Buy Catapres Online

What is Catapres?

Catapres (clonidine) lowers blood pressure by decreasing the levels of certain chemicals in your blood. This allows your blood vessels to relax and your heart to beat more slowly and easily.

Catapres is used to treat hypertension (high blood pressure). The Kapvay brand of clonidine is used to treat attention deficit hyperactivity disorder (ADHD).

Catapres may also be used for purposes not listed in this medication guide.

Important information about Catapres

Before you take Catapres, tell your doctor if you have heart disease or severe coronary artery disease, a heart rhythm disorder, slow heartbeats, low blood pressure, a history of heart attack or stroke, kidney disease, or if you have ever had an allergic reaction to a Catapres transdermal skin patch (Catapres TTS).

Do not take two forms of clonidine at the same time.

If you need surgery, tell the surgeon ahead of time that you are using Catapres. You may need to stop using the medicine for a short time.

Do not stop using Catapres suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using Catapres.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Catapres may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Before taking Catapres

You should not take Catapres if you are allergic to clonidine.

To make sure Catapres is safe for you, tell your doctor if you have:

  • heart disease or severe coronary artery disease;

  • heart rhythm disorder, slow heartbeats;

  • low blood pressure;

  • a history of heart attack or stroke;

  • pheochromocytoma (tumor of the adrenal gland);

  • kidney disease; or

  • if you have ever had an allergic reaction to a clonidine transdermal skin patch (Catapres TTS).

FDA pregnancy category C. It is not known whether Catapres will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Clonidine can pass into breast milk and may harm a nursing baby. Do not take this medication without telling your doctor if you are breast-feeding a baby.

Do not give Kapvay to a child younger than 6 years old.

How should I take Catapres?

Take Catapres exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Do not take two forms of clonidine at the same time.

Catapres may be taken with or without food.

Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

If you need surgery, tell the surgeon ahead of time that you are using Catapres. You may need to stop using the medicine for a short time.

Do not stop using Catapres suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using Catapres.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath) followed by low blood pressure (feeling light-headed, fainting), cold feeling, shallow breathing, weakness, fainting, or pinpoint pupils.

What should I avoid while taking Catapres?

Avoid becoming overheated or dehydrated during exercise and in hot weather.

Drinking alcohol can increase certain side effects of Catapres.

Catapres may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Catapres side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Catapres: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • fast or pounding heartbeats, tremors;

  • a very slow heart rate (fewer than 60 beats per minute);

  • feeling short of breath, even with mild exertion;

  • swelling, rapid weight gain;

  • confusion, hallucinations;

  • flu symptoms;

  • urination problems; or

  • feeling like you might pass out.

Other common Catapres side effects may include:

  • drowsiness, dizziness;

  • feeling tired or irritable;

  • cold symptoms such as runny or stuffy nose, sneezing, cough, sore throat;

  • mood changes;

  • sleep problems (insomnia), nightmares;

  • headache, ear pain;

  • mild fever;

  • feeling hot;

  • constipation, diarrhea, pain in your upper stomach;

  • dry mouth, increased thirst; or

  • loss of interest in sex, impotence, difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Catapres?

Taking Catapres with other drugs that make you sleepy or slow your breathing can increase these effects. Ask your doctor before taking Catapres with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Catapres, especially:

  • clonidine transdermal skin patches (Catapres TTS);

  • digoxin, digitalis;

  • an antidepressant such as amitriptyline, clomipramine, doxepin, imipramine, nortriptyline, and others;

  • a beta-blocker such as atenolol, carvedilol, labetalol, metoprolol, nadolol, propranolol, sotalol, and others;

  • heart or blood pressure medicine such as amlodipine, diltiazem, nifedipine, verapamil, and others;

  • medicines to treat psychiatric disorders, such as chlorpromazine, clozapine, fluphenazine, haloperidol, olanzapine, perphenazine, prochlorperazine, risperidone, thiothixene, trifluoperazine, and others; or

  • any other drugs to treat high blood pressure or heart problems.

This list is not complete. Other drugs may interact with Catapres, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

For the Consumer

Applies to clonidine: oral suspension extended release, oral tablet, oral tablet extended release

Along with its needed effects, clonidine (the active ingredient contained in Catapres) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking clonidine:

Less common
  • Mental depression
  • swelling of the feet and lower legs
Rare
  • Anxiety
  • blistering, burning, crusting, dryness, or flaking of the skin
  • chest pain or discomfort
  • confusion as to time, place, or person
  • decreased urine output
  • dilated neck veins
  • drowsiness
  • dry mouth
  • fast, pounding, or irregular heartbeat or pulse
  • fever
  • general feeling of discomfort or illness
  • holding false beliefs that cannot be changed by fact
  • hyperventilation
  • irregular breathing
  • irritability
  • itching, scaling, severe redness, soreness, or swelling of the skin
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • lightheadedness, dizziness, or fainting
  • mental depression
  • paleness or cold feeling in the fingertips and toes
  • pounding, slow heartbeat
  • problems in urination or increase in the amount of urine
  • raised red swellings on the skin, lips, tongue, or in the throat
  • restlessness
  • seeing or hearing things that are not there
  • shaking
  • shortness of breath
  • skin rash
  • swelling of the face, fingers, feet, or lower legs
  • tightness in the chest
  • tingling or pain in the fingers or toes when exposed to cold
  • trouble with sleeping
  • troubled breathing
  • unusual excitement, nervousness, or restlessness
  • unusual tiredness or weakness
  • vivid dreams or nightmares
  • weight gain
  • wheezing

Get emergency help immediately if any of the following symptoms of overdose occur while taking clonidine:

Symptoms of overdose
  • Dizziness (extreme) or faintness
  • feeling cold
  • pinpoint pupils of the eyes
  • unusual tiredness or weakness (extreme)

Some side effects of clonidine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Constipation
Less common
  • Darkening of the skin
  • decreased sexual ability
  • dry, itching, or burning eyes
  • loss of appetite
  • nausea or vomiting
Rare
  • Blurred vision
  • decreased interest in sexual intercourse
  • hair loss or thinning of the hair
  • inability to have or keep an erection
  • leg cramps
  • loss in sexual ability, desire, drive, or performance
  • muscle or joint pain
  • pale skin
  • swelling of the breasts or breast soreness in both females and males
  • weakness

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Applies to clonidine: compounding powder, injectable solution, oral suspension extended release, oral tablet, oral tablet extended release, transdermal film extended release

Other

The most common adverse side effects are related to the alpha-adrenergic blocking effects of clonidine (the active ingredient contained in Catapres) These side effects are dose-related, typically decrease over time, and mostly affect the nervous system, cardiovascular system, and the gastrointestinal system.

Nervous system

Nervous system side effects have included drowsiness (28%), dizziness (9%), somnolence (19%), fatigue (13%), headache (19%), irritability (6%), insomnia (6%), nightmares (3%), body temperature increased (1%), abnormal sleep-related event (1%), and tremor (3%). Patients with decreased autoregulation of cerebral blood flow appear to be at increased risk for clonidine-induced cerebral hypoperfusion if blood pressure is lowered too much or too quickly. This may be important in some elderly patients. Confusion (13.2%) and hallucinations (5.3%) have been reported with epidural usage. Dose-dependent sedative effects, memory impairment, and reduced cognitive performance have been reported in subjects receiving intravenous clonidine (the active ingredient contained in Catapres)

A study of 13 patients who had pre- and post-clonidine cerebral blood flow (CBF) measured by nuclear scanning revealed that patients with an initially high pretreatment CBF tended to demonstrate decreased CBF after clonidine therapy.

Patients with traumatic spinal cord injury receiving clonidine may experience a delayed-onset of sedation regardless of the route of administration (i.e., intrathecal, intramuscular).

Cardiovascular

Cardiovascular side effects have included hypotension and sinus and atrioventricular arrhythmias. Postural hypotension occurs in 2% of patients. Rebound hypertension (which may be worse than pretreatment values) can present as irritability, tremors, headache, increased salivation, and palpitations. Rebound hypertension may be minimized by gradual reduction of dosage over two to four days.

Hypotension with epidural clonidine (the active ingredient contained in Catapres) has been reported in 45% of 38 patients in one study. Hypotension occurred more commonly in the first four days, in women, in lower weight patients, and those receiving higher dosages.

Other cardiovascular side effects have included sinus bradycardia in approximately 0.3% of patients. A rare case of sinus arrest associated with clonidine has been reported. Patients with preexisting sinus node dysfunction, patients who have developed bradycardia while taking other sympatholytic agents, patients who are on another sympatholytic agent, and patients with renal dysfunction are at increased risk of clonidine-associated sinus bradycardia. Clonidine may cause hypertension in some patients with idiopathic orthostatic hypotension, particularly those with autonomic nervous system dysfunction. There have also been reports of congestive heart failure, electrocardiographic abnormalities (i.e., sinus node arrest, junctional bradycardia, high degree AV block, and arrhythmias), palpitations, Raynaud's phenomenon, syncope, and tachycardia. Cases of sinus bradycardia and atrioventricular block have been reported, both with and without the use of concomitant digitalis.

A case of sinus arrest associated with clonidine has been reported. A 65-year-old man with diabetes, hypertension and unexplained syncope developed more frequent syncope and dizziness associated with documented episodes of sinus arrest during the first week of clonidine therapy. The patient had no hypoglycemia or orthostatic changes. The syncope and dizziness resolved upon discontinuation of clonidine; continuous electrocardiographic monitoring revealed a gradual and complete disappearance of sinus pauses. Junctional bradycardia and AV heart block have also been reported.

Ventricular tachycardia (VT) relatively refractory to lidocaine, but responsive to intravenous phentolamine, has been associated with clonidine withdrawal (case report). The authors believe that the VT was probably produced by humoral or neural stimulation of unregulated myocardial alpha-adrenergic receptors.

Transdermal clonidine has been implicated with hypertension in a quadriplegic patient with a C4 spinal lesion. The proposed mechanism is predominance of clonidine's peripheral alpha-1 adrenergic effects due to the patient's autonomic dysfunction, resulting in vasoconstriction and hypertension.

Sinus bradycardia or other supraventricular bradyarrhythmias are more likely in patients with underlying renal dysfunction.

In one case report, severe hypotension occurred during separation from cardiopulmonary bypass in a patient given intrathecal clonidine. The patient responded to volume expansion and use of vasoconstrictors.

Gastrointestinal

Gastrointestinal side effects have most commonly included dry mouth (30%) and constipation (15%), abdominal pain, anorexia, nausea, vomiting, diarrhea (1%), parotitis, pseudo-obstruction (including colonic pseudo-obstruction), and salivary gland pain. Nausea (13.2%) and vomiting (10.5%) have been reported with epidural clonidine (the active ingredient contained in Catapres)

Genitourinary

Genitourinary side effects have included impotence in male patients (24%), retrograde and delayed ejaculation, and an inability to achieve orgasm in female patients.

Dermatologic

A 66-year-old woman with a history of psoriasis in remission developed erythematous, scaly plaques on the extensor surfaces of her forearms within three days after beginning clonidine (the active ingredient contained in Catapres) therapy for control of flushing. The author of this case report suspected that clonidine may cause a fall in intracellular cAMP, leading to epidermal cell proliferation, and, in some cases, a psoriasiform eruption.

Dermatologic reactions have been reported in 10% to 38% of patients who use transdermal clonidine. These reactions include psoriasis exacerbations, local dermatitis and/or pigmentation, alopecia, angioneurotic edema, hives, pruritus, rash, and urticaria.

Psychiatric

Psychiatric side effects have included emotional disorder (5%), aggression (1%), tearfulness (3%) and rare reports of depression, which has been the most common psychiatric reaction to clonidine (the active ingredient contained in Catapres) Rare cases of frank psychoses and delirium have been associated with clonidine withdrawal. Hallucinations have been reported postmarketing.

Endocrine

Endocrinologic side effects have been limited to rare cases of gynecomastia, hyperprolactinemia, or hyperglycemia.

A 68-year-old black man with hypertension, status post unilateral nephrectomy, was incidentally found to have 4+ proteinuria, 1+ glycosuria, new elevated blood glucose levels, and between 1.8 and 5.4 grams of protein per 24-hour urine collection within 6 weeks after starting clonidine. The signs and symptoms of diabetes and the nephrotic syndrome disappeared within five months after discontinuation of clonidine. Because of his solitary kidney, a renal biopsy was not performed.

Musculoskeletal

Musculoskeletal side effects have included leg cramps and muscle or joint pain. Moderately severe myalgia has been associated with the use of clonidine (the active ingredient contained in Catapres) in patients treated for opioid withdrawal symptoms.

Immunologic

Immunologic side effects have rarely been reported and include one case of immune-complex disease.

A 46-year-old woman developed forearm edema, mild thenar atrophy, and skin hypopigmentation within three months after beginning clonidine for perimenopausal flushing. Electromyelography was consistent with carpal tunnel syndrome. At surgical decompression, a skin biopsy revealed changes consistent with immune-complex disease. The patient's signs and symptoms abated after physical therapy and discontinuation of clonidine.

Respiratory

A 9-year-old boy with asthma developed a severe asthma attack after an oral clonidine (the active ingredient contained in Catapres) stimulation test. He required hospitalization. The authors of this case report suspect that clonidine may have caused acute pulmonary artery vasoconstriction (directly), which could have decreased pulmonary blood flow, producing relative pulmonary hypoxemia, setting off an asthma attack.

Respiratory system reactions have included nasal congestion (5%), asthma (1%), and nasopharyngitis (3%). A case of severe bronchospasm associated with clonidine has been reported in the pediatric literature.

Ocular

Ocular side effects have included accommodation disorder, blurred vision, burning of the eyes, decreased lacrimation, and dryness of the eyes.

Metabolic

Metabolic side effects have included thirst (3%) and throat pain (6%).