What is Clonidine?
Clonidine is a blood pressure medicine that relaxes the smooth muscle of blood vessels, causing them to widen, or dilate. This reduces the pressure of blood flow through the artery. It is also used to prevent and relieve symptoms of menopausal flushing; however, clonidine's effect on hot flashes is not well understood.
Who may Benefit?
Clonidine can be used to treat hot flashes. Because it is a non-hormonal treatment, women with a history of breast cancer can use it without increasing the risk of further cancer cell growth (as in the case of estrogen treatment).
How does it Work?
Clonidine lowers blood pressure, but researchers do not think this is how it relieves hot flushes.
No one really knows why women get hot flushes. They may be triggered by a drop in levels of the female hormones, particularly estrogen. Estrogen seems to affect the hypothalamus, the part of the brain that controls body temperature.
If your body is overheated, your brain sends a signal for blood vessels to relax. This means blood vessels widen and more blood gets near the surface of the skin. The air on your skin cools the blood, which helps cool your whole body. This is why your face tends to go red when you are hot. More of your blood is near the surface of your skin.
Many chemicals are involved in this process. The changing hormone levels during the menopause may disrupt this system.
Some scientists think clonidine reduces hot flushes by blocking the signals from your brain to your blood vessels. This means that your hormone levels do not affect your brain's ability to control your body temperature. Therefore, you get fewer hot flushes.
Before you take Clonidine
It is advisable to tell your doctor if you are taking:
* Other medicines for high blood pressure
* Medications for heart problems
* Medications for depression or mood swings
* Medications for pain or swelling.
Clonidine might not be recommended if you are suffering from the following conditions:
* Coronary heart disease
* Severe coronary artery disease
* History of heart attack/s
* History of stroke
* Kidney disease
* Allergic reaction to a ‘transdermal skin patch’
If you have experienced any of these then mention them to your doctor. Using clonidine may be not a good option also if you are suffering from insomnia or depression as it can worsen these conditions.
How to take Clonidine
The usual starting dose is 25 micrograms twice a day. This can be increased to 50 - 75 micrograms twice a day over two weeks if necessary. It is advisable to take Clonidine at the same time each day. If you miss a dose take it as soon as you remember, however if it is almost time for your next dose, take only your usual dose at that time.
You may feel dizzy on standing when you first start taking Clonidine or when you increase the dose. Get up gradually from sitting or lying down to minimize this effect. If you do become dizzy, sit or lie down until you feel better. This problem usually goes away after the first few days
Other common side effects are:
* Dryness of the mouth
* Headache, constipation, fatigue
* Water retention
* Low blood pressure
* Blurred vision, dry eyes
* Skin rash as a reaction to the patch
* Vivid dreams and nightmares
Due to the noticeable side-effects, the Clonidine popularity has recently decreased among the medical practitioners. However, some women reported it was the only remedy, which helped them to deal with severe hot flashes. In addition, some women reported that the medicine also helped them with menopause-associated migraines as unexpected benefit.
How to stop taking Clonidine
Clonidine should be gradually reduced over seven days to prevent a sudden increase in your blood pressure.
While the mechanism of action is not clear, several studies confirmed the positive impact of Clonidine on the ability to improve the women well-being during menopause, especially targeting the severe hot flashes. In one randomized, crossover study, researchers compared the effectiveness of a clonidine patch with placebo in 110 women with a history of breast cancer. The patch was found to decrease the frequency of hot flashes by 20 percent and the hot flash score by 27 percent compared with placebo. Oral clonidine also has been assessed. In 198 women with a history of breast cancer who were randomized to receive oral clonidine at bedtime or placebo, hot flashes decreased by 38 percent in the clonidine group and by 23 percent in the placebo group (P < .006).
Another study, in which clonidine was administered transdermally in 30 postmenopausal women, confirmed that clonidine substantially decreased the number and the severity and duration of hot flashes compared with placebo.
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