Adult: Initially, 200 mcg once daily in the morning, increase if necessary after 3 wk to 400 mcg daily as single or in 2 divided doses. If necessary, after a further 3 wk, increase to a max of 600 mcg daily in 2 divided doses (max 400 mcg per single dose).
Severe (GFR <30 mL/min): Contraindicated. Moderate (GFR 30-60 mL/min): Max: 400 mcg daily (max 200 mcg per single dose).
May be taken with or without food.
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Sick sinus syndrome or sino-atrial block, 2nd or 3rd degree AV block, bradycardia (<50 beats/min at rest), severe heart failure, severe ischaemic heart disease, Raynaud’s disease, Parkinson’s disease, epilepsy, glaucoma, depression. Severe renal impairment (GFR <30 mL/min). Lactation.
1st degree AV block, moderate heart failure, severe coronary artery disease, unstable angina, history of angioneurotic oedema. Avoid abrupt withdrawal. Moderate renal impairment (GFR 30-60 mL/min).
This drug may cause somnolence and dizziness, if affected, do not drive or operate machinery.
Symptoms: Headache, sedation, somnolence, hypotension, dizziness, asthenia, bradycardia, dry mouth, vomiting, fatigue, upper abdominal pain. Management: May consider admin of IV fluids and dopamine for hypotension, atropine for bradycardia, or α-receptor antagonists for paradoxal hypertensive effects.
Additive effects w/ other antihypertensives. May enhance the sedative effects of benzodiazepines, TCAs, tranquilisers, sedatives and hypnotics. TCAs may reduce the effect of moxonidine.
May potentiate the sedative effect of alcohol.
Description: Moxonidine is a centrally-acting antihypertensive. It acts in the brainstem through stimulation of central imidazoline receptors to reduce sympathetic tone. It also has a low affinity for α2-adrenoceptors. Pharmacokinetics: Absorption: Well absorbed from the GI tract. Bioavailability: Approx 88%. Time to peak plasma concentration: 0.5-3 hr. Distribution: Enters breast milk. Plasma protein binding: Approx 7%. Metabolism: Metabolised via opening of the imidazoline ring, mainly to 4,5-dehydromoxonidine and to a guanidine derivative. Excretion: Via urine (approx 50-75% as unchanged drug). Plasma elimination half-life: 2-3 hr.
C02AC05 - moxonidine ; Belongs to the class of imidazoline receptor agonists, centrally-acting antiadrenergic agents. Used in the treatment of hypertension.
Buckingham R (ed). Moxonidine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/07/2016.Joint Formulary Committee. Moxonidine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/07/2016.