Chronic hypertension:
Oral: 0.5 to 2.5 microgram/kg/dose 6 to 8 hourly. [5, 6]
Neonatal abstinence syndrome:
Initial therapy: 5 microgram/kg/day divided in 6 to 8 doses (oral recommended).
Increase dose by 25% every 24 hours to a maximum 12 microgram/kg/day according to neonatal abstinence syndrome scores. [7]
Weaning/ceasing clonidine:
If a neonate has received regular clonidine for >5 days, the dose should be weaned by about 50% each day for 2 to 3 days (reflecting an average half-life of 17 hours in neonates) before ceasing the drug. Watch for tachycardia, hypertension, sweating, agitation, but remember these may also be opioid withdrawal symptoms.
Intravenous clonidine can be converted to oral/nasogastric route when requirements are less than 0.75 microgram/kg/hour. The same daily dose is divided into 3 doses for 8 hourly administration (i.e. 4 to 6 microgram/kg orally every 8 hours). [Group consensus]
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