Acute Hypertension during Clonidine Taper in an Infant with Neonatal Abstinence Syndrome

A 2,600-gram infant treated with methadone and clonidine for Neonatal Abstinence Syndrome (NAS) developed acute hypertension following initiation of the clonidine taper, requiring treatment with a calcium channel blocker. While transient hypertension after discontinuing alpha-2 agonist treatment is common, prolonged elevation of blood pressure is uncommon. Thus, more gradual tapering and careful monitoring of blood pressure following discontinuation of clonidine in newborn patients could be warranted.