Eligible patients are expected to have stable disease with no alteration to their treatment regimen in the 5 weeks preceding enrollment. If a patient develops uncontrolled pain with a clinical indication for a new treatment during the study period, the participation of the patient in the trial will be discontinued and the new treatment commenced. If any subject’s systolic pressure is found to drop below 80 mmHg during any section of the trial, they will be asked to stop the treatments and they will be removed from the study. Finally, in the event of an anaphylactic reaction to any of the topical treatments used in the study, the patient’s participation in the study will immediately be terminated. In both instances, the coordinator performing the randomization will send the study physician the information required to unblind him to the study drug the patient was taking so the information can be transferred to the medical team that will care for the patient.

Patients will be instructed to contact the study coordinator and/or physician if symptoms of clonidine withdrawal occur during washout or the week following completion of the study. In such an event, the study physician will perform a clinical evaluation of the patient and appropriate medical care will be provided. Unblinding and termination of participation in the study will depend on the study physician’s assessment of the patient’s clinical status.

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