Pediatrics
Clonidine effective in infants with opioid withdrawal: Randomized trial results
October 21, 2024
Length of treatment and final neurobehavioral performance weren’t significantly different between clonidine- and morphine-treated groups.
This randomized trial enrolled infants with prenatal opioid exposure, age ≤7 days, gestational age ≥35 weeks, no other medical conditions, and need for pharmacotherapy for neonatal opioid withdrawal syndrome.
Of 1,107 patients screened for enrollment, 645 were ineligible, in 91 cases parents or staff were unavailable, 216 declined, and 155 consented. Of those 155 infants, 120 required treatment and were randomized to either oral clonidine (n = 60) at 1 µg/kg/dose or morphine (n = 60) at 0.06 mg/kg/dose, q3h. If no improvement was seen, doses were increased by 25% of the initial dose every 12 to 24 hours. If no improvement was observed by the fourth dose increase, adjunct therapy was added. Length of treatment didn’t differ between morphine (median, 15 days) and clonidine (median 17 days). Adjunct therapy was required more frequently in clonidine- vs. morphine-treated infants (45% vs. 10%, adjusted odds ratio, 8.85). After treatment completion, NICU Network Neurobehavioral Scales summary scores were similar between clonidine-treated and morphine-treated infants.
Source:
Bada HS, et al. (2024, October 15). Pediatrics. Clonidine as Monotherapy for Neonatal Opioid Withdrawal Syndrome: A Randomized Trial. https://pubmed.ncbi.nlm.nih.gov/39403061/
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