Disclaimer to the Online Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.
cloNIDine
Indication
- Adjunct medication used in the management of neonatal opioid withdrawal syndrome (NOWS) that results from opioid exposure
Dosage Guidelines
- NOWS: 0.5-1 microgram/kg/dose q4-6 hours
- Sedation and opioid withdrawal management: 2-4 microgram/kg/dose q4-6 hours
Dose limit: 4 mcg/kg/dose
Administration
- Oral
Adverse Effects
- Hypotension, bradycardia, constipation
- Rebound hypertension if abruptly discontinued
Comments
- Do not discontinue therapy abruptly
- When discontinuing, gradually taper the dose over 6-10 days to avoid rebound hypertension
- Adjust doses in patients with renal insufficiency
- Eat, sleep, console (ESC) care model practiced at LHSC for patients experiencing NOWS utilizes pharmacological management as second line when non-pharmacological options have been unsuccessful
Supplied As
- 10 microgram/mL oral suspension
References
Lexi Sick Kids, Lexi Peds