Duraclon (Epidural)

Clonidine injection is used along with injected pain medicine to help manage pain in cancer patients.

Clonidine should be started while your doctor is closely watching you. Once your doctor understands how you respond to clonidine, you might be able to use this medicine at home.

This medicine is available only with a prescription from your doctor.

This medicine should not be stopped without your doctor's supervision. Serious side effects may happen if clonidine is stopped suddenly.

This medicine may increase the effects of alcohol and other CNS depressants (medications that can make you sleepy or less alert). Check with your doctor before taking any such depressants while you are using this medicine.

Dizziness, light-headedness, or fainting may happen, especially when you stand up from lying down or sitting. Getting up slowly may help.

This medicine may cause some people to feel drowsy or less alert than usual. Make sure you know how you react to this medicine before you drive, operate machinery, or do other tasks that need you to be alert.

In deciding to use a medicine, you and your doctor need to consider the risks and benefits. For this medicine, keep the following in mind:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

There is no specific information comparing the use of clonidine in children to other age groups, but it is not expected to cause different side effects or problems in children than in adults. This medicine is typically used in children only when the pain is severe and other pain medications have not helped.

Geriatric

Many medicines have not been studied specifically in older adults. Therefore, it may not be known if they work the same way as they do in younger adults or if they cause different side effects in older adults. There is no specific information comparing the use of clonidine in the elderly to other age groups.

Breast Feeding

Studies suggest that this medication may change milk production or composition. If an alternative medication is not prescribed, you should monitor the infant for side effects and ensure they are getting enough milk.

Interactions with Medicines

Some medicines should never be used together, while in other cases, two different medicines may be used at the same time even if an interaction might happen. In these situations, your doctor may adjust the dose or take other precautions. It is very important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions are selected for their potential significance and may not include all possible interactions.

Using this medicine with any of the following medicines is generally not recommended, but may be necessary in some situations. If both medicines are prescribed, your doctor may adjust the dose or how often you take one or both of the medicines.

• Acebutolol
• Amitriptyline
• Amoxapine
• Atenolol
• Betaxolol
• Bevantolol
• Bisoprolol
• Carteolol
• Celiprolol
• Ceritinib
• Clomipramine
• Crizotinib
• Desipramine
• Dilevalol
• Diltiazem
• Dothiepin
• Doxepin
• Esmolol
• Imipramine
• Iobenguane I 131
• Levobunolol
• Lofepramine
• Macimorelin
• Metipranolol
• Metoprolol
• Mirtazapine
• Nadolol
• Nebivolol
• Nortriptyline
• Oxprenolol
• Penbutolol
• Pindolol
• Propranolol
• Protriptyline
• Sotalol
• Tertatolol
• Timolol
• Trimipramine
• Verapamil

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or how often you take one or both of the medicines.

• Cyclosporine
• Fluphenazine
• Mepivacaine
• Naloxone
• Yohimbine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used during meals or with certain foods due to possible interactions. Using alcohol or tobacco with certain medicines may also cause interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Other medical conditions may affect how you can use this medicine. Be sure to tell your doctor if you have any other medical issues, particularly:

• Anticoagulant therapy or
• Bleeding problems—There is a risk of bleeding around the spinal cord

• Heart or blood vessel disease—Clonidine may worsen these conditions

• Infection at the injection site or catheter (tube)—There is an increased risk of developing meningitis or an abscess

• Kidney disease—Clonidine effects may be heightened due to slower clearance from the body

• Pain related to surgery or
• Pain during or after childbirth—Your ability to handle some potential side effects of clonidine may be reduced

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do, they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common

• Dizziness, light-headedness, or fainting
• Slow heartbeat

Less common

• Chest pain
• Extremely shallow or slow breathing
• Fast heartbeat
• Fever
• Hallucinations (seeing, feeling, or hearing things that are not there)
• Mental depression
• Sleepiness (excessive)
• Vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Anxiety
• Confusion
• Dry mouth
• Nausea
• Sleepiness

Less common

• Constipation
• Ringing, buzzing, or other unexplained noises in the ears
• Sweating, unusual
• Weakness

After you stop using this medicine, it may still produce some side effects that need attention. During this time, check with your doctor immediately if you notice the following side effects:

• Agitation
• Headache
• Nervousness
• Pounding heartbeat
• Shaking or trembling

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Duraclon

Available Dosage Forms:

• Solution

Therapeutic Class: Analgesic

Pharmacologic Class: Alpha-2 Adrenergic Agonist

Clonidine is given continuously as an epidural infusion (run around the spinal cord) using an infusion pump. The pump and its tube should be checked regularly to make sure the clonidine flow has not stopped accidentally. The injection or catheter site should also be checked regularly for signs of infection.

If you are using this medicine at home, make sure you understand exactly how to use it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For injection dosage form: For pain: Adults—30 mcg per hour given as a continuous infusion. Children—Dosage is based on body weight and must be determined by your doctor.

Missed Dose

Call your doctor or pharmacist for instructions.

Tell your doctor immediately if you think the clonidine has stopped for any reason.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

• What drugs cause pinpoint pupils?