Clonidine patches for dystonia

Name of medicine

Clonidine

Common brand names: Catapressan, Catapress-TTS

Why is it important for my child to take Clonidine patches?

Children with dystonia (also called hypertonia) or muscle stiffness get painful and distressing movements and muscle spasms. These can may make everyday tasks difficult, such as feeding, washing, dressing, sitting and sleeping.

Clonidine helps to reduce muscle spasms and unwanted movements and improve muscle comfort.

Clonidine can only be prescribed by a specialist as part of a symptoms management plan.

What is Clonidine patches available as?

This leaflet is about clonidine patches.

The patches release the medicine slowly over 7 days.

There are three strengths, which release 100, 200 or 300 micrograms each day.

When should I give Clonidine patches

The patch should be replaced once a week. This should be on the same day each week, which will help you to remember. You can also put reminders in your diary or phone.
If your child has more than one patch, it may be helpful to draw a diagram showing where the patches are and which one you need to change on which day. You can write the days on the patches. We have also provided a record chart to help you remember what to do.

How much should I give?

Your doctor will work out the amount of Clonidine patches (the dose) that is right for your child. The dose will be shown on the medicine label.

How should I give Clonidine patches?

Clonidine patches are brought in from abroad and they may not be labelled in English.

• The package will contain two different shaped patches.
  • The medicine patches are usually square and may have a red stripe on the packet.
  • The second pack contains two protective covers, which are usually round. These do not contain any medicine.
• If you are not sure which patch contains the medicine, check with your pharmacist.
• Choose an area of skin that is dry and not hairy, red or sore, such as the upper arm or body. The back may be better for young children so they cannot peel off the patch.
• Avoid using soap, creams, oils or ointments on the skin where you will apply a patch.
• Peel off the old medicine patch and cover. Fold the medicine patch in half, sticky sides together, and put in the household waste.
• Put the new medicine patch on the other arm or a different area of the body from the old patch.
• Each medicine patch is in a sealed pouch. These patches are usually square. When you are ready to apply the patch, cut or tear open the pouch along the dotted line. Be careful not to damage the patch inside.
• The sticky side of the medicine patch is protected by plastic foil. Try not to touch the sticky side of the patch.
• Peel off half the foil and stick the medicine patch to the skin. Then remove the rest of the foil and press the patch in place for at least 30 seconds – the warmth from your hand helps the patch to stick. However, you should not rub the patch.
• You can put one of the protective covers (which are normally round) over the top of the medicine patch to help keep it in place, or use surgical tape.
• Wash your hands after handling the patches.

• Do not allow patches to come into contact with direct heat such as head pads or hot-water bottles, as the medicine will be released too quickly.
• Do not use damaged patches.
• Check that the patch is still in place each morning, and after showering, swimming or bathing.
• If a medicine patch starts to come off, you can stick it down with tape or put one of the round covers over it.
• If a patch has come off completely, put on a new patch in a different place. Replace this patch on your usual day, even if this is after fewer than 7 days.

When should the medicine start working?

• Your child may have been taking clonidine by mouth (tablets or liquid medicine) before changing to patches. The change to patches is usually done over a few days. Your child may be in hospital during this change so they can be monitored. This is because it can take 2–3 days for the first patch to reach its full effect.
• If you are not sure the patch is working, contact your doctor but leave the patch in place in the meantime. Do not apply extra patches, as you may cause harm.

What if my child is sick (vomits)?

You do not need to worry if your child is sick, as the medicine will still work.

What if I forget to give it?

If you forget to replace a patch, do it as soon as you remember. Replace this patch on the usual day rather than changing to a new day.

What if I give too much?

If you use the patches according the instructions, you are unlikely to cause harm. However, if you think you may have used too many patches, remove them and start again with a new medicine patch. If your child is drowsy (sleepy) or light-headed contact your healthcare professional for advice.

Are there any possible side effects?

• The patches may make the skin red, itchy or swollen. If this happens contact your healthcare professional.
• Your child may feel dizzy or light-headed when standing or sitting up, or they may faint. Encourage them to change position slowly, and to sit or lie down if they feel dizzy or light-headed. If this happens frequently, contact your doctor to check your child’s blood pressure, as it may be too low.
• Your child may have a dry mouth, feel sleepy or tired, they may get a headache.
• They may get constipation (difficult doing a poo) or nausea (feel sick).

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at mhra.gov.uk/yellowcard

Can other medicines be given at the same time as Clonidine patches?

You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

Clonidine patches should not be taken with some medicines that you get on prescription. It is important to tell your doctor and pharmacist about any other medicines your child is taking before starting Clonidine patches.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

• Order a new prescription at least 2 weeks before you will run out. However, do not keep extra stocks of patches as other children may need them.
• Clonidine patches are brought in from abroad, you maysometimes have difficulty getting a new supply. If this isthe case, contact your healthcare team as soon aspossible for advice.
• You will be given a written plan that explains how to switch to oral clonidine (by mouth) if patches are not available at any time. Make sure that all healthcare professionals who look after your child know about this plan.
• Clonidine is also available as liquid medicine and tablets, and is used to treat several different conditions. If you look for information, make sure it is for dystonia and forpatches, as advice may differ.

General advice about medicines

• If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
• If you think someone else may have stuck on a patch, remove it immediately. If the person is drowsy (sleepy) or feels faint or lightheaded, contact a healthcare professional for advice.
• Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
• Make sure that children cannot see or reach the medicine.
• Keep the medicine in the container it came in.

Who to contact for more information?

Your doctor, pharmacist or nurse will be able to give you more information about Clonidine patches and about other medicines used to treat dystonia.

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review by October 2027.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.