Drug Interaction Report

Naloxone and Clonidine Transdermal Patch: Interaction Details

A pharmacist-reviewed analysis of the Naloxone and Clonidine Transdermal Patch interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Clonidine Transdermal Patch

Catapres Catapres-TTS®
+

Naloxone

Kloxxado Narcan Rextovy Rezenopy Zimhi
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
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.

Of 8 documented Naloxone interactions, 3 are rated moderate — including this one.
Onset
rapid
Evidence
probable
Severity
Moderate

What happens

Hypertension

Interaction Deep Dive

The hypotensive and bradycardic effects of chronic clonidine administration may be temporarily attenuated by intravenous naloxone2. Case reports have demonstrated that when naloxone is used in patients suffering a clonidine overdose there has been a substantial rise in blood pressure 43.

Why it happens (mechanism)

Unknown

Literature reports

2 reports — tap to read

a) Naloxone, when given by intravenous infusion, did not modify the onset, maximal effects, or recovery of the hypotensive and heart rate effects of oral clonidine in hypertensive patients 1. However, intravenous naloxone 0.4 mg was given to temporarily increase blood pressure and heart rate in 14 of 27 patients receiving chronic clonidine (0.3 mg daily); all those that experienced an elevation returned to baseline within 60 minutes 2.

b) Three children became hypertensive after the administration of naloxone for the treatment of clonidine poisoning 3.

Common questions

Can I take Naloxone and Clonidine Transdermal Patch together?

Hypertension Always confirm with your pharmacist or prescriber before making any change.

How serious is the Naloxone and Clonidine Transdermal Patch interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.

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 Naloxone 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 anything you'd monitor while I'm on both?

References (4)

  1. Rogers JF & Cubeddu LX: Naloxone does not antagonize the antihypertensive effect of clonidine in essential hypertension. Clin Pharmacol Ther 1983; 34:68-73. PubMed
  2. Farsang C, Kapocsi J, Juhasz I, et al: Possible involvement of an endogenous opioid in the antihypertensive effect of clonidine in patients with essential hypertension. Circulation 1982; 66:1268-1272. DOI
  3. Gremse DA, Artman M, & Boerth RC: Hypertension associated with naloxone treatment for clonidine poisoning. J Pediatr 1986; 108:776-778. DOI
  4. Wasserberger J & Ordog GJ: Naloxone-induced hypertension in patients on clonidine (letter). Ann Emerg Med 1988; 17:557. PubMed
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Clonidine Transdermal Patch

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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Naloxone + 1,4-butanediol Gamma Butyrolactone (gbl) Gamma-hydroxybutyrate (ghb)

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.