Issues for surgery
Loss of blood pressure (BP) control if omitted (see Further information).
Risk of hypotension if continued.
Risk of Central Nervous System (CNS) depression if continued.
Advice in the perioperative period
Elective and emergency surgery
Continue – monitor BP.
Post-operative advice
Restart post-operatively once enteral intake resumed.
Monitor BP.
Interactions with common anaesthetic agents
Hypotension
Moxonidine can increase the risk of hypotension when used concomitantly with inhalational or intravenous anaesthetics.
CNS depression
See also Interactions with other common medicines used in the perioperative period.
Moxonidine has CNS depressant effects which may be additive with other medicines that also have CNS depressant effects such as:
- benzodiazepines
- inhalational anaesthetics and intravenous anaesthetics
- local anaesthetics
- opioids
(Consult British National Formulary for available drugs in each class.)
Interactions with other common medicines used in the perioperative period
Hypotension
Moxonidine can increase the risk of hypotension when used concomitantly with the antiemetics droperidol and prochlorperazine.
CNS depression
See also Interactions with common anaesthetic agents.
Moxonidine has CNS depressant effects which may be additive with other medicines that also have CNS depressant effects such as:
- antiemetics (e.g. cyclizine, prochlorperazine)
- opioids
(Consult British National Formulary for available drugs in each class.)
Further information
Withdrawal
Rebound hypertension has not been observed after discontinuation of moxonidine; however, it is recommended that the dose is reduced gradually over a period of two weeks rather than stopping abruptly.
References
Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 30th September 2023]
Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 30th September 2023]
Summary of Product Characteristics – Physiotens® (moxonidine) 200 micrograms Tablets. Mylan. Accessed via www.medicines.org.uk 30/09/2023 [date of revision of the text October 2016]