Dothiepin and Clonidine Transdermal Patch: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Clonidine Transdermal Patch
Dothiepin
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Decreased antihypertensive effectiveness
Interaction Deep Dive
Concomitant clonidine and tricyclic antidepressant (TCA) therapy may impair the antihypertensive effects of clonidine6. Tricyclic antidepressants increase the release of noradrenaline, presumably through re-uptake blockade. Clonidine reduces the release of noradrenaline by stimulating pre-synaptic alpha-2 adrenoreceptors, whose function is to inhibit noradrenaline release 1782. Mianserin, a tetracyclic antidepressant, was not shown to exhibit the impairment of clonidine's antihypertensive effects seen with tricyclic antidepressants 45.
Why it happens (mechanism)
Pharmacological antagonism at central alpha-2 receptors
Literature reports
3 reports — tap to read
a) The interaction between clonidine and desipramine was studied in five hypertensive patients. The results of this double-blind placebo controlled study showed that the introduction of the tricyclic antidepressant led to the loss of blood pressure control in four of the five subjects within two weeks. The rise in the arterial pressure was more prominent in the supine position than in the erect. The average blood pressure increase in the desipramine period compared to the placebo period was 22/15 mm Hg in the lying position and 12/11 mm Hg standing 1.
b) Eleven drug-free patients who met the Research Diagnostic Criteria for Major Depressive Disorder enrolled in a study to determine the effects of desipramine on central adrenergic function. Patients were given a clonidine infusion after 0, 1 and 3 weeks of treatment with desipramine. Results showed that the sedative and hypotensive effects of clonidine were significantly inhibited after three weeks of treatment with desipramine. This interaction was also seen at one week, but did not reach clinical significance. The authors concluded that the effects that were observed during the study were due to an acute drug effect, rather than to a chronic adaptive change 2.
c) One case report describes a 65-year-old man who was experiencing perineal pain following the excision of a carcinoma. Pain management of amitriptyline 75 mg nightly and sodium valproate 500 mg three times daily was initiated after slow-release morphine only had a limited effect. A clonidine spinal intrathecal injection of 75 micrograms was given when it was felt that the patient had become tolerant to opioid treatment. Within five minutes, the patient was found to be in severe pain, which resolved within 30 minutes after diamorphine was given. Two mechanisms for this interaction were postulated. In the first, the pain could have been the result of a clonidine-cholinergic interaction. In the second, the tricyclic augmentation of serotoninergic transmission may have unmasked an effect of clonidine at central receptors to enhance nociception 3.
Common questions
Can I take Dothiepin and Clonidine Transdermal Patch together?
Decreased antihypertensive effectiveness Always confirm with your pharmacist or prescriber before making any change.
How serious is the Dothiepin and Clonidine Transdermal Patch interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Dothiepin or Clonidine Transdermal Patch need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (8)
- Briant RH, Reid JL, & Dollery CT: Interaction between clonidine and desipramine in man. Br Med J 1973; 1:522-523. PubMed
- Glass IB, Checkley SA, Shur E, et al: The effect of desipramine upon central adrenergic function in depressed patients. Br J Psychiatry 1982; 141:372-376. DOI
- Hardy PAJ & Wells JCD: Pain after spinal intrathecal clonidine. Anaesthesia 1988; 43:1026-1027. DOI
- Elliott HL, McLean K, Sumner DJ, et al: Pharmacodynamic studies on mianserin and its interaction with clonidine. Eur J Clin Pharmacol 1981; 21:97-102. PubMed
- Elliott HL, McLean K, Sumner DJ, et al: Absence of an effect of mianserin on the actions of clonidine or methyldopa in hypertensive patients. Eur J Clin Pharmacol 1983; 24:15-19. DOI
- Product Information: Catapres(R), clonidine. Boehringer Ingelheim Pharmaceuticals, Inc. Ridgefield, CT, 1996. DailyMed
- Hicks R, Dysken MW, Davis JM, et al: The pharmacokinetics of psychotropic medication in the elderly: a review. J Clin Psychiatr 1981; 42:374-385.
- Hui KK: Hypertensive crisis induced by interaction of clonidine with imipramine. J Am Geriatr Soc 1983; 31:164-165. PubMed
Keep reading about Clonidine Transdermal Patch
Keep reading about Dothiepin
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist