moxonidine: clinical use

Prescribing considerations

• Assess renal function because moxonidine is eliminated mainly through the kidneys.
• Use particular caution in older adults, moderate heart failure, first-degree atrioventricular block, severe coronary disease or unstable angina.
• Avoid abrupt withdrawal; arrange gradual prescriber-led discontinuation.
• Not recommended for children or adolescents because safety and efficacy data are lacking.

Contraindications and cautions

• Hypersensitivity to moxonidine or an excipient
• Sick sinus syndrome or sinoatrial block
• Second- or third-degree atrioventricular block
• Resting bradycardia below 50 beats per minute
• Severe heart failure
• Severe renal dysfunction

Monitoring

• Blood pressure and symptoms of hypotension or orthostatic dizziness
• Heart rate and symptoms suggesting conduction disturbance
• Renal function, particularly before treatment and during review in people with impairment
• Tolerability, including sedation, dry mouth and falls risk

Clinical pharmacology

A selective central I1-imidazoline-receptor agonist with relatively low affinity for central alpha-2 adrenoceptors. Elimination is predominantly renal.

Formulation and product differences

• The selected product is a light-pink, round, biconvex film-coated tablet marked “0.2”.
• It contains lactose; consider this in people with relevant hereditary carbohydrate-intolerance disorders.

Tablet

Route: Oral

Strengths: 200 micrograms, 300 micrograms, 400 micrograms