmacist about ways to stop your smoking habit.

Clonidine may cause drowsiness or dizziness. If affected, do not drive or take part in any activity in which you need to be alert.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Other side effects may include any of the following: dry mouth, constipation, nausea, vomiting, headache, tiredness, difficulty sleeping, rash, and skin irritation.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• severe dizziness or passing out
• slow or abnormal heartbeat

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• other medicines for high blood pressure e.g. propranolol, atenolol, diltiazem, prazosin
• water pills or medicines for water retention e.g. furosemide
• medicines to treat depression e.g. mirtazapine, imipramine
• NSAIDs (medicines for pain and inflammation) e.g. ibuprofen
• medicines that cause drowsiness or affect your concentration
• cardiac glycosides (medicines for heart failure) e.g. digoxin

This list does not include all medicines that may interact with Clonidine.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol. Alcohol intake may worsen the dizziness and drowsiness caused by Clonidine.

Cut down on your salt intake. This may help lower your blood pressure and improve your overall health. Discuss with your doctor or dietitian about ways to cut down on your salt intake.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.