Alternatives to Chlorthalidone/Clonidine If You Can't Fill Your Prescription

Clorpres — the combination of chlorthalidone and clonidine in a single tablet — is no longer available in the United States. If you relied on this medication to control your blood pressure, you'll need to discuss alternatives with your prescriber. The good news is that there are several solid options, starting with the simplest solution: taking the two components as separate generic pills.

This guide covers the most common alternatives, how they compare to Clorpres, and what questions to ask your doctor. Note: never stop or change your blood pressure medication without talking to your prescriber — especially clonidine, which requires gradual tapering to avoid rebound hypertension.

Option 1: The Two Individual Generics (Simplest Path)

The most direct alternative to Clorpres is to take its two components separately: generic clonidine and generic chlorthalidone. This provides the exact same pharmacological effect — there's no therapeutic difference between the combination pill and the individual generics taken together.

Generic clonidine is available in 0.1 mg, 0.2 mg, and 0.3 mg tablets, as well as transdermal patches. Multiple manufacturers produce it, making it widely accessible.

Generic chlorthalidone is available in 25 mg and 50 mg tablets. The 2025 ACC/AHA hypertension guidelines list chlorthalidone as a preferred first-line thiazide-like diuretic.

The main drawback: you now take two pills instead of one. However, this is the closest you can get to the original Clorpres therapy, and both drugs are extremely affordable at their generic prices.

Option 2: Clonidine Transdermal Patch (Catapres-TTS Generic)

For patients who need clonidine but struggle with twice-daily dosing, the clonidine transdermal patch is an alternative. Applied once a week, it delivers clonidine continuously and eliminates the risk of missed doses that could trigger rebound hypertension. Generic patches are available, though supply can be more variable than oral tablets.

Option 3: ACE Inhibitor + Thiazide Diuretic Combinations (First-Line)

If your prescriber determines that clonidine may no longer be the best choice for you, a modern first-line combination may be a better fit. The 2025 ACC/AHA guideline recommends ACE inhibitors, ARBs, calcium channel blockers, and thiazide-type diuretics as first-line agents. Several widely available combination pills may replace Clorpres:

Lisinopril/Hydrochlorothiazide (generic) — Extremely common, affordable, and broadly available. An ACE inhibitor paired with a thiazide diuretic. Good for most patients without contraindications to ACE inhibitors.

Losartan/Hydrochlorothiazide (generic) — ARB + thiazide. A good option for patients who can't tolerate ACE inhibitors (e.g., those with ACE-inhibitor cough).

Amlodipine/Valsartan (generic) — Calcium channel blocker + ARB. Excellent blood pressure control with a favorable side effect profile.

Option 4: Guanfacine (A Clonidine Alternative)

If the main goal is to replace the clonidine component with a similar drug, guanfacine is a centrally acting alpha-2 agonist like clonidine. It has a longer half-life, meaning once-daily dosing is possible, and some patients find it causes less sedation and dry mouth than clonidine. It also has a lower risk of rebound hypertension if a dose is missed. Guanfacine is available as a generic and is widely accessible.

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Option 5: Methyldopa

Another centrally-acting antihypertensive, methyldopa works similarly to clonidine. It is most commonly used in pregnancy-related hypertension (it's one of the safer options during pregnancy). For non-pregnant patients, it's rarely a first choice due to side effects including sedation, depression, and liver concerns — but it may be considered in certain clinical contexts.

What to Discuss With Your Doctor

When you speak with your prescriber about alternatives, consider these questions:

Can I simply switch to the two individual generics at the same doses?

Is there a reason I was on clonidine specifically (vs. a more modern agent)?

Am I eligible for a first-line combination pill that may have better long-term data?

How do I safely taper off clonidine if we're switching to a different drug class?

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Finding Your Alternative Medications Near You

Once you have a new prescription, use medfinder to verify your pharmacy has it in stock before making the trip. For step-by-step help, see our guide on how to find chlorthalidone and clonidine near you.