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guanfacine (Tenex, Estulic, Intuniv)
Tradename: Tenex.
Indications:
- hypertension (old antihypertensive)
- treatment of ADHD (Intuniv), alternative or adjunct treatment* ;
* may be no better than placebo [4]
Contraindications:
- of no benefit for children with tic disorder [5]
Dosage: start 1 mg PO QHS, max 4 mg/day.
Tabs: (Ituniv) 1,2,3, & 4 mg extended release
Adverse effects:
1) increased drowsiness & fatigue
2) withdrawal symptoms may occur with abrupt discontinuation
a) anxiety, nervousness
b) rebound hypertension (less common than with clonidine)
c) no specific taper recommendations [2,3]
Mechanism of action:
1) centrally acting antihypertensive agent
2) a centrally acting agent like clonidine
3) alpha-2-adrenergic receptor agonist
Notes:
- Intuniv costs $165 per month compared to < $50 per month for generic short-acting guanfacine
Interactions
drug interactions
drug adverse effects (more general classes)
General
alpha-2 adrenergic receptor agonist
centrally-active alpha-adrenergic receptor agonist
Properties
AGONIST-FOR: alpha-2 adrenergic receptor
MISC-INFO: elimination route KIDNEY
pregnancy-category B
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996 pg 781
- Prescriber's Letter 15(12): 2008
Common Oral Medications that May Need Tapering
Detail-Document#: 241208
(subscription needed) http://www.prescribersletter.com
- AFHS Drug Information
Guanfacine (Systemic)
http://www.ashp.org/mngrphs/essentials/a308013e.htm
- Newcorn JH et al.
Extended-release guanfacine hydrochloride in 6-17-year olds
with ADHD: A randomised-withdrawal maintenance of efficacy
study.
J Child Psychol Psychiatry 2016 Feb 12
PMID: 26871297
- Murphy TK et al.
Extended-release guanfacine does not show a large effect on
tic severity in children with chronic tic disorders.
J Child Adolesc Psychopharmacol 2017 Jul 19
PMID: 28723227
Component-of
c kit protein/guanfacine