Clonidine is typically prescribed for managing blood pressure, but it’s also been used off-label for decades to ease opioid withdrawal symptoms.

Opioid withdrawal symptoms can be extremely uncomfortable. They can make seeking treatment for opioid use disorder feel especially daunting.

Clonidine (Catapres) is one of several medications that can help reduce opioid withdrawal symptoms. While it’s typically used to lower blood pressure or manage symptoms of attention deficit hyperactive disorder (ADHD), clonidine has a long history of off-label use for withdrawal symptoms.

Here’s a closer look at how clonidine works, potential side effects, and other medications that may help with withdrawal.

Clonidine belongs to a class of drugs called alpha-2 adrenergic agonists.

It helps alleviate some of the symptoms of opioid withdrawal by binding to alpha-2 adrenergic receptors in the brain. This action inhibits the release of norepinephrine, a neurotransmitter involved in the body’s stress response.

This can help decrease the intensity of withdrawal symptoms, such as anxiety, agitation, sweating, muscle aches, and elevated heart rate and blood pressure.

In addition to helping with withdrawal symptoms, clonidine may help people maintain longer periods of abstinence from opioids.

A 2015 study examined whether clonidine could help block the stress-induced seeking of heroin or cocaine among 208 people with opioid dependence. After the participants had maintained abstinence for 5–6 weeks, they were randomly assigned to take clonidine or a placebo for 14 weeks.

The results suggest, compared to a placebo, that clonidine resulted in a longer duration of abstinence from opioids during the intervention phase. Researchers also found that clonidine helped separate day-to-day stress from the craving for opioids.

While clonidine can effectively manage withdrawal, a 2016 review of 26 studies notes that other medications, such as methadone or lofexidine, may have fewer side effects (more on this later).

Clonidine can be administered in different ways for opioid withdrawal depending on the specific situation and your healthcare professional’s recommendation.

It’s commonly available in tablet form, which you can take by mouth. This allows for convenient use at home under the guidance of a healthcare professional.

In some cases, especially in more severe withdrawal situations or when close monitoring is necessary, clonidine may be administered in an inpatient or residential treatment setting. In these settings, it can be given orally or through other routes, such as intravenous infusion or transdermal patches.

The specific administration method depends on factors such as the severity of your withdrawal symptoms, individual needs, and your healthcare professional’s assessment and treatment plan.

Potential side effects of clonidine may include:

  • headache
  • dizziness
  • sedation
  • low blood pressure
  • fatigue
  • diarrhea
  • constipation
  • nausea
  • dry mouth
  • emotional instability
  • sexual dysfunction

In addition to clonidine, several other medications can help with opioid withdrawal symptoms:

  • Lofexidine: Lofexidine is the only non-opioid medication that’s Food and Drug Administration (FDA) approved for managing opioid withdrawal. Like clonidine, it’s an alpha-2 adrenergic agonist.
  • Buprenorphine: Buprenorphine works by binding to the same receptors in the brain as opioids, reducing withdrawal symptoms and cravings. It provides a partial opioid effect, helping to ease withdrawal while minimizing the risk of dependence or overdose.
  • Methadone: Methadone is a long-acting opioid medication. It helps alleviate withdrawal symptoms and reduce cravings by binding to the same receptors in the brain as opioids. It provides a stable and controlled dose, allowing you to gradually taper off opioids with minimal withdrawal symptoms.
  • Naltrexone: Naltrexone is an opioid antagonist. It blocks the effects of opioids in the brain, which can help reduce cravings.

Opioid withdrawal symptoms can make treating opioid use disorder difficult, but clonidine, as well as several other medications, can help ease them.

Talk with a healthcare professional about whether clonidine could be an effective option for you. Depending on your symptoms, health history, and treatment goals, they may recommend a different medication or combine clonidine with another approach.