Substances

Is Clonidine a Controlled Substance? Clonidine Uses, Risks, and Regulation

Medically Reviewed By:

Dr. Po-Chang Hsu, M.D., M.S.

Last medically reviewed June 17, 2024

Is Clonidine A Controlled Substance?

Key Points

  • Clonidine is a prescription medication that treats high blood pressure and some withdrawal symptoms.
  • Clonidine is not a controlled substance and has a low risk of abuse, but it can be abused with other drugs.
  • Clonidine can have serious long-term risks and dangerous withdrawal symptoms, including extremely high blood pressure.
  • You should never try to quit clonidine on your own, as life-threatening withdrawal symptoms can occur.

Clonidine is a prescription medication that’s used to treat high blood pressure. It’s also used in opioid addiction treatment to alleviate some withdrawal symptoms. Clonidine is not a controlled substance and has a low potential for abuse or addiction, but it can be abused in conjunction with other drugs.

Learn more about clonidine regulation, uses, and precautions, particularly as a medication for treating addiction.

What Is Clonidine?

Clonidine belongs to a class of medications known as antihypertensives. It’s used to treat high blood pressure, but it’s not a first-choice treatment because it’s known to cause “rebound hypertension,” which is a sudden rise in blood pressure when the drug is stopped.

In opioid addiction treatment, clonidine may be prescribed to help with the symptoms of opioid withdrawal. It works by blocking the chemicals in the brain that trigger sympathetic nervous system activity, which can reduce the uncomfortable symptoms of opioid detoxification, like watery eyes, hot flashes, sweating, and agitation.

In addition to these primary treatments, clonidine may be prescribed for migraine, diarrhea, some pain conditions, attention-deficit hyperactivity disorder (ADHD), and anxiety disorders.

Clonidine Regulation

Clonidine has minimal risk of abuse or addiction potential and isn’t a controlled substance. It has no schedule under the Drug Enforcement Administration (DEA), though it is only available with a valid prescription.[1]

However, there is some evidence that clonidine may be abused alongside other drugs to achieve a mood-altering state. The research shows that combining amitriptyline, clonidine, and gabapentin with buprenorphine can cause euphoria, so these drugs shouldn’t be co-prescribed – especially in the treatment of opioid addiction.[2]

Clonidine Side Effects

Clonidine Side Effects

Clonidine is generally safe, but it does have some side effects:[3]

  • Dry mouth
  • Drowsiness
  • Dizziness
  • Constipation
  • Low energy
  • Sluggishness
  • Trouble sleeping
  • Sexual dysfunction
  • Sore throat
  • Constipation
  • Taste changes
  • Nausea
  • Nervousness
  • Fever

There is a risk of serious side effects, including dangerously high blood pressure, tremors, confusion, trouble speaking, and seizures.

Long-Term Side Effects of Clonidine

There is a potential for adverse effects with long-term use of clonidine. Taking clonidine for extended periods can affect the heart, leading to heart palpitations, congestive heart failure, and atrioventricular blockage, among other concerns.[4] In some cases, these effects are irreversible.

Clonidine can impact the central nervous system, causing anxiety, hallucinations, depression, and sleep disorders. These effects can be severe. Nausea, vomiting, and other gastrointestinal effects may also occur.

Signs of Clonidine Abuse, Addiction, and Withdrawal

Though there’s a limited potential for abuse and addiction, clonidine can become addictive with long-term use of the drug combined with other substances. Signs of clonidine addiction can include uncontrollable use of the substance, problems at home or work, and increased tolerance to the drug.

Over time, clonidine can cause physical dependence. If you stop suddenly or reduce your dose dramatically, you may experience tremors, headaches, increased agitation, or nervous behavior.[5] A dangerous rise in blood pressure is the most concerning, as this can be life-threatening.

It’s also possible to overdose on clonidine. When an overdose happens, it causes extreme hypertension (high blood pressure) followed by hypotension (low blood pressure).[6] The central nervous system can become depressed, leading to a slowed heart rate, tiredness, slurred speech, drowsiness, shivering, fainting, and coma.

Treating Clonidine Addiction

Clonidine is used as part of addiction treatment during the detox period to manage some of the symptoms of drug withdrawal, such as cravings and anxiety. If you become dependent on the drug or use it alongside other drugs of abuse (polysubstance abuse), addiction treatment is a crucial step to better health.

Stopping clonidine suddenly can cause serious withdrawal symptoms, including a possible coma and a dramatic drop in blood pressure that can be life-threatening. It’s important to taper off the drug, which should be done under the supervision of a doctor.

Medical detox is recommended to treat clonidine addiction or polysubstance abuse. This environment offers a medical team to monitor your health and administer medications as needed to reduce symptoms and keep you safe and comfortable.

Detox is a critical part of successful treatment, but it’s not enough on its own. After detox, you should consider a comprehensive addiction treatment program to address the emotional, psychological, and social aspects of addiction. Treatment programs may occur in an inpatient or outpatient setting. However, the therapies may include individual counseling, group therapy, or behavioral therapies like cognitive behavioral therapy and dialectical behavior therapy.

Seek Help for Clonidine Abuse

Clonidine is not generally considered a drug of abuse or a controlled substance. It may be used to help with addiction treatment, but there are cases of clonidine abuse and addiction that occurred with the use of other drugs. Withdrawal and side effects of clonidine can be dangerous, so it’s important to seek a detox program and addiction treatment to get help for clonidine abuse and addiction.

Frequently Asked Questions

What Is the Main Use of Clonidine?

Clonidine is used alone or together with other medications to treat high blood pressure and as a treatment for certain symptoms during drug withdrawal.

Is Clonidine Good for Anxiety?

Clonidine has been used to treat conditions that involve too much arousal of the nervous system, such as anxiety. It’s not generally considered an anxiety treatment, though.

Is Clonidine an Alpha Blocker?

Clonidine is a peripheral alpha-2 adrenergic agonist that mimics the effects of the hormone norepinephrine and stimulates alpha-2 adrenergic receptors. This is crucial for treating hypertension and other conditions, including drug withdrawal.

Is Clonidine a Controlled Narcotic?

Clonidine hydrochloride is not a controlled substance and has limited potential for abuse or dependence, though it can occur in some cases.

Why Was Clonidine Discontinued?

Catapres, a clonidine hydrochloride drug produced by Boehringer Ingelheim because of subpar test results, has been discontinued.[7] However, there are plenty of generic variations available on the market.

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Sources

[1] National Institutes of Health. (n.d.-a). DailyMed – clonidine tablet, extended release. U.S. National Library of Medicine. Retrieved from https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=99485427-a120-4fc7-bb61-25857d1900ec

[2] Seale, J. P., Dittmer, T., Sigman, E. J., Clemons, H., & Johnson, J. A. (2014). Combined abuse of clonidine and amitriptyline in a patient on buprenorphine maintenance treatment. Journal of addiction medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227908/ 

[3] Clonidine: Uses, side effects, dosage & reviews. GoodRx. (n.d.). Retrieved from https://www.goodrx.com/clonidine/what-is 

[4] Mayo Foundation for Medical Education and Research. (2024, April 1). Clonidine (oral route) side effects. Mayo Clinic. Retrieved from https://www.mayoclinic.org/drugs-supplements/clonidine-oral-route/side-effects/drg-20063252?p=1

[5] Cao, C., Lorenz, M. L., Sojka, P., Brindle, A. W., & Topor, L. S. (2022, March 22). Hypertensive crisis in a pediatric patient experiencing clonidine withdrawal. Case reports in pediatrics. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964232/

[6] Manzon, L. (2023, June 26). Clonidine toxicity. StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK459374/ 

[7] Kansteiner, F. (2021, January 8). Boehringer Ingelheim quietly culls decades-old hypertension med after October recall. Fierce Pharma. Retrieved from https://www.fiercepharma.com/manufacturing/boehringer-ingelheim-facing-supply-disruption-quietly-culls-decades-old-hypertension