Clonidine for Opioid Withdrawal: Uses, Side Effects & Interactions
Last Updated: November 2, 2023
Clonidine for withdrawal can help ease the uncomfortable side effects that are often associated with opioid withdrawal.
Managing the symptoms of opioid withdrawal can be intimidating, but supportive care is available to help make this process easier. Many patients can use medications like clonidine to make these symptoms more bearable by suppressing the sympathetic nervous system’s response during withdrawal.
What Is Clonidine?
Originally released in the U.S. in 1966, clonidine has been used for over 50 years. It belongs to a class of drugs called alpha-adrenergic blockers and has been approved by the FDA to treat conditions, including:
- High blood pressure
- Attention deficit hyperactivity disorder (ADHD)
- Post-traumatic stress disorder (PTSD)
You may wonder, “How does clonidine help with opiate withdrawal?” In addition to the benefits of its primary use in blood pressure management, blocking alpha receptors helps modulate the sympathetic nervous system in general. Many symptoms experienced during opioid withdrawal — including anxiety — are caused or worsened by increased sympathetic nervous system activity (sometimes called a “fight or flight” response). Clonidine helps by lowering this response.
Sometimes, other treatment options for opioid withdrawal are also controlled substances and other opioids, like buprenorphine or methadone. Clonidine offers an effective alternative, which may be particularly helpful for those who want to avoid using more opioids or controlled substances during treatment. The additional support for anxiety management after initial withdrawal can also be beneficial.
Clonidine can be particularly helpful for managing these symptoms during opioid withdrawal:
- Cold sweats
- Dilated pupils
- Elevated body temperature
- Elevated blood pressure
Clonidine Side Effects
While generally well-tolerated, clonidine has the potential for side effects. Some examples of what may be experienced include:
- Sedation (feeling tired)
- Drops in blood pressure
Clonidine is a blood pressure medication, so drops in blood pressure (and the potential for associated dizziness) are one of the more common complaints from patients taking clonidine. Feeling more drowsy is also commonly reported, as a generalized calming effect from counteracting the sympathetic nervous system can sometimes be overextended.
- Nausea and vomiting
- Dry mouth
- Changes in mood
- Confusion (time, place, interpersonal interactions)
- Irregular heartbeat
- Difficulty breathing
Allergic reactions are rare, but any signs of a potential allergic reaction should be reported to a healthcare professional immediately for further assistance, as these may be life-threatening in some cases.
It is essential to let your doctor know about other medications you may be using when starting any new therapy. Clonidine can be dangerous if mixed with other drugs. So, knowing which ones to avoid while taking it is important. These include:
- Blood pressure medications (particularly calcium channel blockers like amlodipine)
- Heart medications (e.g., beta-blockers like metoprolol)
- Sleeping pills
- Anxiety medications
- Seizure medications
In many cases, a primary concern is with increased sedation. The combination of clonidine and other sedating medications can increase this effect. There is also a potential for slowing down heart rate or changing heart rhythm when clonidine is combined with heart or blood pressure medications.
As an alternative to other therapy options, clonidine has been offered for opioid withdrawal symptom management in an estimated 13.8% of treatment facilities as of 2021. Clonidine as an available treatment option can improve access for some patients in the face of a daunting wave of overdoses in the U.S., which has significantly worsened in the last 10 years.
The timeline for withdrawal management can vary depending on the substance used (there are differences in how the body processes heroin and OxyContin, for instance). In general, symptoms can begin within 6–48 hours of the last dose, peak between two to four days and often begin to wane after about seven days.
How Can Clonidine Help in Addiction Treatment?
Opioid withdrawal can be uncomfortable and even scary. By regulating the body’s sympathetic nervous system response, clonidine can help make some withdrawal symptoms easier to manage, making medical detox more likely to be successful.
Actively managing addiction does not stop after medical detox — in many ways, your journey is just beginning. Clonidine provides additional support for daily stress after the initial medical detox process and can also benefit long-term success.
How Is Clonidine Administered?
Clonidine is available in tablet and patch forms. Either approach can help manage opioid withdrawal symptoms.
When taken by mouth, clonidine is absorbed and processed by the body quickly. Peak concentrations usually occur after about two hours, and effects can begin to fade as quickly as five to six hours. For this reason, many patients are prescribed multiple doses per day, often up to three to four times daily.
Dosing depends on individual response (how well the medication manages withdrawal side effects compared with potential side effects). For opioid withdrawal management, total daily dosing often reaches about 0.9 mg–1.35 mg daily. Regular check-ins with a healthcare provider are crucial for monitoring your health and making necessary adjustments.
The primary benefits of patches are:
- Bypassing nausea concerns
- Ease of use (one patch for one week)
- Steady dosing removes peaks in drug concentration, which may minimize side effects
Patches provide clonidine at a steady rate by allowing consistent diffusion of the medication across the skin. Peak levels of clonidine are reached after about two days when using patches. Because of the slower time frame for response, dosage adjustments would be more difficult to make during the withdrawal process. However, avoiding peaks and valleys in drug concentration makes side effects less likely.
How Do I Get a Prescription for Clonidine?
Clonidine is only available by prescription and should only be used with the support of a healthcare provider. If the medication is the best option, your doctor can provide it and monitor your progress. Clonidine is not a controlled substance, so filling the prescription should be simple at many pharmacies.
Medical Detox for Opioid Withdrawal in the Northeastern United States
The Recovery Village Cherry Hill at Cooper is a state-of-the-art facility in Cherry Hill, New Jersey, offering a range of services, from inpatient to outpatient care. Partnerships with Cooper University Health Care and the VA Community Care Network ensure excellent access to resources and quality care with compassionate providers who understand and support treatment’s physical and psychological challenges.
The facility is an accredited medication-assisted treatment (MAT) provider, with programs offering the following medications for medical detox support:
Managing opioid use disorder (OUD) can feel overwhelming, but these challenges can be overcome with professional help. These medications can help prevent some symptoms of opioid withdrawal without promoting dependence, allowing patients to find solid ground as they take their first steps toward recovery. Contact our Recovery Advocates today for more information or to start the journey to a life free from opioids.
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Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.