Clonidine for Neonatal Abstinence Syndrome (NAS)

Helping Hand Logo

Clonidine is a prescription drug used to treat Neonatal Abstinence Syndrome (NAS) in newborn babies. It treats withdrawal symptoms in babies born to mothers who used either illegal drugs or certain prescribed medicines during pregnancy.

How this medicine works

Clonidine works like some of the medicines mom was taking during pregnancy. When the infant gets the same type of medicine, decreased over time, he will eventually not need the drug anymore. Giving the medicine this way prevents withdrawal symptoms, like stiffness, shaking and agitation.

How to give this medicine

  • Read the label carefully. Make sure you are giving your child the right dose. It is easy to confuse the many different dosage forms and strengths. Clonidine comes in many different strengths. Always make sure you get the correct form of the medicine from the pharmacist.
  • Give the exact dose of medicine that your doctor ordered.
  • Stay with your child until he or she has swallowed the dose of medicine.
  • Use a children's measuring device (available at the pharmacy). Do not measure liquid medicines in kitchen spoons.
  • It is very important to give the medicine every day as ordered, even if your child is feeling fine. Do not change doses or stop the medicine without talking to your child's doctor.

Wash and dry your hands before and after using the medicine.

If you forget to give a dose

If you miss a dose, give the medicine as soon as you can. Do not give the missed dose at all if it is almost time for the next dose. Do not double the next dose. Instead, go back to your regular dosing schedule. If you have any questions about this, check with your child's doctor or pharmacist.

If a dose is vomited

  • If the medicine is thrown up (vomited) right after you give it, do not repeat the dose. Even if the medicine is vomited right after giving it, some of the medicine may still be in the stomach.
  • If the vomiting continues, call your child's doctor.

Medicine storage

  • Store all medicine out of the reach of children.
  • Always keep medicine in the original bottle from the pharmacy.
  • Do not keep this medicine in the refrigerator. Store at room temperature.
  • Light and moisture make this medicine not work as well.  Keep the bottle tightly closed.
  • Store it in a dark, dry place. Do not store it in the bathroom or above the kitchen sink.
  • Keep this medicine away from heat or direct sunlight.
  • Do not use this medicine after the expiration date printed on the container.

When the medicine is no longer needed, mix the leftover medicine with an unwanted material, like coffee grounds. Place the mixture into a container or bag that will not leak. Throw it away in the trash where children and pets cannot reach it.

Drug – nutrient interactions

  • If your child is taking any other medicine or herbal supplements, tell your doctor and pharmacist. Certain medicines should not be taken with clonidine.
  • When taken with other central nervous system (CNS) depressants, clonidine can cause more sleepiness and slower breathing. This can get to a dangerous level if too many of any of these medicines are taken together.

Warnings

  • If your child is allergic to clonidine, he or she should not take this medicine.
  • Nervous system depression and very slow breathing can occur, especially in newborns and babies less than 3 months of age.
  • Clonidine may cause very low blood pressure.
  • The doctor has ordered this medicine for your child only. Do not let anyone else take this medicine.
  • Do not change your child's dose unless told by the doctor. Withdrawal and seizures may occur if the dose is changed too soon. Call your child's doctor immediately if your infant's behavior is different (agitation, sleeping, eating, stooling, etc.) after a dose change.

Possible side effects

  • Drowsiness, sleepiness
  • Slow heart rate
  • Low blood pressure
  • Constipation
  • Irritability

What to do about side effects

Call the doctor to check the dose and measuring instructions if your child is more sleepy and drowsy than normal after a dose change.

When to call for emergency help

Call for emergency help if your child has any of these signs of an allergic reaction:

  • Trouble breathing
  • Swelling of the tongue
  • Swelling of hands, feet or ankles

When to call the doctor

Call your child's doctor if any of the following occurs:

  • Your child's heartbeat is slower or faster than usual
  • Your child's behavior changes
  • There are changes in your child's urination
  • There are change in your child's muscle tone
  • There are any side effects that continue or seem to bother your child.

Miscellaneous

  • Some pharmacies may not have this medicine. Please ask your nurse to call your pharmacy before you leave the hospital to see if they have this medicine or can order it for you. You may also have the prescription filled at the Children's Hospital Pharmacy.
  • Ask your nurse for these Helping Hands:

Other advice about the medicine

  • Tell your child's doctor and pharmacist if your child has a strange or allergic reaction to any medicine.
  • Do not stop giving this medicine or change the amount given without first talking with your child's doctor or pharmacist. Too much clonidine can cause bad side effects, like coma and death. Too little clonidine may cause withdrawal symptoms.
  • The doctor has prescribed this medicine for your child only. Do not give it to anyone else.
  • If you carry medicine in your purse, keep it in its childproof bottle and keep your purse out of the reach of children.
  • Bring all your child's medicines with you in the original bottles whenever your child sees a doctor, goes to an emergency room, or is admitted to the hospital. This helps doctors who may not know your child.
  • Learn the name, spelling and dose of this medicine. You will need to know this information when you call the doctor or pharmacist.
  • If your child takes too much of this medicine, or if someone else takes this medicine, first call the Central Ohio Poison Center at 1-800-222-1222 (TTY 614-228-2272). They will tell you what to do.
  • It is important to keep a record of when the medicine is given. You may use a calendar or the Helping Hand: Medication Record, HH-V-1.
  • Tell your child's babysitter and other caregivers your child is taking this medicine and what side effects to watch for.

Follow-up visits

  • Your child's next doctor's visit is on (date) ____________ at (time) ________.
  • Expect regular follow-up visits with your child's doctor.
  • Write down all of your questions. Bring them with you when you see the doctor.
  • Call your child's doctor if you cannot keep the appointment.

If you have any questions, be sure to ask your child’s doctor, nurse or pharmacist.

Other Information

(Write on another sheet if needed): _______________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

If you have any questions, be sure to ask your child’s doctor, nurse or pharmacist.

Clonidine for Neonatal Abstinence Syndrome (NAS) (PDF)

HH-V-275 8/18 Copyright 2018, Nationwide Children's Hospital