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Successful Clonidine withdrawal in patients receiving Cardio-selective Beta - blockers and Beta-Blockers with Alpha-Blocking Activity

Mostafa Ibrahim ElAwady, Wasim Akram, Mohamed Sherbash, Noorudeen Kaladi Kunnunmal and Hanadi Al Hamad

Introduction: Clonidine U.S. prescribing information recommends discontinuation of beta blockers several days prior to clonidine withdrawal to reduce the risk of rebound hypertension. In the three cases clonidine was successfully stopped while the patients were receiving Bisoprolol, Carvedilol and Labetalol without rebound hypertension in two months follow up period.

Methods: Three cases developed Clonidine induced urinary retention, and it was needed to stop it, but the three cases were receiving Labetalol, Carvedilol and Bisoprolol, so it was decided by multidisciplinary team to stop the Clonidine and as the patients’ heart rate was on the higher side, so it was decided to continue on the beta blockers, continue on the other antihypertensive medications, and follow up the patients for rebound hypertension.

Results: It was succeeded to stop the Clonidine, during the two months follow up period, the three patients didn’t develop rebound hypertension, and there was no more urine retention.

Conclusion: Clonidine can be safely withdrawn while the patient is still receiving Beta-Blocker with Alpha-Blocking Activity e.g. Labetalol and Carvedilol or cardio-selective beta-blocker such as Bisoprolol especially if the patient is getting other antihypertensive medications.