High-alert status
Clonidine is not named on the ISMP acute care high-alert list. The list's epidural and intrathecal medications entry would cover epidural clonidine, which is outside this oral tablet record.
Sources: [1]
Narrow therapeutic index
The label does not describe a narrow therapeutic index or direct dosing by measured blood levels of the drug; doses are adjusted to blood pressure response.
Sources: [1]
Boxed warning
None on the current label. Withdrawal with rebound hypertension is a labeled warning instead.
Sources: [1]
Antidote or reversal
No specific antidote. Overdose can cause early hypertension, then hypotension, bradycardia, respiratory depression, hypothermia, drowsiness, reduced reflexes, and small pupils, usually within 30 minutes to 2 hours; as little as 0.1 mg has caused toxicity in children. Do not induce vomiting; consider gastric lavage or activated charcoal, and give atropine for bradycardia, IV fluids or vasopressors for hypotension, and vasodilators for hypertension. Naloxone may help respiratory depression, hypotension, or coma, but watch for paradoxical hypertension. Dialysis is unlikely to help much.
Sources: [1]