Clonidine with Mepivacaine Interaction Details
Brand Names Associated with Clonidine
- Catapres®
- Clonidine
- Clorpres® (as a combination product containing Chlorthalidone, Clonidine)
- Combipres® (as a combination product containing Chlorthalidone, Clonidine)
- Jenloga®
- Kapvay®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 13, 2023
Interaction Effect
Prolongation of sensory and motor block
Interaction Summary
A patient experienced a prolongation in sensory and motor block of more than four times following the use of 2% mepivacaine during an outpatient surgical procedure. The patient was also using a clonidine patch for hypertension control, and had applied a new patch the day prior to the surgical procedure. The authors hypothesized that clonidine was responsible for the prolonged recovery from the anesthetic block.
Severity
Moderate
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Closely monitor patients receiving clonidine for prolongation of motor and sensory block following spinal anesthesia with mepivacaine.
Mechanism Of Interaction
Unknown
Literature Reports
A) A 57-year-old male had been using a clonidine transdermal patch for 16 months prior to a left knee arthroscopy and meniscus repair outpatient procedure. He was given 3 mL of mepivacaine 2% via the L3-L4 interspace. Five hours after the induction of anesthesia, the patient still showed a cephalad level of sensory analgesia at T11 and a complete motor block in the lower limbs. The resolution of his anesthesia was recorded at T12-S5, L2-S4, L3-S4, L5-S4, S1-S4, and S4 at the seventh to twelfth hours post block, respectively. The extraordinary increase in this patient's duration of anesthesia was at least partly attributed to the use of his clonidine patch, which had been applied the day prior to surgery on the lower abdomen. It was postulated that the vasodilation and increase in skin blood flow caused by the anesthesia may have resulted in an increase in the amount of absorbed clonidine .
Clonidine Overview
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Clonidine tablets (Catapres) are used alone or in combination with other medications to treat high blood pressure. Clonidine extended-release (long-acting) tablets (Kapvay) are used alone or in combination with other medications as part of a treatment program to control symptoms of attention deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age) in children. Clonidine is in a class of medications called centrally acting alpha-agonist hypotensive agents. Clonidine treats high blood pressure by decreasing your heart rate and relaxing the blood vessels so that blood can flow more easily through the body. Clonidine extended-release tablets may treat ADHD by affecting the part of the brain that controls attention and impulsivity.
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High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.