Clonidine (Catapres) for quitting smoking

Examples

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Brand Name	Generic Name
Catapres	clonidine

Clonidine is available by prescription in pill or patch form.

Clonidine has not been approved by the U.S. Food and Drug Administration (FDA) for use in helping people to quit smoking. However, the Tobacco Use and Dependence Clinical Practice Guideline Panel of the U.S. Public Health Service recommends it as a second-choice medication for this use.¹

The preferred medications to help you quit smoking are bupropion, varenicline, and nicotine replacement therapy.

How It Works

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Doctors normally use clonidine to treat high blood pressure. In some people, it reduces the craving for cigarettes. It is not entirely understood how clonidine does this.

Although clonidine is not normally used as a first-choice medication for smoking cessation, some people find it calms them when they are dealing with tobacco withdrawal symptoms.

Why It Is Used

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Doctors prescribe clonidine for people who want to quit smoking but cannot take the first-choice medications (bupropion, varenicline, and nicotine replacement therapy) or have not been able to quit smoking by using those medications.²

How Well It Works

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People using clonidine were twiceas likely to be successful at quitting smoking as people who were not using any medication.¹

Side Effects

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The most common side effects of clonidine include:

• Dry mouth (occurs in 40% of users).
• Drowsiness (33%).
• Dizziness (16%).
• Sleepiness (10%).
• Constipation (10%).

The clonidine patch may irritate the skin.

Clonidine lowers blood pressure, so monitor your blood pressure while you are taking this medication. It can also cause depression. Low blood pressure may occur if you sit or stand up quickly (postural or orthostatic hypotension).

Suddenly stopping the use of clonidine can cause side effects. These effects include nervousness, agitation, headache, confusion, and tremor along with a sudden rise in blood pressure (rebound hypertension). You can avoid this by slowly decreasing clonidine over 2 to 4 days.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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Side effects can limit clonidine's usefulness for helping people quit smoking. It often has more side effects than other medicines used to help people quit smoking.¹

You begin using clonidine 3 to 4 days before your quit date to build up the level of medicine in your body. You use the patch for up to 10 weeks.

You will change the clonidine patch weekly.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Fiore MC, et al. (2000). Clinical Practice Guideline: Treating Tobacco Use and Dependence. Rockville, MD: U.S. Department of Health and Human Services. Also available online: http://www.surgeongeneral.gov/tobacco/treating_tobacco_use.pdf.

2. Drugs for tobacco dependence (2003). Treatment Guidelines From the Medical Letter, 1(10): 65–68.

Credits

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Author	Debby Golonka, MPH
Author	Caroline Rea, RN, BS, MS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Michele Cronen
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	John Hughes, MD - Psychiatry
Last Updated	July 24, 2007