Patient acceptance of transdermal clonidine
Shanwan Chen, MD
Donald G. Vidt, MDAddress reprint requests to Donald G. Vidt, MD, Chairman, Department of Hypertension and Nephrology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland OH 44195.
The clinical records of 25 ambulatory patients who received clonidine (Catapres-TTS) for periods of one to 19 months were reviewed to determine the effectiveness and long-term patient tolerance of this trans-dermal antihypertensive medication. In 11 patients with mild to moderate hypertension in whom Catapres-TTS was initiated as monotherapy or added to an oral diuretic, significant blood pressure reduction was observed during the initial four weeks of therapy. In 14 patients who had more severe hypertension and who were receiving multiple antihypertensive agents, Catapres-TTS did not result in significantly reduced blood pressure. Daily home blood pressure measurements in five patients showed no day-to-day variations in blood pressure during the seven days each patch was worn. Catapres-TTS was discontinued in 11 patients because of localized contact dermatitis (six patients), patient dissatisfaction (three patients), and physician’s decision (two patients). In three patients, localized contact dermatitis developed only after continuous use for periods of four to 13 months. Other adverse effects such as drowsiness and dry mouth were less apparent than with comparable doses of oral clonidine, and did not necessitate discontinuation of therapy in any patient. Black patients appear to tolerate Catapres-TTS better than whites. Catapres-TTS appears to be effective in patients with mild to moderate hypertension and may be a useful alternative to oral clonidine in patients experiencing drowsiness or dry mouth with the oral preparation.