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January 11, 1985, Vol 253, No. 2 >
ARTICLE | January 11, 1985

Transdermal Clonidine Therapy in Hypertensive Patients: Title and subTitle BreakEffects on Office and Ambulatory Recorded Blood Pressure Values FREE

Marie-Denise Schaller, MD; Jürg Nussberger, MD; Bernard Waeber, MD; Marinette Porchet, RN; Hans R. Brunner, MD
[+] Author Affiliations

Reprint requests to Division of Nephrology and Hypertension, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland (Dr Brunner).


JAMA. 1985;253(2):233-235. doi:10.1001/jama.1985.03350260085031
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References

The antihypertensive effect of clonidine hydrochloride delivered at a constant rate for seven days by transdermal disks was evaluated in seven patients with essential hypertension. Blood pressure values measured at the physician's office were not significantly decreased by one month of treatment with one (n=2) or two (n=5) once-weekly applied clonidine transdermal disks. In contrast, blood pressure values recorded during patients' customary daily activities by means of a portable blood pressure recorder were considerably reduced, from 159/97±2/2 to 136/76±7/5 mm Hg. Plasma drug concentration at the end of the fourth week averaged 1.22±0.24 ng/mL. Plasma renin, vasopressin, and epinephrine levels were not modified by clonidine, whereas plasma norepinephrine level was significantly reduced. Local skin erythema developed in three patients and dry mouth in six. These findings suggest that clonidine transdermal disks lower blood pressure in hypertensive patients, but produce local skin lesions and general side effects.

(JAMA 1985;253:233-235)

REFERENCES

1 +
Kobinger W, Walland A:  Investigations into the mechanism of the hypotensive effect of 2-(2,6-dichlorophenylamino)-2-imidazoline HCl . Eur J Pharmacol 1967;;2:155-162.
2 +
Pettinger WA:  Clonidine, a new antihypertensive drug . N Engl J Med 1975;;293:1179-1180.
3 +
Mroczek WJ:  Preliminary evaluation of transdermal clonidine administration in hypertensive patients receiving a diuretic , in Bock KD (ed): Catapresan® (Clonidin), Wege der Entwicklung eines Pharmakons . Aulendorf, Editio Cantor, 1983;, pp 126-132.
4 +
Hinman AT, Engle BT, Bickford AF:  Portable blood pressure recorder: Accuracy and preliminary use in evaluating intradaily variations in pressure . Am Heart J 1962;;63:663-668.
5 +
Sealy JE, Gerten-Banes J, Laragh JH:  The renin system: Variations in man measured by radioimmunoassay or bioassay . Kidney Int 1972;; 1:240-253.
6 +
Brunner DB, Burnier M, Brunner HR:  Plasma vasopressin in rats: Effect of sodium, angiotensin and catecholamines . Am J Physiol 1983;; 224:H259-H265.
7 +
Arndts D, Stahle H, Struck CJ:  A newly developed precise and sensitive radioimmunoassay for clonidine . Arzneimittelforsch 1979;;29:532-538.
8 +
Bresnahan MR, Hatzinikolaou P, Brunner HR, et al:  Effects of tyrosine infusion in normotensive and hypertensive rats . Am J Physiol 1980;;239:H206-H211.
9 +
Peuler JD, Johnson GA:  Simultaneous simple isotope radioenzymatic assay of plasma norepinephrine, epinephrine and dopamine . Life Sci 1977;;21:625-636.
10 +
Jacot des Combes B, Porchet M, Waeber B, et al:  Ambulatory blood pressure recordings: Accuracy and reproducibility . Hypertension 1984;;6:110-114.
11 +
Gould BA, Mann S, Davies AB, et al:  Does placebo lower blood pressure? Lancet 1981;; 2:1377-1381.
12 +
Velasquez MT, Rho J, Maronde RF, et al:  Plasma clonidine levels in hypertension . Clin Pharmacol Ther 1983;;34:341-346.
13 +
Weber MA, Drayer JIM, Hubbell FA:  Effects on the renin-angiotensin system of agents acting at central and peripheral adrenergic receptors . Chest 1983;;83( (suppl) ):374-377.
14 +
Golub MS, Thananopavarn C, Eggena P, et al:  Hormonal and hemodynamic effects of short- and long-term clonidine therapy in patients with mild-to-moderate hypertension . Chest 1983;; 83( (suppl) ):377-379.
15 +
Reid IA, Nolan PL, Wolf JA, et al:  Suppression of vasopressin secretion by clonidine: Effects of α-adrenoceptor antagonists . Endocrinology 1979;;104:1403-1406.
16 +
Groth H, Vetter H, Knuesel J, et al:  Allergic skin reactions to transdermal clonidine . Lancet 1983;;2:850-851.
17 +
McMahon FG, Weber MA:  Allergic skin reactions to transdermal clonidine . Lancet 1983;; 2:851.

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1 +
Kobinger W, Walland A:  Investigations into the mechanism of the hypotensive effect of 2-(2,6-dichlorophenylamino)-2-imidazoline HCl . Eur J Pharmacol 1967;;2:155-162.
2 +
Pettinger WA:  Clonidine, a new antihypertensive drug . N Engl J Med 1975;;293:1179-1180.
3 +
Mroczek WJ:  Preliminary evaluation of transdermal clonidine administration in hypertensive patients receiving a diuretic , in Bock KD (ed): Catapresan® (Clonidin), Wege der Entwicklung eines Pharmakons . Aulendorf, Editio Cantor, 1983;, pp 126-132.
4 +
Hinman AT, Engle BT, Bickford AF:  Portable blood pressure recorder: Accuracy and preliminary use in evaluating intradaily variations in pressure . Am Heart J 1962;;63:663-668.
5 +
Sealy JE, Gerten-Banes J, Laragh JH:  The renin system: Variations in man measured by radioimmunoassay or bioassay . Kidney Int 1972;; 1:240-253.
6 +
Brunner DB, Burnier M, Brunner HR:  Plasma vasopressin in rats: Effect of sodium, angiotensin and catecholamines . Am J Physiol 1983;; 224:H259-H265.
7 +
Arndts D, Stahle H, Struck CJ:  A newly developed precise and sensitive radioimmunoassay for clonidine . Arzneimittelforsch 1979;;29:532-538.
8 +
Bresnahan MR, Hatzinikolaou P, Brunner HR, et al:  Effects of tyrosine infusion in normotensive and hypertensive rats . Am J Physiol 1980;;239:H206-H211.
9 +
Peuler JD, Johnson GA:  Simultaneous simple isotope radioenzymatic assay of plasma norepinephrine, epinephrine and dopamine . Life Sci 1977;;21:625-636.
10 +
Jacot des Combes B, Porchet M, Waeber B, et al:  Ambulatory blood pressure recordings: Accuracy and reproducibility . Hypertension 1984;;6:110-114.
11 +
Gould BA, Mann S, Davies AB, et al:  Does placebo lower blood pressure? Lancet 1981;; 2:1377-1381.
12 +
Velasquez MT, Rho J, Maronde RF, et al:  Plasma clonidine levels in hypertension . Clin Pharmacol Ther 1983;;34:341-346.
13 +
Weber MA, Drayer JIM, Hubbell FA:  Effects on the renin-angiotensin system of agents acting at central and peripheral adrenergic receptors . Chest 1983;;83( (suppl) ):374-377.
14 +
Golub MS, Thananopavarn C, Eggena P, et al:  Hormonal and hemodynamic effects of short- and long-term clonidine therapy in patients with mild-to-moderate hypertension . Chest 1983;; 83( (suppl) ):377-379.
15 +
Reid IA, Nolan PL, Wolf JA, et al:  Suppression of vasopressin secretion by clonidine: Effects of α-adrenoceptor antagonists . Endocrinology 1979;;104:1403-1406.
16 +
Groth H, Vetter H, Knuesel J, et al:  Allergic skin reactions to transdermal clonidine . Lancet 1983;;2:850-851.
17 +
McMahon FG, Weber MA:  Allergic skin reactions to transdermal clonidine . Lancet 1983;; 2:851.

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