Clinical Uses

The primary indication for clonidine use is in mild and moderate hypertension that has not responded adequately to treatment with a diuretic or a p-blocker. Since clonidine causes sodium and water retention and plasma volume expansion, it generally is administered in combination with a diuretic. A vasodilator can be added to the clonidine-diuretic regimen in the treatment of resistant forms of hypertension. Such drug combinations can be quite effective, since the reflex increases in heart rate and cardiac output that result from vasodilator administration are reduced or negated by clonidine-induced decreases in heart rate and cardiac output.

For severely hypertensive patients, clonidine has been used in combination with a diuretic, a vasodilator, and a p-blocker. Some care must be taken, however, because the coadministration of clonidine and a p-blocker may cause excessive sedation. Clonidine is especially useful in patients with renal failure, since its duration of action is not appreciably altered by renal disease and it does not compromise renal blood flow.

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