Kidney Impairment Can Be Costly
Although renal impairment is often reversible if the offending drug is discontinued, the condition can be costly and may require multiple interventions, including hospitalization, Dr. Naughton explained. To help you avoid getting to that point, we learned about medications that commonly cause kidney damage from Rebekah Krupski, PharmD, RPh, pharmacy resident at the Cleveland Clinic and clinical instructor of pharmacy practice at Northeast Ohio Medical University.
Pharmacist Tips For Catapres
Catapres is usually taken together with other medications for better blood pressure control
Many people notice drowsiness and dizziness, especially after they first start on Catapres . The patch usually causes fewer side effects.
Take the tablet at the same time every day and avoid skipping doses. If you are on the patch, pick a day of the week that helps you remember to change it every 7 days.
If you are prescribed the patch, make sure the area is clean and dry before applying. Apply it to a hairless area on the chest or upper arm, and make sure to change the location with each new patch every week.
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Other Drugs Like Catapres
While Catapres is not the only drug of its kind, it is essentially the only one that patients are likely to encounter as a normal part of high blood pressure treatment. The only other drug in the same family as clonidine is alpha-methyldopa, which is only used in special circumstances and is typically only given in a hospital setting. Catapres, though, is still used in pill form outside of the hospital.
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What Other Information Should I Know
Keep all appointments with your doctor. Your blood pressure should be checked regularly to determine your response to clonidine.
Your doctor may ask you to check your pulse daily and will tell you how rapid it should be. Ask your doctor or pharmacist to teach you how to take your pulse. If your pulse is slower or faster than it should be, call your doctor before taking this medication that day.
To relieve dry mouth caused by clonidine, chew gum or suck sugarless hard candy.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
How Should I Take Clonidine
Take clonidine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Clonidine is usually taken in the morning and at bedtime. If you take different doses of this medicine at each dosing time, it may be best to take the larger dose at bedtime.
Clonidine may be taken with or without food.
Swallow the extended-release tablet whole and do not crush, chew, or break it.
Tell your doctor if you have a planned surgery.
You may have withdrawal symptoms if you stop using this medicine suddenly. Ask your doctor before stopping the medicine.
Call your doctor if you are sick with vomiting. This is especially important for a child taking clonidine.
If you have high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms.
Store at room temperature away from moisture, heat, and light.
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Typical Dosing For Catapres
- Tablet: The typical starting dose is 0.1 mg twice a day. The dose can be adjusted to get to your blood pressure goal, but most people don’t need more than 0.6 mg total per day.
- Patch: Catapres patch doses are based on how much clonidine absorbs into your body each day . Most people start with taking one 0.1 mg per day patch. The dose can be adjusted to get to your blood pressure goal some people may need up to two of the 0.3 mg per day patches. Apply a new patch every 7 days.
Approach And Management Of Hypertension After Kidney Transplantation
- 1Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine School of Medicine, Orange, CA, United States
- 2Nephrology Section, Department of Medicine, Tibor Rubin Veterans Affairs Medical Center, VA Long Beach Healthcare System, Long Beach, CA, United States
- 3Section of Nephrology, Department of Internal Medicine, Multi-Organ Transplant Center, William Beaumont Hospital, Oakland University William Beaumont School of Medicine, Royal Oak, MI, United States
- 4Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, United States
- 5Methodist University Hospital Transplant Institute, Memphis, TN, United States
- 6Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, United States
- 7Division of Nephrology and Hypertension, Department of Medicine, Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- 8Division of Transplantation, Department of Surgery, University of California Irvine School of Medicine, Orange, CA, United States
- 9Department of Medicine, University of California Irvine School of Medicine, Orange, CA, United States
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Are There Any Other Precautions Or Warnings For This Medication
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Depression: This medication can cause symptoms of depression. If you have a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, or decreased interest in activities, or notice them in a family member who is taking this medication, contact your doctor as soon as possible.
Drowsiness/reduced alertness: Clonidine can cause drowsiness and dizziness and may affect the ability of your eyes to change focus quickly between distance and close up. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how you are affected by this medication.
Eyes: This medication may affect the eye. People taking clonidine should receive periodic eye examinations. This medication can cause decreased tear production, and contact lenses may become uncomfortable to wear.
Blood Pressure Guideline For Kidney Transplant Recipients
BP targets have been a controversial topic not only in the non-transplant population but also in kidney transplant recipients. Several professional societies from different countries have created clinical practice guidelines with some similarities and differences .
Table 4. Summarized blood pressure guideline for kidney transplant recipients from different scientific medical societies.
Until there is strong clinical outcome evidence in terms of CV, patients, or renal allograft survival, BP targets should be individualized, taking into account immunologic and non-immunologic factors that are contributing to HTN in each kidney transplant recipient.
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Outcomes Of Hypertension After Kidney Transplantation
Pre-transplant BP is associated with renal allograft and patient survival outcomes after kidney transplantation. Very low pre-transplant SBP and DBP are associated with a decrease in renal allograft loss. Specifically during dialysis lower pre- and post-dialysis DBP are associated with better patient survival post-transplantation .
During the post-transplant period, elevated BP is associated with poorer renal allograft and patient outcomes. However, as discussed above, various forms of renal allograft injury are also associated with post-transplant HTN. Several studies have demonstrated an association between post-transplant HTN and renal allograft failure . Opelz et al. conducted a retrospective study of 29,751 kidney transplant recipients followed for over 7 years. Increased post-transplant SBP and DBP were associated with progressively decreased renal allograft function and death-censored chronic graft failure. Another study from the same cohort database examined the association between changes in BP levels at 1- and 3-years post-transplantation and long-term graft outcomes up to 10 years following transplantation. They found that patients with a SBP > 140 mmHg at 1 year who were controlled to a SBP â¤ 140 mmHg at 3 years post-transplantation had improved renal allograft outcomes and reduced CV death compared to those with persistent SBP of > 140 mmHg both at 1 and 3 years post-transplantation .
What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
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What Is Clonidine Used For
Clonidine may be used for different conditions:
- Impulsivity that is seen withAD/HD
- Tic disorders
- Sleep difficulties
- Anxiety disorders
- Smoking cessation
There may also be other reasons why your doctor is prescribing this medication . If you are unclear why this medication is being prescribed, please ask your doctor.
What Precautions Should My Doctor And I Be Aware Of When Taking Clonidine
Several medications can interact with clonidine, including high blood pressure medications some cough and cold medications anti-histamines such as diphenhydramine some antidepressants such as nortriptyline some medications used for sleep, anxiety, seizures, or other psychiatric disorders and several others. If you are taking any other prescription or over-the-counter medications, be sure to check with your doctor or pharmacist to see if they are safe to use. Your doctor may need to change the doses of your medication or monitor you carefully for side effects if you are taking medications that interact with clonidine.
Tell your doctor of pharmacist if you:
- have any allergies or have experienced a reaction to a medication.
- have diabetes or kidney disease
- have heart conditions or a family history of early heart disease or sudden death
- have psychiatric conditions such as depression or bipolar disorder
- have Raynauds disease
- miss a period, are pregnant or are breast-feeding. Tell your doctor if you become pregnant while taking clonidine
- are currently using alcohol or street drugs, as these substances can decrease how well clonidine works for you and/or make you feel drowsy
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Surgical Renal Denervation By Bilateral Native Nephrectomy
Complete RDN can be performed by bilateral native nephrectomy. A retrospective study in 32 kidney transplant recipients undergoing pre-transplant bilateral native nephrectomy revealed lower SBP, a number of antihypertensive medications, left ventricular mass index, and left atrial volume index but higher left ventricular diastolic dysfunction compared to a matched control group . This data supports the effect of RDN as treatment options for HTN in this population.
Although native nephrectomy can improve post-transplant HTN, both pre- and post-transplant native nephrectomy can lead to surgical complications, which can cause impaired renal allograft function. Therefore, native nephrectomy for the purpose of BP control in kidney transplant recipients should be performed in select patients with severely uncontrolled post-transplant HTN whom, without treatment, would have deterioration of renal allograft function or be at increased risk of CV complications. Patients who undergo bilateral native nephrectomy for alternative indications such as recurrent infection, discomfort from large polycystic kidneys, or suspicious native renal tumors may have the added benefit of improved BP control.
Are There Other Uses For This Medicine
Clonidine is also used in the treatment of dysmenorrhea , hypertensive crisis , Tourette’s syndrome ,menopausal hot flashes, and alcohol and opiate withdrawal. Clonidine is also used and as an aid in smoking cessation therapy and to diagnose pheochromocytoma . Talk to your doctor about the possible risks of using this medication for your condition.
This medication may be prescribed for other uses ask your doctor or pharmacist for more information.
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Interactions Between Catapres And Other Medications
Catapres may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements that you are currently taking. The list below does not include all possible drug interactions with Catapres . Please note that only the generic name of each medication is listed below.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
What Should I Do In Case Of Overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
- smaller pupils
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Drugs That Increase Drowsiness
Dont combine these drugs with clonidine. Taking these drugs with clonidine might increase drowsiness:
- barbiturates such as:
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
This drug comes with several warnings.
Why Is This Medication Prescribed
Clonidine tablets are used alone or in combination with other medications to treat high blood pressure. Clonidine extended-release tablets are used alone or in combination with other medications as part of a treatment program to control symptoms of attention deficit hyperactivity disorder 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.
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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Clonidine In Children And Adolescents
In the United States, a long-acting form of clonidine has been approved for treating AD/HD in children and adolescents.
However in Canada, like many medications used to treat childhood disorders, Clonidine is not officially approved by Health Canada for use in children and adolescents.
Nonetheless, when the potential benefits of using Clonidine outweigh the potential risks , many doctors may prescribe it off-label to treat several conditions.
Clonidine does not cure AD/HD. This medication aims to improve functioning by moderately reducing AD/HD symptoms such as hyperactivity, impulsive behaviour. It can also help people with ADHD tolerate frustration better. In comparison, clonidine may be less beneficial for improving attention and concentration. Despite this, clonidine remains an important treatment option for AD/HD patients who have undesirable side effects from, or do not respond to stimulant medications.
Whenever possible, adding behavioral management strategies to clonidine increases the chance for benefit.
Is Clonidine Hard On The Kidneys
. Accordingly, what is the most common side effect of clonidine?
Clonidine FAQA: Clonidine is sometimes used to treat insomnia or sleep problems in children with attention deficit disorder or autistic spectrum disorders. Common side effects include dry mouth, headache, nausea, constipation, and fatigue.
Beside above, what are the side effects of clonidine 0.1 mg? Common clonidine side effects may include:
- drowsiness, dizziness
- dry mouth, loss of appetite
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What Side Effects Can This Medicine Cause
Clonidine may cause side effects. Tell your doctor if any of these symptoms or those listed in the SPECIAL PRECAUTIONS section, are severe or do not go away:
- dry mouth
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:
What Is The Highest Mg Of Clonidine
Maximum Dosage 0.4 mg/day PO extended-release tablets safety and efficacy of immediate-release tablets have not been established however, doses up to 2.4 mg/day for hypertension have been recommended. Maximum doses of transdermal and epidural clonidine in pediatric patients have not been established.
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