Lofexidine Disease Interactions

Lofexidine can cause a decrease in blood pressure, a decrease in pulse, and syncope. It is recommended to monitor vital signs before dosing and for symptoms related to bradycardia and orthostasis. If clinically significant or symptomatic hypotension and/or bradycardia occur, the next dose of lofexidine should be reduced in amount, delayed, or skipped. Avoid using lofexidine in patients with severe coronary insufficiency, recent myocardial infarction, cerebrovascular disease, chronic renal failure, and in patients with marked bradycardia.

Lofexidine can potentiate the CNS depressive effects of alcohol and other CNS depressive substances. Care should be exercised when using this agent in patients with alcohol disorders.

Hepatic impairment slows the elimination of lofexidine, but exhibits less effect on the peak plasma concentration following a single dose. Dosage adjustments are recommended based on the degree of hepatic impairment. Close monitoring is recommended when using this agent in patients with hepatic impairment.

Lofexidine prolongs the QT interval. Its use should be avoided in patients with congenital long QT syndrome. It is recommended to monitor ECG prior to and during treatment in patients with congestive heart failure, bradyarrhythmias, hepatic impairment, renal impairment, or patients taking other medicinal products that lead to QT prolongation (e.g., methadone). Electrolyte abnormalities must be corrected prior to initiating therapy.

Renal impairment slows the elimination of lofexidine but exhibits less effect on the peak plasma concentration than on AUC values following a single dose. Dosage adjustments are recommended based on the degree of renal impairment. Only a negligible fraction of the lofexidine dose is removed during a typical dialysis session, so no additional dose needs to be administered after a dialysis session; therefore, the agent may be administered without regard to the timing of dialysis. Close monitoring is recommended when using this agent in patients with renal impairment.