Comparing clonidine and Klonopin: Uses, side effects, and risks

In this article:

• What are the main differences between clonidine and Klonopin?
• Conditions treated by clonidine and Klonopin
• Efficacy
• Cost and coverage
• Side effects
• Interactions
• Warnings
• FAQs

In this article

• What are the main differences between clonidine and Klonopin?
• Conditions treated by clonidine and Klonopin
• Efficacy
• Cost and coverage
• Side effects
• Interactions
• Warnings
• FAQs

While clonidine and Klonopin sound similar, they are two very different medications. Clonidine is a generic medication used to treat hypertension—also known as high blood pressure—and attention deficit hyperactivity disorder (ADHD). Klonopin is a brand-name medication that is FDA approved for certain types of seizures and panic disorder. 

These drugs also work differently—clonidine belongs to the centrally acting alpha-agonist drug class and works by stimulating certain receptors (proteins) in the brain to decrease heart rate, widen blood vessels, and regulate the part of the brain involved in behavior, attention, and impulsivity. On the other hand, Klonopin, which is also referred to by its generic name clonazepam, is a benzodiazepine that works by enhancing the effects of gamma-aminobutyric acid (GABA)—a neurotransmitter that slows down brain activity. 

These medications differ in virtually every way, including their indications, dosages, side effects, and drug interactions. In this article, we’ll discuss the differences of clonidine and Klonopin in depth.  

What are the main differences between clonidine and Klonopin?

Aside from clonidine and Klonopin both being prescription medications, there aren’t many similarities between the drugs. They are used for different purposes, have different mechanisms of action, and come with different risks. It’s important to note also that Klonopin is a schedule IV controlled substance due to its potential for misuse and addiction. Clonidine is not classified as a controlled substance because it has no known risk of abuse. 

Main differences of clonidine versus Klonopin
	Clonidine	Klonopin
Drug class	Centrally acting alpha-agonist	Benzodiazepine
Brand/generic status	Brand and generic versions available	Brand and generic versions available
What is the generic/brand name?	Brand: Catapres, Catapres-tts, Kapvay, Duraclon Generic: clonidine	Brand: Klonopin Generic: clonazepam
What forms does the drug come in?	Immediate-release tablet, extended-release tablet, transdermal patch, injection	Oral tablet
What is the starting dosage?	Immediate-release tablet:  0.1 mg twice daily Extended-release tablet: 0.1 mg at bedtime Transdermal patch: 0.1 mg patch applied once weekly Injection: determined by a healthcare provider	Seizures: Adults: 0.5 mg three times daily Children: depends on the child’s weight Panic disorder: 0.25 mg twice daily
How long is the typical treatment?	Long-term	Short-term or long-term depending on the use
Who typically uses the medication?	Adults and children ages 6 years and older	Seizures: adults and children Panic disorder: adults

Conditions treated by clonidine and Klonopin

Clonidine is prescribed to treat high blood pressure in adults and ADHD in adults and children ages 6 years and older. It may be prescribed alone or with other medications for the management of these health conditions. Additionally, healthcare providers sometimes prescribe clonidine off-label for conditions such as anxiety, insomnia, post-traumatic stress disorder (PTSD), and alcohol or opioid withdrawal. 

Klonopin contains the active drug clonazepam. It’s a schedule IV controlled substance that’s approved by the U.S. Food and Drug Administration (FDA) to treat panic disorder and certain seizure disorders, such as Lennox-Gastaut syndrome, akinetic, and myoclonic seizures. Klonopin may also be useful for certain people with absence—or petit mal—seizures. It’s typically used as a short-term treatment for panic disorder and long-term treatment for seizures. Healthcare providers may prescribe Klonopin alone or with other drugs for the treatment of seizure disorders. Off-label uses of Klonopin include restless leg syndrome, insomnia, acute mania, and tardive dyskinesia. 

Is clonidine or Klonopin more effective?

Studies have shown that both clonidine and Klonopin are effective for their respective indications. 

While clonidine isn’t a first-line treatment for hypertension, studies have shown it is an effective antihypertensive that can produce a significant reduction in average mean blood pressure. When combined with a diuretic, the reduction in blood pressure is greater than with either drug alone. Nevertheless, clonidine is an older drug that has taken a back seat to newer antihypertensives due to its side effect profile. Clinical guidelines recommend thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, or angiotensin II receptor blockers (ARBs) as first-line treatment for hypertension. 

Clonidine extended-release tablets were approved for the treatment of ADHD in 2010. Studies have shown clonidine extended-release and immediate-release are effective for ADHD, with participants experiencing improvements in inattention, impulsivity, and hyperactivity. Both formulations provided additional benefits in ADHD symptoms when taken with stimulant drugs and were well tolerated. However, researchers noted that clonidine has a risk of serious heart side effects, and more studies are needed to determine the long-term effects and safety of clonidine in children with ADHD. 

Clonazepam’s—Klonopin’s generic counterpart—efficacy in the treatment of panic disorder is well documented. In a 9-week study, 74% of patients who took 0.5 mg twice daily of clonazepam were completely free of panic attacks by the time the study ended. For the treatment of seizure disorders, clonazepam has been found to have “remarkably good” antiepileptic effects. 

While these drugs are effective treatment options, they aren’t right for everyone. Always consult a healthcare provider when determining the most beneficial medication for you. This can differ depending on your medical condition, medical history, and medications. 

Coverage and cost comparison of clonidine vs. Klonopin

Coverage of clonidine tablets or patches varies depending on the insurance or Medicare plan. If you’re paying for clonidine patches without insurance, the average cost is $126 for 1 box of 4 patches. A SingleCare coupon can help lower this price to $28. 

While brand-name Klonopin typically isn’t covered by insurance and Medicare plans, generic clonazepam is usually covered. Without insurance, the average cash price for Klonopin is $107 for 30, 0.5 mg brand-name tablets. A free SingleCare coupon can lower the cost to $4 for 30, 0.5 mg tablets of the generic clonazepam. 

Clonidine vs. Klonopin costs
	Clonidine	Klonopin
Typically covered by insurance?	Yes	Brand name: no Generic: yes
Typically covered by Medicare Part D?	Yes	Brand name: no Generic: yes
Quantity	One box of 4 patches	30, 0.5 mg tablets
Typical Medicare copay	Varies	Varies
SingleCare cost	$28	$4

Common side effects of clonidine vs. Klonopin

Although clonidine and Klonopin work differently, both drugs can cause side effects ranging from mild to serious in severity. Common side effects of clonidine include dry mouth, drowsiness, constipation, and dizziness. Some of Klonopin’s most common side effects are drowsiness, problems with coordination, and depression. 

Serious side effects of clonidine include low blood pressure, fainting, bradycardia (slow heart rate), heart block, and severe allergic reactions. Klonopin can cause drug dependence, withdrawal, behavior changes, such as irritability, aggression, and anger, and respiratory depression—defined as slow or shallow breathing. 

As mentioned above, Klonopin also has a risk of misuse and addiction, which is why it is classified as a Schedule IV controlled substance. 

Clonidine may also cause: 

• Nausea
• Chest pain
• Hallucinations
• Confusion
• Depression
• Serious gastrointestinal problems
• Rebound high blood pressure 

Other possible side effects of Klonopin include: 

• Fatigue 
• Memory problems
• Confusion
• Elevated liver enzymes
• Slurred speech
• Erectile dysfunction
• Suicidal thoughts or behaviors
• Worsening of seizures in those taking it for seizure disorders

Keep in mind this is only a partial list of side effects. For a complete list, talk to a healthcare provider. 

Drug interactions of clonidine vs. Klonopin

Klonopin has a boxed warning about the risk of use with opioids. Combining Klonopin with an opioid can cause extreme drowsiness, respiratory depression, coma, and in some cases, death. Due to these risks, healthcare professionals typically don’t prescribe these drugs together unless it’s the only available option. If they are prescribed together, report any signs or symptoms of severe drowsiness and problems breathing to your healthcare provider right away. 

While clonidine doesn’t have any boxed warnings, it can still interact with opioids or any other drugs known to cause drowsiness. These include other benzodiazepines, sleep aids, and certain antipsychotic medications. Additionally, clonidine can interact with drugs that slow the heart rate, such as Lanoxin (digoxin), beta blockers, and some calcium channel blockers. It can also interact with tricyclic antidepressants. 

Clonidine and Klonopin are also known to interact with alcohol. Mixing alcohol with clonidine can increase the risk of drowsiness, which may lead to difficulty focusing, thinking, and reacting. Consuming alcohol while taking Klonopin may increase the risk of misuse, addiction, and extreme sleepiness. Because of these risks, it’s usually recommended to avoid alcohol while taking these drugs.  

Warnings of clonidine and Klonopin

As discussed earlier, Klonopin has a boxed warning regarding the use of opioids. It also has a boxed warning regarding the risk of misuse and addiction, even if it’s taken at the recommended dosage. Misuse and addiction can lead to overdose and death, especially if the drug is combined with other sedating medications, alcohol, or illegal substances. 

Additionally, Klonopin use can cause severe withdrawal reactions if the drug is stopped abruptly or the dosage is decreased too quickly. Due to this risk, Klonopin should only be stopped under the supervision of a healthcare provider. They will likely lower the dosage of Klonopin slowly over time until it’s safe to stop completely. 

Discontinuing clonidine may also cause withdrawal symptoms, such as nervousness, agitation, and a rapid increase in blood pressure. To avoid these symptoms, healthcare providers will gradually decrease the dosage of clonidine over the course of a few days. 

For those using the patch, it’s important to note that the clonidine patch contains aluminum and should be removed before undergoing a magnetic resonance imaging (MRI) scan. 

It isn’t known if clonidine or Klonopin is safe for use during pregnancy or breastfeeding. If taken late during pregnancy, Klonopin may cause sedation or withdrawal symptoms in newborns. 

Frequently asked questions about clonidine vs. Klonopin

What is clonidine?

Clonidine is a generic prescription drug. Clonidine immediate-release tablets and transdermal patches are used to treat hypertension, while the extended-release tablets are approved to treat ADHD. 

What is Klonopin?

Klonopin is a brand-name prescription drug used to treat certain seizure disorders and panic disorder. 

Are clonidine and Klonopin the same?

No. While clonidine and Klonopin sound similar, these drugs are not used for the same purposes, and they work differently in the body. 

Is clonidine or Klonopin better?

These drugs are both considered safe and effective for their respective indications. They are not used for the same conditions.

Can I use clonidine or Klonopin while pregnant?

It’s not known if clonidine or Klonopin is safe for pregnant women. If taken late in pregnancy, Klonopin can cause sedation or withdrawal symptoms in newborns. 

Can I use clonidine or Klonopin with alcohol?

It’s not recommended to drink alcohol while taking clonidine or Klonopin. Both drugs can cause drowsiness. Combining these drugs with alcohol can increase the risk of extreme drowsiness. This can make it difficult to focus, think, or react. Consuming alcohol while taking Klonopin may also increase the risk of misuse and addiction. 

What is the best replacement for Klonopin?

Klonopin belongs to the benzodiazepine drug class. There are several other drugs in this class that may be used as an alternative for Klonopin, however, most have similar adverse effect profiles and warnings. To determine the best alternative for Klonopin, talk to your doctor.