Medication and Treatment Reviews

Kapvay

Generic Name: Clonidine hydrochloride

Uses

Kapvay, known as clonidine hydrochloride in its generic form, is an alpha agonist medication primarily used to treat hypertension. It may also reduce the hyperactivity associated with attention deficit hyperactivity disorder (ADHD) in children ages 6-12, adolescents, and adults. Kapvay is sometimes used in conjunction with stimulant medications.

Kapvay has not been studied in children younger than 6. Kapvay does not have a high risk of abuse or dependence. It is not a controlled substance.

Kapvay is also used off label to treat hot flashes that occur from menopause, and sometimes withdrawal from narcotic drugs or nicotine.

How to Use Kapvay

Before starting or refilling a Kapvay prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage

As with all medications, follow your Kapvay prescription instructions exactly.  Kapvay is an extended-release tablet, taken orally once or twice daily with or without food, in the morning or at bedtime. Each dose can last up to 24 hours. Tablets are available in 0.1mg and 0.2mg dosages. The time-release formulation is designed to maintain a steady level of medication in your body throughout the day. Tablets should never be crushed, broken, or chewed.

The optimal dosage varies patient by patient. Your doctor may adjust your daily dosage by 0.1mg increments until you or your child experiences the best response — that is, the lowest dosage at which you experience the greatest improvement in symptoms without side effects.

Do not drink alcohol while taking this drug.

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication by no more than 0.1mg every 3 to 7 days. Stopping Kapvay suddenly can create withdrawal symptoms including nausea, flushing, anxiety, agitation, headache, tremor, or tightness in chest.

Some patients report developing a tolerance to Kapvay after long-term usage. If you notice that your dosage is no longer controlling your symptoms, talk to your doctor to plan a course of action.

Side Effects

The most common side effects of Kapvay are as follows: sedation, tiredness, cough, runny nose, sneezing, irritability, sore throat, insomnia, nightmares, change in mood, constipation, increased body temperature, dry mouth, and ear pain.

Kapvay can temporarily raise levels of growth hormone for children and adults, but this effect generally wears off with time.

Other serious side effects include low blood pressure or heart rate, sleepiness, or withdrawal symptoms. Taking Kapvay may impair your or your teenager’s ability to drive, operate machinery, or perform other potentially dangerous tasks. If side effects are bothersome, or do not go away, talk to your doctor. Most people taking this medication do not experience any of these side effects.

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities, renal failure, and serious heart problems could experience complications while taking Kapvay. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experience warning signs such as chest pain, shortness of breath, or fainting while taking Kapvay.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions and Safety

Store Kapvay in a secure place out of the reach of children, and at room temperature. Do not share your Kapvay prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

You should not take Kapvay if you have an allergy to Kapvay hydrochloride or any of the other ingredients. You should use caution taking Kapvay if you have kidney problems, a history of fainting, heart problems, a history of stroke, or developed a rash from using the transdermal form of Kapvay.

Avoid becoming overheated or dehydrated while taking Kapvay.

If you’re thinking of becoming pregnant, discuss the use of Kapvay with your doctor. Animal studies indicate a potential risk of fetal harm. Kapvay is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

Interactions

Before taking Kapvay, discuss all other active prescription medications with your doctor. Kapvay can exacerbate the drowsiness created by depressants including alcohol, barbiturates, antihistamines, or other sedatives. Taking Kapvay with tricyclic antidepressants can limit the drug’s ability to lower blood pressure.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Kapvay before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Sources:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=aa7700e2-ae5d-44c4-a609-76de19c705a7
http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022331s001s002lbl.pdf

12 reviews

  1. My son is always anxious, has trouble getting to sleep and way too active/impulsive in the day. He was taking clonidine every evening and it really helped him fall asleep. His doctor put him on Kapvay (1 at 8 pm and 1 at 4 pm). Rather than help him sleep he was up until 12:30 or later every evening unable to sleep. He also got terrible stomach pains. After 3 weeks I took him off.

  2. We did clonidine 0.1 mg, which is very short acting, we then switched to Kapvay Er, 0.1 mg (we dose a couple times a day) which is a little longer acting clonidine only stays in your system a very short time the half life is only a couple hours or less. We still use this in conjugation with
    Focalin. We have tried everything else. My son also has other issues other than just ADHD.

  3. I recently started my 7-year-old son, who is on Focalin 20 mg on both Intuniv and then a few weeks later, tried Kapvay. Both medicines (which are from the same class of alpha-2-agonist) caused my son to have visual disturbances. He began seeing squares, circles, strange shapes. The visual disturbances were worse at night and in the early morning. He also had very bad nightmares on Intuniv. He became highly anxious about what he was seeing and eventually didn’t want to go to bed. As soon as we took him off each medication, the visual disturbances went completely away.

  4. We use Concerta and are now using Kapvay with it. He formerly slept 10-12 hours at night and went to a 6-hour night with intermittent sleeping. This caused more meltdowns. The Kapvay is taken every night at 6:00 pm and allows him to go to sleep on time and stay asleep. Made a huge difference.

  5. My 6-year-old son was diagnosed with ADHD last year. I saw signs during the preschool years as he was kicked out of three schools. This has been a trying year as we started him on Concerta, Focalin 2.5, & Focalin ER, Intuniv. Although the stimulants were great and we saw the benefits, it was difficult for me to see the negative side effects (tics and meltdowns). I had mentioned to my doctor a month ago about Clonidine to reduce side of effects of stimulants. She contacted me about Kapvay, which has been wonderful. Day 6 and he is a bit sleepy unlike Intuniv (sedated). It should be mentioned that he is on Kapvay only. I have noticed during the day he is calmer but I am not sure about his concentration. Be patient with the sleepiness as it will get better with time.

  6. I started my 10-year-old son on Kapvay 8 days ago. I got the sample kit from the dr. He was taking 0.1mg at night, until day 8. Then we upped his dose to a pill at night plus a pill in the morning. That was yesterday. He was sleepy the entire day. Still managed to function but struggled a little. He had soccer practice in the evening, fell asleep on the way there, practiced, did well and almost fell asleep on the way home. I called the doctor and she said to cut the pill in half in the morning. She’s discovered that some kids need to titrate slower to get their bodies to adjust to it. She says the company doesn’t want you to cut it, but that there’s no other way. Hopefully today will go a little better for him. I should note that days 1 through 7, we didn’t see a significant change in him.

  7. On January 20, 2011, my son developed a head tic after being on Vyvanse for 20 days. Turns out we have a family history of tics we just didn’t know it until my son developed one. The head tic was very scary because it came out of nowhere and came on extremely strong. Our research suggested finding a psychiatrist and neurologist. Through a friend we found a psychiatrist and through his pediatrician a neurologist (we still haven’t seen the neurologist – 2 month waiting period) but the psychiatrist has been wonderful. He started him on Kapvay for the tic, he felt like the ADD could wait, controlling the tic is the most important thing, and we fully agreed. He’s been on it for 31 days and is now up to .3mg. We have found that each time we up the dosage it takes a little while for him to adjust, it makes him really tired. I think going from .2 to .3 was the longest and more tiring adjustment period. On .3mg he is about 75%, which compared to the frequency of the tic before this is amazing. For the ADD aspect, I don’t know that I would say his concentration or focus has gotten any better since he’s been on it but it has slowed him down and now we don’t seem to have as many meltdowns while doing homework. We still need to sit with him and constantly remind him to focus and to help keep him on track.

    1. Thanks K’s Mama. My son has been on Kapvay for 19 days now. He takes one pill at night and half a pill in the morning. He hasn’t been sleepy on this dose and I plan on making it one pill in the morning and one at night starting 4/4. He plays soccer and I fear the medication may make him a bit tired on the field, so I’m waiting for a Monday (after the weekend games). We have seen an improvement in his overall attitude and constant movement. He sees a therapist along with taking the Kapvay. While talking to her, he mentioned that he feels tired on the medicine. However, when she followed up with questions, they realized that he only feels more tired when he first wakes up and when he’s sitting down not doing much. After talking with him further, she thinks it’s not that he’s ‘tired’ but that he’s actually calm in those moments and that this is a new feeling for him. We’re hoping for the best.

  8. After increasing the dosage and no longer impacted by the sleepiness, we (with doctor’s approval) stopped this med. We found our son to have become exceedingly aggressive. We had multiple incidents of him fighting with kids and actually hitting them. This was very unusual. For a medication that had no positive redeeming qualities, it wasn’t worthwhile to ride it out any longer. Anger has always been a problem but the aggression/anger levels definitely receded when we stopped.

  9. We have an 8 yr. old boy who has anxiety, OCD tendencies, ADHD, and Tourette’s, although he does not have many tics at all. We have had NO luck with any of the medicines we have tried. Intuniv and Strattera made him very, very angry, sad irritable…horrible. His symptoms increased tremendously. Then we tried Concerta which worked great for the ADHD for about 2 1/2 weeks. then every day at 3 when it wore off he was a mess. He has taken clonidine since he was 4 to help him get to sleep at night. although our first neurologist told us it was only supposed to last 4 hours and be out of his system, both we and our son saw improvements during the day with him being able to “tolerate” annoyances. Because the clonidine seemed to help our new neurologist recommended the Kapvay ext. release (clonidine) during the day. We have tried it twice now and have only lasted a day each time because it also, like the non-stimulants, made him very tired, but also very angry and irritable. It also did nothing for his attention of course. We will probably continue to try to find something to help with schoolwork. He finds it boring and overwhelming to sit through the day.

  10. We have tried Intuniv and Tenex with our 10-year-old son and they both seemed to make him more “dulled” emotionally except that his anger went through the roof. He has ADHD and Tourette’s Syndrome. We are now on Kapvay with him. He is on his second day with a morning and evening dose. We are not seeing much difference between him on the medication and him off the medication except the decrease of tics. We are going to try it for at least a month unless we see severe side effects but we are asking the question…what is more important, decrease of the tics or help with the ADHD. We were so hoping that this medication would help with both but we are not seeing that at all. If anything he is more scatterbrained and more easily distracted on this medication.

  11. My son who is 7 started last week and we have seen great things. A little tired, but so far that is the only side effect we have seen. Nothing compared to the horrible side effects he experienced on Focalin and Vyvanse. He received great reports from his teacher for the entire week. First time in months!

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