Clonidine may be prescribed off-label to treat attention-deficit/hyperactivity disorder (ADHD) in adults. It’s also U.S. Food and Drug Administration (FDA)-approved for blood pressure control.
Learn more about clonidine. And if you’re after fast, affordable ADHD treatment from a caring, licensed provider, find one on Klarity Health. You can schedule a convenient online appointment today and get seen often within 24 hours.*
Providers on Klarity Health are independent practitioners with clinical autonomy; a diagnosis, treatment, or prescription is not guaranteed.
Providers on Klarity Health are independent practitioners with clinical autonomy; a diagnosis, treatment, or prescription is not guaranteed.
Clonidine is a prescription medication that belongs to a class of drugs known as central alpha agonists. It was approved by the FDA as an antihypertensive to treat high blood pressure in 1974.
During clinical trials, it was discovered that clonidine helps reduce the release of norepinephrine. Norepinephrine is a transmitter that affects the stress response, sleep-wake cycle, and attention and focus, which can play a role in ADHD.
In May 2024, the FDA approved a once-daily extended-release form of clonidine called Onyda XR for the treatment of ADHD in children and adolescents but not for adults.
Clonidine is also used off-label (for something it’s not FDA-approved for) to treat ADHD in adults. Prescribing medications for off-label use is a common and legal medical practice and can be done at the discretion of medical providers.
Clonidine is a non-stimulant compared to stimulants like Adderall for ADHD. It’s also a second-line treatment for ADHD. It may be prescribed to people who don’t get enough symptom relief from stimulant medications alone or who can’t take or tolerate stimulants.
Other off-label uses for clonidine include treating anxiety symptoms, post-traumatic stress disorder (PTSD), restless leg syndrome (RLS), and withdrawal symptoms from opioids, alcohol, and benzodiazepines (a class of medications that slow brain activity and make people feel calm).
Generic clonidine is available as standard-release clonidine and clonidine XR (extended-release). It’s also sold under the brand names Nexiclon XR and Onyda XR, an oral liquid.
Learn more about stimulants vs non-stimulant for ADHD.
Clonidine is classified as an alpha-2 adrenergic agonist. This means it stimulates alpha-2 receptors in the brain. These receptors act like a “dimmer switch” for neurotransmitters, like norepinephrine, that carry chemical signals between nerve cells. When alpha-2 receptors are activated, neurotransmitter levels decrease, which makes people feel more calm.
For individuals with ADHD, clonidine can help reduce hyperactivity and impulsivity by turning on alpha-2 receptors and regulating the neurotransmitters that affect attention and behavior. It can also help reduce restlessness and agitation. Research has found alpha-2 antagonists, like clonidine, are effective for treating ADHD symptoms of impulsivity and hyperactivity in children, but not inattention.
One study of clonidine treatment in children and adolescents reported that symptoms began improving during week 2 of treatment and reached full effect during weeks 4 and 5.
Clonidine is FDA-approved to treat ADHD in children and adolescents ages 6 to 17. It’s also approved to treat hypertension in adults.
If your provider thinks clonidine can help you manage your adult ADHD symptoms, they can prescribe it for you off-label. Prescribing medications for off-label use is a common and legal medical practice.
Clonidine is only available with a prescription. You’ll need to meet with a licensed healthcare provider, such as a primary care physician (PCP or MD), psychiatrist (MD), psychiatric nurse practitioner (PNP), physician assistant (PA), or nurse practitioner (NP), who can evaluate your symptoms and decide if clonidine is medically necessary for your ADHD treatment.
On Klarity Health, you can find compassionate, board-certified providers skilled in managing ADHD through both therapy and medications. You can see select providers for a free consultation to ensure they’re the right fit for you. Note that if both therapy and medication are recommended, you’ll see separate providers for each.
If you and your provider decide that clonidine is the right choice for you, your provider will send your prescription to the pharmacy of your choice, whether it’s online or local.
Clonidine is available as a standard-release tablet, extended-release tablet, a transdermal patch, and an oral suspension. The standard-released tablet is only available as generic clonidine. The extended-release tablet is available as a generic and brand-name Nexiclon XR. The oral suspension is only available as brand-name Onyda XR.
If you take clonidine standard-release tablets, the starting dose is usually 0.1 milligrams a day. Slowly increasing your dose, if needed, can help you and your provider find the minimum effective dosage for you and decrease your risk of side effects.
Generic clonidine extended-release tablets are available in 0.1 milligram tablets. The starting dose is usually 0.1 milligrams at bedtime. Your provider may have you increase your daily dosage by 0.1 milligrams each week. The highest dose prescribed is usually 0.4 milligrams per day.
Nexiclon XR doses start with a 0.17-milligram tablet once a day at bedtime. Your provider may have you increase your daily dose by 0.09 milligrams weekly. The highest dose usually prescribed is 0.52 milligrams a day. If you take more than one tablet a day, take half in the morning and at bedtime. For example, if your dose is 0.2 milligrams a day, take one tablet in the morning and the other at night. If your dose is 0.3 milligrams a day, take a 0.1-milligram tablet in the morning and the higher dose of 0.2 milligrams (2, 0.1-milligram tablets) at bedtime.
The transdermal patch delivers medication through your skin. Patches are available in 0.1-, 0.2-, and 0.3-milligram strengths that last for 7 days. You’ll likely start with the 0.1-milligram patch. If your symptoms don’t improve, your doctor may have you add another 0.1-milligram patch or change to a higher dosage.
Onyda XR is taken once a day at bedtime. Each 1 millimeter of liquid contains 0.1 milligrams of clonidine.
If you stop taking clonidine in any form other than the patch, reduce your dose gradually over 2 to 4 days.
If you have side effects while on clonidine, Nexiclon XR, or Onyda XR, they may include dry mouth, drowsiness, sedation, dizziness, or constipation. They’re usually mild and decrease with continued use.
People taking clonidine, Nexiclon XR, or Onyda XR have also reported less common but more serious side effects. They include bradycardia (low heart rate), tachycardia (rapid heart rate at rest), congestive heart failure, palpitations, agitation, anxiety, abdominal pain, and low levels of platelets in your blood. Many people who reported these effects were also taking another medication, so it’s not known which medication caused the side effects.
Before you start clonidine or any medication, talk to your doctor or pharmacist and read the medication guide so you understand all potential side effects, risks, drug interactions, and contraindications.
The cost of 30 clonidine tablets for a dose of 0.1 to 0.3 milligrams ranges from $10 to $14. The cost of 30 extended-release clonidine tablets is roughly $52 for the 0.1 milligrams 12-hour extended-release form. The brand name Nexiclon XR tablets cost more, up to $512 for the 0.17 milligrams 24-hour extended-release form. Depending on the dosage, transdermal patches cost anywhere from $62 to $104. Costs are from drugs.com and reflect its discount.
Brand-name forms of clonidine cost more. Nexiclon XR, the brand name of clonidine XR, costs around $587. Nexiclon XR’s manufacturer, Athena Bioscience LLC, offers a savings card for individuals with insurance that lets them pay as little as a $5 copay per prescription fill.
Pricing for Onyda XR wasn’t available at the time of publication. Tris Pharma, the maker of Onyda XR does have a co-pay savings program for insured people. If you qualify, you could pay just $25 for your prescription.
You can also save between 3% and 80% on your clonidine prescription by using a prescription or drug discount card from services like SingleCareRx, drugs.com, GoodRx, WellRx, and others.
There’s little research on clonidine’s effectiveness for ADHD in adults or how it compares to other ADHD medications.
Clonidine is a non-stimulant medication. It works differently than other ADHD medications, including stimulant medications like Adderall (amphetamine/dextroamphetamine) and Ritalin (methylphenidate).
Adderall is FDA-approved to treat ADHD. It’s a central nervous system stimulant that increases the levels of certain neurotransmitters in the brain, primarily dopamine and norepinephrine. These chemicals help with mood regulation, improved focus, and better impulse control.
Clonidine, an alpha-2 agonist, decreases sympathetic nervous system activity. Because of the proven effectiveness of drugs like Adderall, clonidine is usually a second-line treatment for ADHD in adults. However, clonidine has fewer risks of dependency or misuse than stimulant medications.
Another non-stimulant medication your provider may consider is a selective norepinephrine reuptake inhibitor (SNRI), like Strattera (atomoxetine). SNRIs increase the level of norepinephrine and have a more gradual onset of symptom relief compared to stimulants.
A blood pressure medication, guanfacine (Intuniv), is also used off-label to treat ADHD in adults. Like clonidine, its effectiveness for ADHD in adults isn’t well studied.
Adderall, atomoxetine, and guanfacine all have side effects. Adderall can cause stomachache, reduced appetite, rapid heartbeat, and nervousness as well as more serious side effects. It’s a controlled substance and can lead to abuse, misuse, and dependence. Atomoxetine and guanfacine may cause nausea, vomiting, fatigue, insomnia, and other side effects.
Your prescriber may recommend using medications like guanfacine and clonidine along with stimulants such as Adderall. Using them together may help manage more ADHD symptoms. For example, because stimulants can sometimes lead to side effects, such as increased heart rate or insomnia, taking a drug like clonidine that calms the central nervous system may decrease the chances of these side effects.
Read more about ADHD medications.
Reviews from real patients who received treatment from providers on Klarity Health.
Providers on Klarity Health are licensed, board-certified, and offer a personalized approach to your unique online ADHD treatment needs. See detailed profiles for each provider and find an approach that’s best for you. (Costs for treatment options may vary.)
Your journey to reduced ADHD symptoms starts with an initial consultation. Your provider will work with you to recommend the right program for you and that may or may not include prescription medication and/or therapy.
Your initial ADHD consultation is just the beginning. You and your provider will follow up to make sure you’re doing okay and are reaching your goals. You stay on track with ongoing support from your provider(s) and medication refills if needed.
If you have questions or need assistance, the friendly Klarity Health Patient Support team is there to help. Along with your provider, they’re committed to making sure you have the best care and support throughout treatment.
*Appointments are generally available within 24 hours. Free initial consultations are available only with select providers. Prescriptions, particularly for controlled substances, may require an in-person evaluation depending on the state of residence and current federal regulations.
The information provided in this article is for educational purposes only and should not be construed as medical advice. Controlled substances like Adderall or Ritalin may not be appropriate for all patients and any mention of these medications is for educational purposes only, not for marketing or encouraging self-diagnosis. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with clinical autonomy. Nothing in this article is intended to diagnose or treat any condition, including guaranteeing prescription medication of any kind or dosage. Not all providers on Klarity Health prescribe all medications, particularly medications that are controlled substances.
If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.