Tuesday September 12, 2006
Clonidine Toxicity !!


Q; The treatment of clonidine toxicity is mostly supportive. Which antidote has shown (only anecdotal reports) to reverse altered mental status and associated hypotension with clonidine toxicity ?


A; Naloxone (Narcan).

There are few case reports in literature describing naloxone to improve the altered mental status associated with clonidine toxicity. It also reverses hypotension but may induce severe hypertension while reversing clonidine effect and should be use with caution. Dose should be initiated from 0.2 IV and can be titrated upto 2 mg IV. Doses upto 5-10 mg have been reported but again caution should be exercise.

Another antidote described in literature for clonidine toxicity is yohimbine. (Yohimbine is a central alpha2-adrenergic antagonist) .The dose is a single 5.4 mg tablet via enteral route.

Dopamine is the choice of vasopressor in clonidine induced hypotension after IVF boluses. And, atrpoine to counteract bradycardia associted with it.


References: click to get abstract / article

1. Reversal of clonidine toxicity by naloxone - Ann Emerg Med. 1986 Oct;15(10):1229-31.
2. Clonidine toxicity revisited - J Toxicol Clin Toxicol. 2002;40(2):145-55.
3. Yohimbine as an antidote for clonidine overdose - Am J Emerg Med.1996 Nov;14(7):678-80.
4. Clonidine overdose: report of six cases and review of the literature - Ann Emerg Med. 1981 Feb;10(2):107-12.
5. Toxicity, Clonidine - emedicine.com