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Clonidine extended-release (previously, Kapvay®): Basic information

Clonidine extended-release (generic; US brand name Kapvay® has been discontinued) is a centrally-acting alpha2-adrenergic agonist. 

On this page, we will provide basic information about this medication. Links to other articles on this website with more advanced information and tips related to this medication and related topics are provided below—under Related pages below.


FDA-approved indications

Treatment of attention deficit hyperactivity disorder (ADHD):

– As monotherapy, or

– As adjunctive therapy to stimulant medications


Dosage

Dosage needs to be individualized according to therapeutic needs and response. Initiated with 0.1 mg at bedtime and then adjusted in 0.1 mg/day increments at weekly intervals until the desired response is achieved. Doses should be taken twice a day, with either an equal or higher split dosage being given at bedtime.

Dosage guidance

Starting: 0.1 mg/day at bedtime and then adjusted weekly as below until the desired response

Morning: 0.1 mg/day, Bedtime: 0.1 mg/day (Total: 0.2 mg/day)

Morning: 0.1 mg/day, Bedtime: 0.2 mg/day (Total: 0.3 mg/day)

Morning: 0.2 mg/day, Bedtime: 0.2 mg/day (Total: 0.4 mg/day)

Dosing instructions

  • The tablets should NOT be crushed, chewed, or broken before swallowing.
  • Do not substitute for other clonidine products on a mg-per-mg basis, because of differing pharmacokinetic profiles
  • Doses higher than 0.4 mg/day have not been evaluated and therefore not recommended.
  • Since it has not been systematically evaluated for long-term maintenance treatment, physicians should periodically assess its usefulness if it is prescribed for extended periods.

Discontinuation

The total dose should be tapered in decrements of no more than 0.1 mg every 3 to 7 days


Dosage forms and strengths

Extended-release tablets (generic only): 0.1 mg and 0.2 mg 

(0.2 mg tablets of clonidine extended-release are no longer available as either generic or brand name)


Pharmacokinetics

The half-life of clonidine is about 12 hours but in some persons, it may extend even up to 24 hours (Almanac et al., 2014).


Important! This page does not provide all the information needed to prescribe this medication. Please refer to the full Prescribing Information (see link below) before prescribing this medication.


Related Pages

Clonidine

Clonidine (Kapvay®) extended-release tablets: Basic Information

Clonidine for ADHD

Guanfacine versus clonidine for ADHD


Guanfacine

Guanfacine extended-release (Intuniv®): Basic Information

Does guanfacine work for ADHD in adults?

Should we combine methylphenidate and guanfacine? 

Guanfacine versus clonidine for ADHD

How to manage stimulant-induced hypertension


References

Prescribing information for clonidine (Kapvay®) extended-release tablets


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Disclaimer: The material on this website is provided as general education for medical professionals. It is not intended or recommended for patients or other laypersons or as a substitute for medical advice, diagnosis, or treatment. Patients must always consult a qualified healthcare professional regarding their diagnosis and treatment. Healthcare professionals should always check this website for the most recently updated information.

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