Clonidine in the treatment of menopausal symptoms

• there is evidence that clonidine improves the symptoms of menopausal hot flushes in approximately 40% of women (1)
  
  
  
  (3)
  • clonidine is often used as a first-line treatment in a dose of two or three 25μg tablets twice daily (2)
    
    
  • a maximum of 75 micrograms bd or 50mcg tds should be used (3)
    
    
  • however side effect with clonidine treatment are common and include dizziness, irritability, nausea and dry mouth
  • interaction with anti-hypertensive drugs and not suitable for patients with baseline low blood pressure
  • must be reduced gradually otherwise causes rebound hypertension (3)
    
    
  • dose related side-effects include sleep disturbance in at least 50% of patients, dry mouth nausea and fatigue

The summary of drug characteristics should be consulted before prescribing this drug.

Reference:

1. Laufer LR et al (1982). Effect of clonidine on hot flushes in postmenopausal women. Obstet Gynecol, 60, 583-6.
2. Grady D. Clinical practice. Management of menopausal symptoms. N Engl J Med. 2006;355(22):2338-47.
3. British Menopause Society. Prescribable alternatives to HRT (Accessed 12/2/2020).
4. Prescriber (2001), 12, 13 (5), 47-58.