Clonidine side effects: what 50,904 FDA adverse event reports show
Drug class
Centrally acting alpha 2 -adrenergic agonist
Who reports
50,904 reports · 70% serious · 6,058 with death outcome · 59% female
Used for
Clonidine hydrochloride extended-release tablets is a centrally acting alpha 2 -adrenergic agonist indicated for the treatment of attention deficit hyperactivity disorder (ADHD) as monotherapy or as adjunctive therapy to stimulant medications. ( 1 ) Cl.
What it is
Clonidine hydrochloride extended-release is a centrally acting alpha 2 -adrenergic agonist available as 0.1 mg extended-release tablets for oral administration. Each 0.1 mg tablet is equivalent to 0.087 mg of the free base.
Boxed warning
None in the current label
Causality screen of the 40 strongest signals
What the badges mean
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,152 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Withdrawal hypertension | 52 | 143.4 104.5–196.7ROR 143.5 · calibrated p 1e-8 ✓ | 102.3 EB05 81.0 · IC025 +5.3 3/3 methods agree | Labeled (related wording) related wording | serious n=45 · ♀ 0% (drug 59%) · 100% clinician | not reported in cached trials |
| Device wireless communication issue | 62 | 135.8 101.9–181.1ROR 136.0 · calibrated p 2e-8 ✓ | 99.0 EB05 80.0 · IC025 +5.4 3/3 methods agree | Reporting / coding artifact | 100% consumer | not reported in cached trials |
| Neovascularisation | 59 | 123.3 92.1–164.9ROR 123.4 · calibrated p 4e-8 ✓ | 92.0 EB05 73.9 · IC025 +5.3 3/3 methods agree | Not in label — unassessed | serious n=59 · ♀ 100% (drug 59%) · 100% clinician | not reported in cached trials |
| Victim of child abuse | 48 | 99.3 72.4–136.1ROR 99.3 · calibrated p 2e-7 ✓ | 77.5 EB05 60.8 · IC025 +5.0 3/3 methods agree | Reporting / coding artifact | serious n=48 · ♀ 0% (drug 59%) · 100% clinician | not reported in cached trials |
| Temperature regulation disorder | 418 | 97.4 87.6–108.4ROR 98.2 · calibrated p 1e-7 ✓ | 78.5 EB05 72.3 · IC025 +6.0 3/3 methods agree | Not in label — unassessed | serious n=414 · ♀ 100% (drug 59%) | not reported in cached trials |
| Child abuse | 42 | 83.0 59.6–115.7ROR 83.1 · calibrated p 9e-7 ✓ | 67.1 EB05 51.7 · IC025 +4.7 3/3 methods agree | Reporting / coding artifact | serious n=42 · ♀ 0% (drug 59%) · 100% clinician | not reported in cached trials |
| Device maintenance issue | 93 | 81.2 65.0–101.5ROR 81.4 · calibrated p 7e-7 ✓ | 66.9 EB05 56.3 · IC025 +5.3 3/3 methods agree | Reporting / coding artifact | serious n=34 · 100% consumer | not reported in cached trials |
| Epidural lipomatosis | 54 | 75.5 56.4–100.9ROR 75.5 · calibrated p 1e-6 ✓ | 62.4 EB05 49.7 · IC025 +4.9 3/3 methods agree | Not in label — unassessed | serious n=54 · ♀ 0% (drug 59%) · 100% clinician | not reported in cached trials |
| Chronic kidney disease-mineral and bone disorder | 147 | 65.1 54.7–77.5ROR 65.3 · calibrated p 3e-6 ✓ | 55.9 EB05 48.7 · IC025 +5.3 3/3 methods agree | Not in label — unassessed | serious n=147 | not reported in cached trials |
| Nephrogenic anaemia | 564 | 56.4 51.7–61.6ROR 57.1 · calibrated p 6e-6 ✓ | 49.6 EB05 46.2 · IC025 +5.4 3/3 methods agree | Not in label — unassessed | serious n=564 · 100% clinician | not reported in cached trials |
| Hyperparathyroidism secondary | 296 | 54.5 48.2–61.5ROR 54.8 · calibrated p 8e-6 ✓ | 48.0 EB05 43.6 · IC025 +5.3 3/3 methods agree | Not in label — unassessed | serious n=296 | not reported in cached trials |
| Oppositional defiant disorder | 43 | 49.7 36.2–68.1ROR 49.7 · calibrated p 2e-5 ✓ | 43.5 EB05 33.7 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious n=38 · ♀ 0% (drug 59%) · 100% clinician | not reported in cached trials |
| Body tinea | 55 | 44.4 33.6–58.6ROR 44.5 · calibrated p 4e-5 ✓ | 39.6 EB05 31.6 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious n=54 · ♀ 100% (drug 59%) · 100% clinician | not reported in cached trials |
| Infusion site discharge | 144 | 37.8 31.9–44.8ROR 37.9 · calibrated p 8e-5 ✓ | 34.5 EB05 30.0 · IC025 +4.7 3/3 methods agree | Not in label — unassessed | serious n=44 · ♀ 82% (drug 59%) · 100% consumer | not reported in cached trials |
| Infusion site irritation | 100 | 36.0 29.3–44.1ROR 36.0 · calibrated p 1e-4 ✓ | 32.9 EB05 27.9 · IC025 +4.5 3/3 methods agree | Not in label — unassessed | 100% consumer | not reported in cached trials |
| Infusion site induration | 111 | 34.8 28.7–42.3ROR 34.9 · calibrated p 1e-4 ✓ | 32.0 EB05 27.3 · IC025 +4.5 3/3 methods agree | Not in label — unassessed | ♀ 80% (drug 59%) · 100% consumer | not reported in cached trials |
| Infusion site nodule | 64 | 31.4 24.4–40.5ROR 31.5 · calibrated p 3e-4 ✓ | 29.0 EB05 23.5 · IC025 +4.2 3/3 methods agree | Not in label — unassessed | ♀ 100% (drug 59%) · 100% consumer | not reported in cached trials |
| Food allergy | 535 | 31.3 28.7–34.2ROR 31.7 · calibrated p 2e-4 ✓ | 29.1 EB05 27.1 · IC025 +4.7 3/3 methods agree | Not in label — unassessed | serious n=531 · ♀ 100% (drug 59%) | not reported in cached trials |
| Device infusion issue | 171 | 30.8 26.4–36.0ROR 30.9 · calibrated p 2e-4 ✓ | 28.7 EB05 25.2 · IC025 +4.5 3/3 methods agree | Reporting / coding artifact | serious n=74 · 83% consumer | not reported in cached trials |
| Infusion site haemorrhage | 223 | 30.4 26.5–34.8ROR 30.5 · calibrated p 3e-4 ✓ | 28.3 EB05 25.3 · IC025 +4.5 3/3 methods agree | Not in label — unassessed | serious n=58 · 100% consumer | NCT01082874: 2/2,499 (0.1%) on Clonidine (serious AE) |
| Infusion site inflammation | 46 | 30.1 22.3–40.6ROR 30.1 · calibrated p 3e-4 ✓ | 27.8 EB05 21.7 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | 100% consumer | not reported in cached trials |
| Infusion site infection | 153 | 29.8 25.3–35.1ROR 29.8 · calibrated p 3e-4 ✓ | 27.7 EB05 24.2 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious n=70 · ♀ 82% (drug 59%) · 88% consumer | not reported in cached trials |
| Infusion site warmth | 81 | 29.7 23.7–37.2ROR 29.7 · calibrated p 3e-4 ✓ | 27.6 EB05 22.9 · IC025 +4.2 3/3 methods agree | Not in label — unassessed | ♀ 81% (drug 59%) · 100% consumer | not reported in cached trials |
| Infusion site discolouration | 55 | 28.0 21.3–36.8ROR 28.1 · calibrated p 5e-4 ✓ | 26.1 EB05 20.8 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | ♀ 100% (drug 59%) · 100% consumer | not reported in cached trials |
| Implant site extravasation | 49 | 27.1 20.3–36.2ROR 27.2 · calibrated p 6e-4 ✓ | 25.3 EB05 19.9 · IC025 +3.9 3/3 methods agree | Not in label — unassessed | serious n=36 | not reported in cached trials |
| End stage renal disease | 1,124 | 26.7 25.2–28.4ROR 27.3 · calibrated p 4e-4 ✓ | 25.1 EB05 23.9 · IC025 +4.5 3/3 methods agree | Not in label — unassessed | serious PRR 20.7 | not reported in cached trials |
| Infusion site pain | 776 | 26.6 24.7–28.6ROR 27.0 · calibrated p 5e-4 ✓ | 25.0 EB05 23.6 · IC025 +4.5 3/3 methods agree | Not in label — unassessed | serious n=207 · 93% consumer | NCT01082874: 1/2,499 (0.0%) on Clonidine; 1/2,510 (0.0%) control (serious AE) |
| Infusion site mass | 64 | 26.2 20.4–33.7ROR 26.2 · calibrated p 6e-4 ✓ | 24.5 EB05 19.9 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | serious n=35 · 100% consumer | not reported in cached trials |
| Infusion site erythema | 485 | 25.5 23.3–28.0ROR 25.8 · calibrated p 6e-4 ✓ | 24.1 EB05 22.3 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious n=134 · 94% consumer | not reported in cached trials |
| Choreoathetosis | 39 | 24.8 17.9–34.2ROR 24.8 · calibrated p 9e-4 ✓ | 23.2 EB05 17.7 · IC025 +3.7 3/3 methods agree | Not in label — unassessed | serious n=39 · ♀ 0% (drug 59%) · 100% clinician | not reported in cached trials |
| Rebound acid hypersecretion | 174 | 24.7 21.2–28.8ROR 24.8 · calibrated p 7e-4 ✓ | 23.3 EB05 20.5 · IC025 +4.2 3/3 methods agree | Not in label — unassessed | serious n=174 | not reported in cached trials |
| Infusion site swelling | 340 | 24.0 21.5–26.8ROR 24.2 · calibrated p 8e-4 ✓ | 22.7 EB05 20.8 · IC025 +4.3 3/3 methods agree | Not in label — unassessed | serious n=95 · 93% consumer | not reported in cached trials |
| Malignant hypertension | 40 | 20.0 14.6–27.5ROR 20.1 · calibrated p 0.002 ✓ | 19.0 EB05 14.5 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious n=39 · 100% clinician | not reported in cached trials |
| Foetal death | 237 | 19.7 17.3–22.4ROR 19.8 · calibrated p 0.002 ✓ | 18.8 EB05 16.9 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | serious n=237 · ♀ 100% (drug 59%) · 92% clinician | not reported in cached trials |
| Nephrogenic systemic fibrosis | 135 | 19.0 16.0–22.5ROR 19.0 · calibrated p 0.003 ✓ | 18.1 EB05 15.7 · IC025 +3.8 3/3 methods agree | Not in label — unassessed | serious n=135 | not reported in cached trials |
| Hypertensive emergency | 50 | 18.4 13.8–24.4ROR 18.4 · calibrated p 0.003 ✓ | 17.5 EB05 13.8 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious n=50 · 100% clinician | not reported in cached trials |
| Infusion site reaction | 121 | 17.8 14.9–21.4ROR 17.9 · calibrated p 0.004 ✓ | 17.1 EB05 14.7 · IC025 +3.7 3/3 methods agree | Not in label — unassessed | serious n=44 · 100% consumer | not reported in cached trials |
| Coeliac disease | 406 | 17.7 16.1–19.6ROR 17.9 · calibrated p 0.003 ✓ | 17.0 EB05 15.7 · IC025 +3.9 3/3 methods agree | Not in label — unassessed | serious PRR 17.4 · ♀ 100% (drug 59%) | not reported in cached trials |
| Infusion site discomfort | 42 | 17.6 12.9–24.0ROR 17.6 · calibrated p 0.004 ✓ | 16.8 EB05 12.8 · IC025 +3.3 3/3 methods agree | Not in label — unassessed | ♀ 100% (drug 59%) · 100% consumer | not reported in cached trials |
| Immunodeficiency | 559 | 16.2 14.9–17.6ROR 16.4 · calibrated p 0.005 ✓ | 15.6 EB05 14.6 · IC025 +3.8 3/3 methods agree | Not in label — unassessed | serious PRR 14.0 · ♀ 97% (drug 59%) | not reported in cached trials |
Trial evidence (ClinicalTrials.gov)
✓ Trial adverse-event data found on ClinicalTrials.gov
Largest completed trials with posted results that list Clonidine as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (2 of 40 signal terms matched).
- NCT01082874 — PeriOperative ISchemic Evaluation-2 Trial (N=10010, PHASE3; 124 AE terms posted; arms: Active Clonidine and Active ASA; Active Clonidine and Placebo ASA; Placebo Clonidine and Active ASA; Placebo Clonidine and Placebo ASA)
Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Drug ineffective (drug did not work) | 3,985 | 1.2 1.2–1.3ROR 1.3 · calibrated p 0.486 | 1.2 EB05 1.2 · IC025 +0.3 | Reporting / coding artifact | serious PRR 1.8 | not reported in cached trials |
| Pain | 3,116 | 2.1 2.0–2.2ROR 2.2 · calibrated p 0.971 | 2.1 EB05 2.0 · IC025 +1.0 3/3 methods agree | Not in label — unassessed | serious PRR 2.2 | NCT01082874: 1/2,499 (0.0%) on Clonidine; 1/2,510 (0.0%) control (serious AE) |
| Nausea | 3,026 | 1.6 1.5–1.6ROR 1.6 · calibrated p 0.718 | 1.6 EB05 1.5 · IC025 +0.6 | Labeled adverse reaction exact term | serious PRR 1.7 | not reported in cached trials |
| Fatigue (tiredness) | 3,009 | 1.6 1.5–1.7ROR 1.6 · calibrated p 0.728 | 1.6 EB05 1.5 · IC025 +0.6 | Labeled adverse reaction exact term | serious PRR 1.8 | not reported in cached trials |
| Off label use (used outside approved label) | 3,004 | 1.4 1.4–1.5ROR 1.5 · calibrated p 0.611 | 1.4 EB05 1.4 · IC025 +0.5 | Reporting / coding artifact | serious PRR 1.6 | not reported in cached trials |
| Headache | 2,918 | 1.9 1.9–2.0ROR 2.0 · calibrated p 0.933 | 1.9 EB05 1.9 · IC025 +0.9 | Labeled adverse reaction exact term | serious PRR 2.3 | not reported in cached trials |
| Hypertension (high blood pressure) | 2,690 | 5.3 5.1–5.5ROR 5.5 · calibrated p 0.185 | 5.2 EB05 5.1 · IC025 +2.3 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 4.7 | not reported in cached trials |
| Dyspnoea (shortness of breath) | 2,352 | 1.7 1.6–1.8ROR 1.7 · calibrated p 0.800 | 1.7 EB05 1.7 · IC025 +0.7 | Not in label — unassessed | serious PRR 1.6 | NCT01082874: 2/2,502 (0.1%) on Clonidine; 1/2,510 (0.0%) control (serious AE) |
| Diarrhoea (diarrhea) | 2,313 | 1.5 1.4–1.5ROR 1.5 · calibrated p 0.645 | 1.5 EB05 1.4 · IC025 +0.5 | Not in label — unassessed | serious PRR 1.4 | not reported in cached trials |
| Chronic kidney disease | 2,115 | 11.7 11.2–12.2ROR 12.1 · calibrated p 0.016 ✓ | 11.4 EB05 11.0 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious PRR 9.5 | not reported in cached trials |
| Vomiting | 2,109 | 1.9 1.8–1.9ROR 1.9 · calibrated p 0.884 | 1.9 EB05 1.8 · IC025 +0.8 | Not in label — unassessed | serious PRR 1.8 | NCT01082874: 1/2,502 (0.0%) on Clonidine; 1/2,510 (0.0%) control (serious AE) |
| Renal failure (kidney failure) | 1,920 | 6.0 5.7–6.3ROR 6.2 · calibrated p 0.139 | 5.9 EB05 5.7 · IC025 +2.5 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 4.9 | NCT01082874: 1/2,510 (0.0%) control (serious AE) |
| Dizziness | 1,917 | 1.6 1.5–1.7ROR 1.6 · calibrated p 0.713 | 1.6 EB05 1.5 · IC025 +0.6 | Labeled adverse reaction exact term | serious PRR 1.6 | not reported in cached trials |
| Acute kidney injury (sudden kidney damage) | 1,845 | 5.0 4.8–5.3ROR 5.2 · calibrated p 0.215 | 5.0 EB05 4.8 · IC025 +2.2 3/3 methods agree | Labeled (related wording) related wording | serious PRR 4.1 | not reported in cached trials |
| Blood pressure increased | 1,733 | 4.7 4.5–4.9ROR 4.8 · calibrated p 0.254 | 4.7 EB05 4.5 · IC025 +2.1 3/3 methods agree | Labeled (related wording) related wording | serious PRR 3.7 | NCT01082874: 1/2,510 (0.0%) control (serious AE) |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Neovascularisation — n=59, PRR 123.3
- Temperature regulation disorder — n=418, PRR 97.4
- Epidural lipomatosis — n=54, PRR 75.5
- Chronic kidney disease-mineral and bone disorder — n=147, PRR 65.1
- Nephrogenic anaemia — n=564, PRR 56.4
- Hyperparathyroidism secondary — n=296, PRR 54.5
- Oppositional defiant disorder — n=43, PRR 49.7
- Body tinea — n=55, PRR 44.4
- Infusion site discharge — n=144, PRR 37.8
- Infusion site irritation — n=100, PRR 36.0
✓ A hand-written Bradford Hill causality assessment exists for this drug: Clonidine ↔ Rebound hypertension / withdrawal syndrome.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Clonidine?
In FDA FAERS, the most frequently co-reported reaction terms for Clonidine are pain, nausea, fatigue, headache, hypertension, dyspnoea. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Clonidine have an FDA boxed warning?
No. The FDA label retrieved for Clonidine has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Clonidine causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 99485427-a120-4fc7-bb61-25857d1900ec, effective 20251205; matched on
openfda.generic_name.exact:"CLONIDINE") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 1,192 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath - ClinicalTrials.gov API v2 (query
CLONIDINE, results-bearing studies sorted by enrollment)
Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.