Catapres (clonidine) interactions to avoid

In this article:

• Catapres drug interactions
• How to minimize Catapres interactions
• When to talk to a healthcare provider
• Expert Takeaways

In this article

• Catapres drug interactions
• How to minimize Catapres interactions
• When to talk to a healthcare provider
• Expert Takeaways

Catapres is the brand name for clonidine, an alpha-2 adrenergic agonist that’s FDA approved to treat hypertension, as well as attention deficit hyperactivity disorder (ADHD) in children, tic management in conditions like Tourette syndrome, cancer-related pain, and neonatal opioid withdrawal syndrome.

Catapres can interact negatively with several drugs, including beta-blockers, calcium channel blockers, tricyclic antidepressants, opioids, and other sedatives. When taken with these drugs, people may experience dangerously low blood pressure or lowered heart rate which may result in fainting, drowsiness, or dizziness. It’s essential to keep your healthcare provider updated if you are taking Catapres, and share information about other medications you are taking.

Catapres drug interactions

Catapres can interact with certain medications. On its own, Catapres has side effects like low blood pressure, dizziness, drowsiness, and lowered heart rate. When combined with other medications with similar effects, these symptoms become amplified, resulting in more serious side effects and adverse reactions.

The following medicines may interact poorly with Catapres. 

Beta blockers

Beta blockers are medications prescribed to treat hypertension, chest pain, heart failure, an irregular heartbeat, and other cardiovascular conditions. “Beta blockers may increase the rebound hypertensive effects of Catapres,” explains Jessica Iroanya, Pharm.D., BCMTMS. That means that combining beta blockers with Catapres can cause excessively low blood pressure, slow down your heart rate too much, and cause symptoms like dizziness or fainting.

Calcium channel blockers

Calcium channel blockers are medications that lower blood pressure by preventing calcium from entering your blood vessel cells, causing the blood vessels to relax. This reduces blood pressure. Similar to beta blockers, the problem with mixing calcium channel blockers with Catapres is that they have similar side effects to each other. “Calcium channel blockers can enhance the blood pressure lowering effects of clonidine, increasing the risk of hypotension,” Dr. Iroanya describes.

Tricyclic antidepressants

Tricyclic antidepressants are a type of antidepressant with less effectiveness compared to SSRIs and are more likely to cause side effects. According to Ritu Goel, MD, psychiatrist at Mindclaire Psychiatry, combining tricyclic antidepressants with Catapres “can increase the metabolism of clonidine, reducing its effectiveness, as well as increasing sedation and leading to unstable blood pressure.”

Central nervous system depressants

Central nervous system depressants are medications that slow down your brain activity and have calming and relaxing effects. Examples of central nervous system depressants include benzodiazepines and opioids, which can interact poorly with Catapres. Additionally, says Dr. Goel, “sleep aids, and even allergy medications like hydroxyzine can interact with clonidine, resulting in excessive drowsiness, respiratory depression, confusion, or impaired reaction time and coordination.” This may pose safety risks while driving or operating machinery. 

Catapres and grapefruit

Catapres doesn’t interact poorly with any food. Although many medications interact with grapefruit, when it comes to Catapres, “no known harmful interactions exist,” Dr. Goel says. Still, according to Dr. Goel, consuming large amounts of grapefruit may cause interactions with medications like Catapres. Dr. Iroanya suggests eating grapefruit in moderation when taking Catapres.

Catapres and alcohol

Like opioids and benzodiazepines, alcohol is also a central nervous depressant. As such, it can be dangerous to combine Catapres with alcohol. “Being a CNS depressant, Catapres can increase drowsiness, dizziness, and increased reaction time,” Dr. Goel says. “I recommend avoiding alcohol when on the medication.”

Catapres and caffeine

Caffeine doesn’t have to be avoided completely when taking Catapres, but some precaution is warranted. “Caffeine might slightly raise blood pressure, but small amounts are usually okay,” Dr. Iroanya says. If you are consuming caffeine with Catapres, “it is advised to monitor blood pressure and heart rate,” Dr. Goel shares.

Combining Catapres with CBD and illicit drugs

According to Dr. Goel, mixing Catapres with CBD can increase some of the sleep-inducing effects of both drugs, making you more lethargic and drowsy ,and may cause difficulty waking. The same is true of marijuana, which is another central nervous depressant that can interact poorly with Catapres, according to Dr. Goel.

On the flip side, certain central nervous system stimulants can also be dangerous when combined with Catapres. “Psychostimulants like cocaine, MDMA, and methamphetamine can dangerously interact to increase blood pressure or even cause arrhythmias (irregular heart rate),” Dr. Goel warns. 

Catapres and herbal supplements

There are certain herbal supplements that may interact poorly with Catapres. “It is important to disclose all herbal supplements and vitamins being taken to your provider, as there can be drug interactions with some herbal supplements,” Dr. Goel says. She warns against combining Catapres with St. John’s wort, which can lessen the effectiveness of Catapres while metabolizing it faster. Additionally, Valerian root and melatonin may increase sedation.

How to minimize Catapres interactions

To date, no clinical trials have been conducted on the use of Catapres in pregnant individuals. As such, Catapres should be avoided if you are pregnant. It’s not known if Catapres gets into the breast milk of breastfeeding parents, so caution should be exercised if you are taking Catapres while breastfeeding.

Overall, if you are taking Catapres, it is important to remain in close contact with your healthcare provider or pharmacist. “It is essential to provide your doctor with a complete list of all medications, supplements, and herbal treatments you are currently taking,” Dr. Goel says. “This will allow the doctor to review any possible interactions.”

Here are Dr. Goel’s recommendations for managing Catapres interactions:

• Don’t take Catapres along with other sedative medications or drugs
• Avoid alcohol and other illicit drugs
• Use caffeine in moderation and monitor your blood pressure and heart rate
• Don’t stop Catapres suddenly, as doing so can cause rebound dangerously-high blood pressure

When to talk to a health care provider about Catapres interactions

Most Catapres interactions can be managed by adjusting doses or stopping medications that interact badly with Catapres. All of this should be done in conjunction with your healthcare provider or pharmacist.

At times, you may experience symptoms that require more immediate medical attention. “Emergency care may be needed if people experience symptoms like chest pain, severe dizziness, irregular pulse or very slow heart rate, difficulty breathing, or even unresponsiveness due to interactions with Catapres,” Dr. Goel advises.

This article isn’t a complete list of possible Catapres interactions. There are other medications that can interact with Catapres. This is why it’s vital to seek medical advice and communicate openly with your healthcare provider about all medications, supplements, and drugs you take before taking Catapres.

Expert Takeaway:

Catapres is an important medication to help decrease blood pressure, but a keen knowledge of patient’s other medical conditions, other prescribed medications, and the patient’s recreational use of alcohol and drugs is important to consider. Close follow up is needed to confirm that the patient is not experiencing low pulse, low blood pressure, dizziness, chest pain, or tiredness. Catapres should be used with caution in patients with severe coronary insufficiency, heart conduction disturbances (arrhythmias), recent heart attack, recent stroke, or chronic renal failure.