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Thread: Is clonidine more effective combined with another anti-flushing medication?

  1. #1
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    Default Is clonidine more effective combined with another anti-flushing medication?

    Hi everyone,

    I was wondering, as I have an appointment with my dermatologist in January, if anyone has had success by combining clonidine with another form of anti-flushing medication. I am currently just taking clonidine at the moment, and although fairly effective, I still struggle with burning and flushing (especially as a consequence of central heating). If anyone could give me advice I would be very grateful. Thanks again.

    burner.

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    Hi Burner

    for me the combination of clonidine with propranolol and mirtazapine proved most effective to cut down the flushing. I used to take 0,0075 mcg clonidine 3 times a day (8 hs interval) and 40 mg propranolol 3 times a day (cut that down to once a day 40 mg now) and 22,5 mg mirtazapine at night. Mirtazapine works from 15 mg - 30 mg but not higher than 30 mg typically, but it comes with more side effects than the clonidine and propranolol.

    I also take Xyzal (antihistamine) when needed, 10 mg.

    Hope this helps

    Best wishes Nat

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    Quote Originally Posted by nat007 View Post
    Hi Burner

    for me the combination of clonidine with propranolol and mirtazapine proved most effective to cut down the flushing. I used to take 0,0075 mcg clonidine 3 times a day (8 hs interval) and 40 mg propranolol 3 times a day (cut that down to once a day 40 mg now) and 22,5 mg mirtazapine at night. Mirtazapine works from 15 mg - 30 mg but not higher than 30 mg typically, but it comes with more side effects than the clonidine and propranolol.

    I also take Xyzal (antihistamine) when needed, 10 mg.

    Hope this helps

    Best wishes Nat
    Hi Nat

    Thank you for replying. I have been thinking of asking my dermatologist about combining clonidine with propranolol for a while now, as I have not tried the two together yet. I feel it is increasingly difficult to find out what works best to suppress the flushing, so I appreciate your advice. It does seem to me though, that unless we come up with viable answers ourselves, modern day dermatologists will just continue to bat us off and see us again in three months. A never ending cycle. I hope you are well and thanks again. All the best.

    burner.

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    Yeh agreed Burner, I had seen many dermatologists for my facial flushing and burning and redness, and all they had to throw at me were antibiotics, which all made it worse for me. That was about it. Then my London derm suggested all these anti flushing medications and I'm happy with the improvements, although it's no cure by far. But at some point all improvement is a victory.

    I see him in February again so I'm planning on asking on new treatment options out there perhaps for the flushing and burning, will post my findings later on.
    I find mirtazapine (remeron) very affective, also tackling some of the anxiety/depression/insomnia, and also by lowering the central nervous system related flushing. But it's a shame that these medications are all designed for different problems than rosacea, and that they aren't really tailered to our needs and come with side effects...

    hope this helps, best wishes Nat

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    Quote Originally Posted by nat007 View Post
    Yeh agreed Burner, I had seen many dermatologists for my facial flushing and burning and redness, and all they had to throw at me were antibiotics, which all made it worse for me. That was about it. Then my London derm suggested all these anti flushing medications and I'm happy with the improvements, although it's no cure by far. But at some point all improvement is a victory.

    I see him in February again so I'm planning on asking on new treatment options out there perhaps for the flushing and burning, will post my findings later on.
    I find mirtazapine (remeron) very affective, also tackling some of the anxiety/depression/insomnia, and also by lowering the central nervous system related flushing. But it's a shame that these medications are all designed for different problems than rosacea, and that they aren't really tailered to our needs and come with side effects...

    hope this helps, best wishes Nat
    That's true Nat. They all seem to have side effects. Can you tell what side effects you get from Mirtazapine, I heard that people gain a lot of weight. Thanks.

    burner.

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    Quote Originally Posted by burner View Post
    That's true Nat. They all seem to have side effects. Can you tell what side effects you get from Mirtazapine, I heard that people gain a lot of weight. Thanks.

    burner.
    Hi Burner,
    Yeh that's correct, weight gain, increased appetite mostly. I find it possible to limit the weight gain with exercise and watching diet but nevertheless, it is a very undesirable side effect. That's about it for me, in the first months of using it I had some restless legs, nerve twitches right after taking them, and tiredness but those are usually temporary side effects, when your body is adjusting to the drug.

    The positives of mirtazapine for me are less flushing and facial redness, improved mood, sleep, reduction of anxiety, food tastes better.

    I would first try a beta blocker like propranolol and a good antihistamine like Xyzal personally before mirtazapine because of the weight side effect. But for me the side effects are worth it either way, I rather suppress hunger than ongoing flushing and depression, but this is different for everybody of course and also, it seems these drugs don't work as well for everybody unfortunately.

    best wishes

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    Quote Originally Posted by burner View Post
    That's true Nat. They all seem to have side effects. Can you tell what side effects you get from Mirtazapine, I heard that people gain a lot of weight. Thanks.

    burner.
    I took mirtazepine (maximum 45mg) for many years for depression and insomnia, it is well known for a good side effects profile but we all differ. I had few side effects but a worsening of Restless Legs Syndrome, increased appetite (not hunger as such) and very grouchy with my partner in the morning.

    The RLS could be reduced/ controlled with sufficient magnesium intake and/ or Self Myofascial Release on the piriformis muscle (deep in buttock). Increase appetite you can control with awareness and discipline, we rosaceans need to be watching our diet anyway so that is hopefully second nature to you.

    Extreme tiredness when commencing is not uncommon, some are wiped out for a week or two then adjust. If you are taking mirtazepine for reasons other than depression, you can start on half a 15mg tablet to ease into it.

    I have also taken propranolol for anxiety (10mg as and when OR 80mg slow release daily for a while), no side effects for me at all. Again sufficient magnesium intake was important - I really must research any possible links with rosacea since I have known issues with deficiency spanning many years.
    Last edited by Firefox7275; 29th December 2014 at 02:22 AM.

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    Quote Originally Posted by nat007 View Post
    Hi Burner,
    Yeh that's correct, weight gain, increased appetite mostly. I find it possible to limit the weight gain with exercise and watching diet but nevertheless, it is a very undesirable side effect. That's about it for me, in the first months of using it I had some restless legs, nerve twitches right after taking them, and tiredness but those are usually temporary side effects, when your body is adjusting to the drug.

    The positives of mirtazapine for me are less flushing and facial redness, improved mood, sleep, reduction of anxiety, food tastes better.

    I would first try a beta blocker like propranolol and a good antihistamine like Xyzal personally before mirtazapine because of the weight side effect. But for me the side effects are worth it either way, I rather suppress hunger than ongoing flushing and depression, but this is different for everybody of course and also, it seems these drugs don't work as well for everybody unfortunately.

    best wishes
    Thanks Nat,

    I think I am going to give the clonidine and propranolol combination a go first. Thanks ever so much for your advice, you have been a great help. Hope everything goes ok with your derm appointment in February, and I wish you a happy new year. Take care.

    burner.

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    Quote Originally Posted by Firefox7275 View Post
    I took mirtazepine (maximum 45mg) for many years for depression and insomnia, it is well known for a good side effects profile but we all differ. I had few side effects but a worsening of Restless Legs Syndrome, increased appetite (not hunger as such) and very grouchy with my partner in the morning.

    The RLS could be reduced/ controlled with sufficient magnesium intake and/ or Self Myofascial Release on the piriformis muscle (deep in buttock). Increase appetite you can control with awareness and discipline, we rosaceans need to be watching our diet anyway so that is hopefully second nature to you.

    Extreme tiredness when commencing is not uncommon, some are wiped out for a week or two then adjust. If you are taking mirtazepine for reasons other than depression, you can start on half a 15mg tablet to ease into it.

    I have also taken propranolol for anxiety (10mg as and when OR 80mg slow release daily for a while), no side effects for me at all. Again sufficient magnesium intake was important - I really must research any possible links with rosacea since I have known issues with deficiency spanning many years.
    Thanks Firefox,

    you have answered a lot of my queries. This disease can be really complicated to treat at times. I hope you find the answers you are looking for and I wish you a happy 2015. All the best.

    burner.

  10. #10
    Senior Member nat007's Avatar
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    Quote Originally Posted by Firefox7275 View Post
    I took mirtazepine (maximum 45mg) for many years for depression and insomnia, it is well known for a good side effects profile but we all differ. I had few side effects but a worsening of Restless Legs Syndrome, increased appetite (not hunger as such) and very grouchy with my partner in the morning.
    Oh I never connected the dots there, but now that you mention it, yes count me in on the grouchy morning moods too. I contribute it to very deep sleep on remeron and a strong dislike to wake up in the mornings. It also gives me very vivid dreams, no nightmares but very life like dreams. As I don't experience that much in my days I kind of love that side effect.

    For me the restless leg syndrome was fleeting and temporary at the start of the medication use.

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