Clonidine ER suspension
ONYDA XR
What it isExtended-release alpha-2 and imidazoline agonist suspension for ADHD; Approved ages (ADHD label): 6-17.
Why this oneDuration of action 12-16 h (Carlat Table 1); the liquid formulation serves patients unable to swallow extended-release tablets.
What limits itSedation, bradycardia, and hypotension can limit treatment; taper rather than stopping abruptly to prevent rebound hypertension.
FDA-approved for
- ADHD (2024)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| ADHD, as monotherapy or adjunctive to CNS stimulants | Peds ≥6 yr | 0.1 mg PO QHS (with or without food) | 0.4 mg QHS |
Titration Increase by 0.1 mg/day at weekly intervals
Renal Adjust initial dose to degree of renal impairment; monitor for hypotension/bradycardia; no supplemental dose after routine hemodialysis
Hepatic Undefined
Instructions
- Gently shake ≥10 seconds before each dose; use the provided oral dosing dispenser and bottle adapter
- Take once daily at bedtime, with or without food
- Do NOT substitute for other clonidine products on a mg-per-mg basis (different PK)
- When discontinuing, taper by no more than 0.1 mg every 3–7 days to avoid rebound hypertension
Contraindications
- History of a hypersensitivity reaction to clonidine (reactions have included generalized rash, urticaria, and angioedema)
Cautions
- Hypotension/bradycardia (titrate slowly; monitor vitals)
- Somnolence/sedation (additive with CNS depressants; avoid alcohol)
- Rebound hypertension on abrupt discontinuation
- Allergic reactions (cross-sensitization with clonidine transdermal system)
- Cardiac conduction abnormalities (may worsen sinus node dysfunction/AV block)
Adverse reactions
- Somnolence
- Fatigue
- Irritability
- Nightmare
- Insomnia
- Constipation
- Dry mouth
- Decreased appetite
- Dizziness
Pregnancy Prolonged clonidine experience has not identified a drug-associated risk of major birth defects or miscarriage
Lactation Clonidine present in human milk (relative infant dose 4.1–8.4%); monitor breastfed infant for hypotension/bradycardia (sedation, lethargy, poor feeding)
NO BOXED WARNINGS
Principal riskRebound hypertension on abrupt withdrawal
Classes and tags
Clinical profile
Mechanism of action: Clonidine ER suspension ballicule
Open Clonidine ER suspension in the interactive console ↗
Memory aids: mascots and interaction avatars
orange plus signs → alpha-2 agonist
