Can You Take Clonidine And Venlafaxine Together?
In our latest question and answer, our pharmacist discusses the combined use of clonidine and venlafaxine.
Hello, my GP has prescribed Venlafaxine 37.5 mg/day to help with menopausal hot flushes, but it doesn't seem to be helping much. She has now prescribed Clonidine instead. Can I start taking Clonidine while I'm slowly tapering off Venlafaxine, or do I need to discontinue Venlafaxine first? Thank you.
Jun 19, 2023- Clonidine and venlafaxine can generally be taken together, though your doctor should monitor you closely while using both medications.
- Most people don't experience problems when combining these drugs, though rare side effects have been reported in a few case studies.
- If you're taking clonidine for hot flashes rather than blood pressure control, the potential interaction between these medications is less likely to be a concern for you.
Quick Answer
Clonidine can be used while gradually discontinuing venlafaxine in many cases. For most individuals, it is not necessary to completely stop venlafaxine first, but when using both together for a period of time, it is recommended that you are closely monitored by your doctor.
Detailed Answer
As mentioned above, generally, there is no need to completely discontinue venlafaxine before starting clonidine.
However, it's important to mention that some online drug interaction checkers may indicate that venlafaxine can potentially interfere with the effects of clonidine, but this is primarily regarding the blood pressure-lowering effects of clonidine.
Given that venlafaxine has the potential to increase blood pressure, and clonidine is commonly used to lower blood pressure, there appears to be a conflict in this regard. However, since you are taking clonidine specifically for the treatment of hot flashes, this particular interaction may not be a significant concern for you.
I also want to state here that a few small case studies have reported side effects when combining alpha2-agonists (such as clonidine and guanfacine) with serotonin/norepinephrine reuptake inhibitors (such as venlafaxine and milnacipran).
These effects include dystonia (with venlafaxine and guanfacine), piloerection (with milnacipran and tizanidine), and unexplained fever (with duloxetine and clonidine). The exact relationship between these effects and potential drug interactions remains unclear. The paucity of studies reporting these types of side effects indicates they occur rarely, and again, their root cause is unknown.
Most individuals don't experience any issues when drugs like clonidine and venlafaxine are combined.
Summary
So, overall, clonidine is generally considered to be safe to take while gradually tapering off venlafaxine, but it's important to be monitored closely by your doctor.
Although some studies have reported higher blood pressure in patients taking both medications, it may not be a concern if you are not using clonidine primarily for blood pressure control (you mentioned in your question you are taking clonidine for hot flashes).
Additionally, rare side effects have been reported with the combination, but their causes are not yet fully understood.
As always, I recommend consulting with your doctor or healthcare provider for personalized advice based on your specific situation. They will be able to provide the most appropriate recommendations for your needs.
Final Words
Thanks so much for reaching out and please do so again anytime.
References & sources
- Noradrenergic function in generalized anxiety disorder: impact of treatment with venlafaxine on the physiological and psychological responses to clonidine challenge — PubMed
- Dystonia as a side effect of nonneuroleptics — PubMed
- Piloerection induced by replacing fluvoxamine with milnacipran — PubMed
- Unexplained high fever in an elderly patient treated with clonidine, duloxetine, and atorvastatin — PubMed
Glossary — Terms in This Answer
- Venlafaxine
- An antidepressant medication that works by increasing levels of serotonin and norepinephrine in the brain.
- Clonidine
- A medication that lowers blood pressure and can be used to treat hot flashes by affecting blood vessels and nerve signals.
- Alpha2-agonists
- A class of medications that activate certain nerve receptors to lower blood pressure and treat other conditions.
- Serotonin/norepinephrine reuptake inhibitors
- A type of antidepressant that works by preventing the brain from reabsorbing two specific chemical messengers.
- Dystonia
- A condition involving involuntary muscle contractions that cause abnormal postures or repetitive movements.
- Piloerection
- The reflex causing body hair to stand up, commonly known as goosebumps.
- Taper
- Gradually reducing the dose of a medication over time rather than stopping it suddenly.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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