Clonidine pediatric dose calculator
Use this Clonidine pediatric dose calculator to match the prescribed child dose to the exact liquid, tablet, or capsule strength before you give it.
dose calculator basics
Clonidine pediatric dose calculator details
Use this Clonidine calculator as the fast parent page for weight-based dose checks, mL conversion, common strengths, and the practical safety steps that generic calculator sites often skip.
Formula
mL per dose = (child weight in kg x prescribed mg/kg/day / doses per day) / medication concentration in mg per mL.
Worked example
For a 20 kg child using 0.005 mg/kg/day divided 2 times daily with 0.02 mg/1 mL, calculate the daily mg target, divide by the schedule, then convert that mg amount into mL for the selected product.
Safety checks before using the result
- Use the exact product strength in hand before measuring the dose.
- Confirm maximum dose, age limits, and indication-specific cautions when they apply.
- Escalate urgent symptoms or medication reactions instead of repeating doses from calculator output alone.
Practical dosing guide
Before you measure the dose
Use this page to match the prescribed Clonidine plan to the exact liquid or tablet strength and the follow-up checks that matter most.
- What it is usually used for
- Clonidine is an alpha-2 agonist used in pediatrics for hypertension, ADHD adjunct, sleep dysregulation, and withdrawal management.
- Common forms
- Common forms include 0.1 mg (100 mcg) tablet, 20 mcg/mL (0.02 mg/mL) compounded immediate-release liquid, and 0.1 mg/mL (100 mcg/mL) Onyda XR extended-release suspension, once daily at bedtime, not weight-based.
- How the schedule is usually written
- Onyda XR (extended-release liquid, 0.1 mg/mL = 100 mcg/mL) and Kapvay (extended-release tablets) are for ADHD in ages 6–17 and are NOT weight-based: start 0.1 mg (100 mcg) at bedtime, increase by 0.1 mg (100 mcg) per day at weekly intervals, max 0.4 mg (400 mcg) per day.
Clonidine pediatric medication summary
Clonidine is an alpha-2 agonist used in pediatrics for hypertension, ADHD adjunct, sleep dysregulation, and withdrawal management.
Establish baseline vitals (sitting/standing blood pressure and heart rate) and repeat 1–2 weeks after each dose change.
Advance doses no sooner than every 5–7 days for oral therapy and every 7 days for patch adjustments to avoid sudden hypotension or bradycardia.
Clonidine indications and common pediatric uses
Clonidine is an alpha-2 agonist used in pediatrics when clinicians need additional control of hyperactivity, sleep-onset problems, blood pressure, or autonomic withdrawal symptoms.
Attention-deficit/hyperactivity disorder (adjunct to stimulants or monotherapy with ER product)
Attention-deficit/hyperactivity disorder (adjunct to stimulants or monotherapy with ER product): ER formulation is the ADHD-labeled product; stopping abruptly can precipitate rebound symptoms.
Specialist-directed add-on therapy for pediatric hypertension not controlled with first-line agents
Specialist-directed add-on therapy for pediatric hypertension not controlled with first-line agents: Best used when adherence can be supported and a clear taper plan is documented.
Sleep-onset difficulty in children with neurodevelopmental conditions
Sleep-onset difficulty in children with neurodevelopmental conditions: Set expectations early: clonidine can help sleep initiation but does not replace behavioral sleep work.
Adjunct for neonatal and adolescent opioid withdrawal protocols
Adjunct for neonatal and adolescent opioid withdrawal protocols: Most effective when embedded in multidisciplinary withdrawal pathways.
Tic disorders/Tourette syndrome, especially when ADHD coexists
Tic disorders/Tourette syndrome, especially when ADHD coexists: Often chosen when families prefer to avoid dopamine-blocking adverse-effect burden.
How to give Clonidine
- Practical administration guidance for pediatric clonidine across immediate-release, extended-release, and patch formulations.
- Measure liquid formulations with an oral syringe and check whether the label is in mg or mcg (0.1 mg = 100 mcg). Onyda XR (0.1 mg/mL = 100 mcg/mL extended-release suspension) is given once daily at bedtime at a fixed, non-weight-based dose; shake it well and do not use it for twice-daily mg/kg plans. Extended-release tablets (Kapvay) must be swallowed whole and should not be cut, crushed, or chewed. When using patches, press firmly for 10 seconds and use the provided overlay if needed for adhesion.
- Document a taper plan before discontinuation and monitor blood pressure/heart rate during dose changes or missed-dose recovery.
Clonidine side effects, contraindications, and interactions
Clonidine frequently causes sedation, hypotension, and dry mouth; missed doses can trigger dangerous rebound hypertension. Most side effects are mild and temporary. Keep your child hydrated, use the medicine exactly as prescribed, and call your pediatrician for red-flag symptoms like trouble breathing, severe rash or swelling, persistent vomiting, signs of dehydration, or blood in stool. Most side effects are mild and temporary. Keep your child hydrated, use the medicine exactly as prescribed, and call your pediatrician for red-flag symptoms like trouble breathing, severe rash or swelling, persistent vomiting, signs of dehydration, or blood in stool.
Common side effects
- Expect drowsiness during titration—plan dose increases for evenings and notify school staff.
- Check blood pressure and heart rate at home during dose changes and illness with poor intake.
- Taper clonidine over 7–14 days when discontinuing to avoid rebound hypertension.
Safety checks
- Bradycardia or conduction disease: Clonidine can further slow heart rate and AV conduction.
- Renal impairment (eGFR <30 mL/min/1.73 m2): Reduced clearance increases hypotension and sedation risk.
- Fainting, chest pain, or severe bradycardia: Serious cardiovascular compromise requires urgent evaluation.
- Severe headache, agitation, or hypertension after missed doses: Abrupt withdrawal can cause dangerous BP spikes.
- New suicidal ideation or severe depression: Mood changes require rapid reassessment.
Drug interactions
- Review the full medication list with a clinician or pharmacist before combining therapies.
Clonidine mechanism and clinical pearls
Clonidine is a centrally acting alpha-2 adrenergic agonist. Its main effect is to reduce norepinephrine release from sympathetic pathways, which lowers autonomic tone. In pediatric practice, that mechanism supports blood pressure lowering, reduction of hyperarousal, and autonomic symptom control in selected withdrawal pathways. The same mechanism also explains predictable adverse effects: sedation, bradycardia, hypotension, and rebound hypertension if the drug is stopped abruptly.
Document a practical taper schedule in both the chart and after-visit summary for any child expected to use clonidine beyond a short trial. Families should know who to call before making abrupt dose changes.
Do not assume milligram-for-milligram equivalence across immediate-release, extended-release, and transdermal clonidine. Confirm the exact product at every refill and transition.
During titration, use brief symptom questions and seated BP/HR trends together. Sedation without hypotension and hypotension without reported symptoms can both occur.
Give each family a clear missed-dose plan that distinguishes a single late dose from repeated missed doses. Multiple missed doses should trigger clinician contact before returning to the prior schedule.
Frequently asked questions about Clonidine
Not for ADHD. Onyda XR (extended-release liquid, 0.1 mg/mL = 100 mcg/mL) and Kapvay (extended-release tablets) are not weight-based: they start at 0.1 mg (100 mcg) at bedtime and go up by 0.1 mg (100 mcg) per day each week, to no more than 0.4 mg (400 mcg) per day. Onyda XR is given once daily at bedtime; Kapvay above 0.1 mg is split into two doses. A mg/kg calculation only applies to immediate-release clonidine prescribed by a specialist. Always check whether a dose is written in mg or mcg: 0.05 mg is 50 mcg.
Give the dose when you remember unless it is within 4 hours of the next scheduled time. If two doses are missed, call your clinician—do not double up. Watch for headache, irritability, or elevated blood pressure, which can signal rebound symptoms.
Use an appropriately sized pediatric cuff. Take readings seated, after 5 minutes of rest, at the same times each day. Log the date, time, heart rate, and any symptoms such as dizziness.
Sedation is common when clonidine is started or increased. Give the largest dose at bedtime, keep after-school activities calm during the first week, and contact the care team if daytime sleepiness interferes with school or safety.
Yes. Many children take clonidine with methylphenidate or amphetamine products. Clinicians monitor blood pressure, heart rate, appetite, and sleep so the combination remains balanced.
Apply a new patch to a different hairless site and note the date. If more than 24 hours remain before the scheduled change, notify your clinician—an interim oral dose may be needed.
Stay hydrated, especially in hot weather or during sports, because clonidine can lower blood pressure. Avoid alcohol or sedating antihistamines unless your clinician approves. Encourage slow position changes to prevent dizziness.
It depends on the condition being treated. ADHD regimens are reviewed every 3–6 months; blood pressure control is reassessed with lifestyle changes and growth. Always plan any taper with your clinician to avoid withdrawal.
Sources reviewed for Clonidine
fda-clonidine-er-2023
aap-adhd-2019
aap-htn-2017
kidney-int-2020
sleep-clonidine-2016
aap-now-2020