Clonidine disposition in children; a population analysis

Abstract

Clearance in neonates is approximately one-third that described in adults, consistent with immature elimination pathways. Maintenance dosing, which is a function of clearance, should be reduced in neonates and infants when using a target concentration approach.

Pharmacokinetics and Pharmacodynamics of Orally Administered Clonidine: A Model-Based Approach

“…Published data suggest a terminal half-life of clonidine of 9-12.5 h [11,12]. This implies that the effects of clonidine can be expected to be relatively long-lasting.…”

Pediatric Cardiac Intensive Care Society 2014 Consensus Statement

“…There is limited evidence available regarding the use of IV clonidine in pediatric patients. (Table 4) The available data support starting clonidine infusions at 0.25 μg/kg/hr and increasing the dose by 0.1 μg/kg/hr until adequate sedation is achieved, and that most children are adequately controlled at 1 μg/kg/hr (72,75).…”

“…Clonidine is metabolized in the liver and excreted through the urine. Clearance of clonidine in neonates is about one third of the adult rate due to immature clearance pathways and reaches about 82% of adult rate by 1 year (75).…”

A Review of the Rationale and Clinical Utilization of α2-Adrenoceptor Agonists for the Treatment of Attention-Deficit/Hyperactivity and Related Disorders

“…At least one population pharmacokinetic study has been published in children and adolescents (0-15 years of age) who received CLON-IR by intravenous, rectal, and epidural administration during anesthesia, which determined that by 1 year of age, 82% of the adult clearance rate is achieved (Potts et al 2007). Of significance is a recent finding of reduced bioavailability in children (3-10 years of age) who received CLON-IR orally (Larsson et al 2011).…”