Enteral Clonidine for the Management of Rigors in Pediatric Oncology.
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Rigors are a distressing symptom commonly experienced by oncology patients and may occur secondary to infection, medications, or the disease process itself. Historically, meperidine has been used in the symptomatic management of patients experiencing rigors, but utilization and availability of this medication have declined due to safety concerns. We report the case of a 14-year-old male with acute myeloid leukemia who experienced recurrent severe rigors associated with fever throughout his illness. Enteral clonidine was initiated at a dose of 100 µg every six hours as needed for rigor management and was titrated as high as 100 µg every six hours scheduled during prolonged fever periods. The patient experienced rapid improvement in the severity of rigors following the initiation of clonidine after a single dose. These fevers had been present throughout the duration of his illness and could not always be correlated with specific infections or treatment elements. This case supports the use of enteral clonidine as a possible therapy for patients experiencing painful or distressing rigors.