Abstract
Epidural administration of clonidine, a partial alpha 2-adrenergic agonist, provides effective relief for patients with intractable cancer pain. However, clonidine's long plasma elimination half-life suggests a potential for plasma accumulation following repeated doses or constant infusion. Adult male and female cancer patients experiencing severe, intractable pain were administered a continuous epidural infusion (30 μg/h) of clonidine hydrochloride for 14 days. Plasma clonidine concentrations were determined for 31 patients using a radioimmunoassay with a limit of quantitation of 0.062 ng/mL. Mean (± SD) plasma clonidine concentration and calculated total body clearance after 7 days of infusion (respectively, 2.19 ± 1.17 ng/mL, n = 24; 279 ± 184 mL/min, n = 27) were comparable to those following 14 days of infusion (2.50 ± 1.51 ng/mL, n = 19; 272 ± 163 mL/min, n = 21). Clonidine does not appear to accumulate in the plasma compartment during prolonged (14-day) continuous epidural infusion in cancer patients.
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