Sedation/Analgesia in Mechanically Ventilated Patient Clinical Pathway — CICU

Dexmedetomidine to Clonidine Transition

1 mcg/kg/hour of dexmedetomidine = 10 mcg/kg/DAY (0.01 mg/kg/DAY) divided q6-12h (typically q6h dosing) Minimum dose of clonidine is 0.005 mg (0.05 mL). For patients whose dexmedetomidine converts to a clonidine dose < 0.005 mg, consider spacing interval to q8h to q12h.

  • Step 1: Start clonidine xxx mg PO/NG q6h
  • Step 2: Decrease dexmedetomidine by 50% to xxx mcg/kg/hour 30 minutes following the 2nd dose of enteral clonidine
  • Step 3: Decrease dexmedetomidine by another 50% to xxx mcg/kg/hour 30 minutes following the 3rd dose of enteral clonidine
  • Step 4: Discontinue dexmedetomidine 30 minutes following the 4th dose of enteral clonidine