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Why is this drug prescribed?

Catapres is prescribed for high blood pressure. It is effective when used alone or with other high blood pressure medications.

Doctors also prescribe Catapres for alcohol, nicotine, or benzodiazepine (tranquilizer) withdrawal; migraine headaches; smoking cessation programs; Tourette's syndrome (tics and uncontrollable utterances); narcotic/methadone detoxification; premenstrual tension; and diabetic diarrhea.

Most important fact about this drug

If you have high blood pressure, you must take Catapres regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Catapres; and you must continue taking it even if you are feeling well. Catapres does not cure high blood pressure; it merely keeps it under control.

How should you take this medication?

Take this medication exactly as prescribed, even if you are feeling well. Try not to miss any doses. If Catapres is not taken regularly, your condition may get worse.

The Catapres-TTS patch should be put on a hairless, clean area of the upper outer arm or chest. Normally, a new one is applied every 7 days to a new area of the skin. If the patch becomes loose, use some adhesive tape or an adhesive bandage to keep it in place.

--If you miss a dose...

Take it as soon as you remember, then go back to your regular schedule. If you forget to take the medication 2 or more times in a row, or if you forget to change the transdermal patch for 3 or more days, contact your doctor.

--Storage instructions...

Store at room temperature in a tightly closed container away from light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Catapres.

• More common side effects may include:
  Agitation, constipation, dizziness, drowsiness, dry mouth, fatigue, impotence, loss of sex drive, nausea, nervousness, sedation (calm), vomiting, weakness

• Less common side effects may include:
  Changes in heartbeat, excessive nighttime urination, headache, loss of appetite, mental depression, pounding heartbeat, vague bodily discomfort, weight gain

• Rare side effects may include:
  Abdominal pain, anxiety, behavior changes, blurred vision, breast development in males, burning eyes, congestive heart failure, constipation, delirium, dry eyes, dry nasal passages, fainting, fever, greater sensitivity to alcohol, hallucinations, heart irregularities, hepatitis, hair loss, hives, insomnia, itching, joint pain, leg cramps, little or no urination, muscle pain, pallor, restlessness, vivid dreams or nightmares

• Additional side effects of Catapres-TTS may include:
  Abrasions, blisters, burning or reddened skin, discolored or whitened skin, pimples, throbbing skin

Why should this drug not be prescribed?

Do not take this medication if you have ever had an allergic reaction to Catapres or to any of the components of the transdermal patch.

Special warnings about this medication

Catapres should not be stopped suddenly. Headache, nervousness, agitation, tremor, confusion, and rapid rise in blood pressure can occur. Severe reactions such as disruption of brain functions, stroke, fluid in the lungs, and death have also been reported. Your doctor should gradually reduce your dosage over several days to avoid withdrawal symptoms.

If you see redness, blistering, or a rash near the transdermal patch, call your doctor. You may need to remove the patch. If you are troubled by mild irritation before completing 7 days of use, you may remove the patch and apply a new one at a different site.

If your doctor has switched you to oral Catapres (tablet) because you had an allergic reaction, such as a rash or hives, to the transdermal skin patch, be aware that you may have a similar reaction to the Catapres tablet.

If you have severe heart or kidney disease, are recovering from a heart attack, or have a disease of the blood vessels of the brain, your doctor will prescribe Catapres with caution.

If you are taking Catapres and a beta blocker such as Inderal or Tenormin, and your doctor wants to stop your medication, the beta blocker should be stopped several days before the gradual withdrawal of Catapres.

Catapres may cause drowsiness. If it has this effect on you, avoid driving, operating dangerous machinery, or participating in any hazardous activity that requires full mental alertness.

The used Catapres-TTS patch still contains enough drug to be harmful to children and pets. Fold the patch in half with the adhesive sides together and dispose of it out of the reach of children.

Possible food and drug interactions when taking this medication

Catapres may increase the effects of alcohol. Do not drink alcohol while taking this medication.

If Catapres is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Catapres with the following:

Barbiturates such as Nembutal and Seconal
Beta-blocker drugs such as the blood pressure medications Inderal and Lopressor
Calcium blockers such as the heart medications Calan and Cardizem
Digitalis
Sedatives such as Valium, Xanax, and Halcion
Tricyclic antidepressants such as Elavil and Tofranil

Special information if you are pregnant or breastfeeding

The effects of Catapres during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Catapres appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with this medication is finished.

Recommended dosage

ADULTS

The dosage will be adjusted to your individual needs.

The usual starting dose is 0.1 milligram, twice a day (usually in the morning and at bedtime).

The regular dose of Catapres is determined by increasing the daily dose by 0.1 milligram at weekly intervals until the desired response is achieved. A larger portion of the increased dose can be taken at bedtime to reduce potential side effects of drowsiness and dry mouth that may appear when you begin taking this drug.

The most common effective dosages range from 0.2 milligram to 0.6 milligram per day divided into smaller doses. The maximum effective dose is 2.4 milligrams per day; however, this dose is not usually prescribed.

Transdermal Patch

The patch comes in different strengths, and your doctor will determine which is best for you based on your blood pressure response.

People who are using another high blood pressure medication should not stop taking it abruptly when they begin using the patch, because the medication in the patch may take a few days to begin working. The other medication should be discontinued slowly as the patch begins to take effect.

CHILDREN

Safety and effectiveness of the Catapres tablets and patch in children below the age of 12 have not been established.

OLDER ADULTS

Dosages are generally as above; however, the initial dosage for an older person may be lower than the regular starting dose.

Overdosage

• Symptoms of Catapres overdose may include:
  Constriction of pupils of the eye, drowsiness, high blood pressure followed by a drop in pressure, irritability, low body temperature, slowed breathing, slowed heartbeat, slowed reflexes, weakness

Large overdoses can cause changes in heart function or rhythm, coma, seizures, and temporary interruptions in breathing.

Getting a patch in the mouth or swallowing one can cause an overdose.

If you suspect symptoms of a Catapres overdose, seek medical attention immediately.