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Menopause - Management
What issues should I consider before prescribing clonidine?
- Hypotension, dizziness, sedation, dry mouth, fluid retention, and nausea are the most common adverse effects.
- Clonidine may also aggravate depression or produce insomnia:
- Tricyclic antidepressants (TCAs) can antagonize the effects of clonidine, and a higher dose of clonidine (75 micrograms twice daily) may be required.
- Clonidine may potentiate bradyarrhythmic conditions:
- Avoid in women with sinus bradycardia or atrioventricular block.
- Avoid concomitant use of beta-blockers or cardiac glycosides if possible.
- There is a risk of rebound hypertension when a beta-blocker or a TCA is stopped in someone taking clonidine. Withdraw the beta-blocker or TCA slowly over a few days to avoid this. Clonidine should also be reduced gradually over a few days if used at high dose.
[ABPI Medicines Compendium, 2002]
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