Why we are recommending this best practice
Strategies for implementation
- Develop unit-specific guidelines for initiation of clonidine as adjunct therapy if NAS is not adequately controlled with first-line therapy alone.
- Establish guidelines for escalation of clonidine.
- When weaning clonidine, consider a two-step reduction of the clonidine dose over 48 hours or weaning of opioids before stopping clonidine. This may reduce rebound NAS withdrawal symptoms.
- Clonidine has the potential to cause heart rate or blood pressure changes and monitoring is recommended. Monitor heart rate and blood pressure more closely during the first two days of clonidine therapy and for 48 hours after discontinuation.
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