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Guanfacine

Brand names:

Intuniv®

    • Tablets: 1 mg, 2 mg, 3 mg, 4 mg (extended release)

Tenex®

    • Tablets: 1 mg, 2 mg (immediate release)

Generic name: guanfacine (GWAHN fa seen)

Medication class: central alpha agonist

All FDA warnings are at the end of this fact sheet. Please consult them before taking this medication.

What are Intuniv®/Tenex® and what do they treat?

Guanfacine is a prescription medication that is used to treat attention-deficit hyperactivity disorder (ADHD) in individuals between 6 and 17 years of age. Guanfacine is also used to treat blood pressure in both children and adults.

Symptoms of ADHD interfere with an individual’s ability to function at school or work or in social settings and include:

  • Inattention (e.g., making careless mistakes, losing things necessary for tasks)

  • Hyperactivity (e.g., inability to sit still)

  • Impulsivity (e.g., interrupting or intruding on others)

A person may have severe inattention without hyperactivity or impulsivity.

Guanfacine is used in addition to non-medication treatments to manage ADHD symptoms.

What is the most important information I should know about Intuniv®/Tenex®?

Although some symptoms may improve within days of starting guanfacine, it may take several weeks before you notice the full benefits of the medication.

Are there specific concerns about Intuniv®/Tenex® and pregnancy?

If you are planning on becoming pregnant, notify your healthcare provider so that he/she can best manage your medications. People living with ADHD who wish to become pregnant face important decisions. There are no well-controlled studies of guanfacine use in pregnant women. Animal studies did not demonstrate evidence of fetal harm. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.

Regarding breastfeeding, caution is advised since guanfacine does pass into breast milk.

What should I discuss with my healthcare provider before taking Intuniv®/Tenex®?

  • Symptoms of your condition that bother you the most

  • If you have thoughts of suicide or harming yourself

  • If you experience side effects from your medications, discuss them with your provider. Some side effects pass with time, but others may require changes in the medication.

  • Any other psychiatric or medical problems you have, including heart disease

  • All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have

  • Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.

  • If you are pregnant, plan to become pregnant, or are breast-feeding

  • If you drink alcohol or use drugs

How should I take Intuniv®/Tenex®?

Guanfacine is usually taken 1-2 times per day. Guanfacine can be taken with or without food. However, taking it with a high fat meal can increase absorption and may increase effects.

The dose usually ranges from 1 mg to 4 mg per day. Only your healthcare provider can determine the correct dose for you.

Extended release tablets (Intuniv®) should not be crushed, chewed or divided. Swallow the tablet whole.

What happens if I miss a dose of Intuniv®/Tenex®?

If you miss a dose of guanfacine take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.

What should I avoid while taking Intuniv®/Tenex®?

Guanfacine may cause dizziness or drowsiness, especially when first starting the medication. Make sure you know how you react to the medication before you drive, operate machinery, or participate in other activities that may be dangerous if you are not alert.

Avoid drinking alcohol or using illegal drugs while you are taking this medication. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.

What happens if I overdose with Intuniv®/Tenex®?

If an overdose occurs call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.

Overdosing with guanfacine may cause sleepiness, dizziness, low blood pressure and slow heart rate.

A specific treatment to reverse the effects of guanfacine does not exist.

What are possible side effects of Intuniv®/Tenex®?

Common

  • Sleepiness, drowsiness, dizziness, headache, irritability

  • Low blood pressure

  • Nausea, stomach pain, dry mouth, constipation and decreased appetite

Rare

  • Very low blood pressure or heart rate

  • Fainting

Are there any risks for taking Intuniv®/Tenex®for long periods of time?

There are no known problems associated with long term use of guanfacine.

What other medications may interact with Intuniv®/Tenex®?

The following medications may increase the levels and effects of guanfacine:

  • Increased levels: ketoconazole (Nizoral®)

  • Increased effects:

    • Medications that lower blood pressure or cause sedation (sleepiness)

    • Other products containing guanfacine or clonidine (Catapres® or Kapvay®)

The following medications may decrease the levels and effects of guanfacine: rifampin (Rifadin®), carbamazepine (Tegretol®), and phenytoin (Dilantin®)

Guanfacine may increase the levels and effects of: valproic acid (Depakene®, Depakote®, Depakote-ER®, Stavzor®)

How long does it take for Intuniv®/Tenex® to work?

Although you may experience beneficial effects from guanfacine within a few days of starting the medication, it often takes several weeks to get the full effect of the medication. Your healthcare provider may also need to adjust gradually the dose to find the dose that works best for you.

Provided by the College of Psychiatric and Neurologic Pharmacists

(January 2013)

Intuniv®/Tenex®do not have any Black Box Warnings


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