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Guanfacine Brand Names- Intuniv | Tenex
What is Guanfacine
Guanfacine is an oral, centrally-acting alpha-2 adrenergic receptor agonist. It used alone or in combination with other drugs for the treatment of hypertension.
For the treatment of hypertension, it works by producing a decrease in sympathetic outflow, resulting in a reduction in peripheral vascular resistance, renal vascular resistance, heart rate, and blood pressure.
Guanfacine is similar to clonidine but is more selective for alpha-2 adrenergic receptors and longer-acting, which allows for once-daily dosing and may delay the risk of rebound hypertension with abrupt discontinuation.
Extended-release guanfacine is used in the treatment of attention deficit hyperactivity disorder (ADHD); the drug targets ADHD symptoms through central alpha-2 adrenergic receptor activity in the prefrontal cortex.
Guanfacine may be advantageous for treating ADHD in children with comorbid tics, since the use of stimulants in such patients may exacerbate the tic condition.
Guanfacine is used ‘off-label’ for Tourette’s syndrome and chronic tic disorder. The American Academy of Neurology practice guideline states that guanfacine is probably more likely than placebo to reduce tic severity in patients with Tourette’s syndrome or chronic tic disorders, and for those with comorbid ADHD, the drug may provide benefits for both conditions
Indications
- attention-deficit hyperactivity disorder (ADHD)
- hypertension
- Tourette’s syndrome
Side Effects
- abdominal pain
- agitation
- alopecia
- amnesia
- anxiety
- arrhythmia exacerbation
- arthralgia
- asthenia
- AV block
- blurred vision
- bradycardia
- bronchospasm
- chest pain (unspecified)
- confusion
- conjunctivitis
- constipation
- depression
- diarrhea
- dizziness
- drowsiness
- dysgeusia
- dyspepsia
- dysphagia
- dyspnea
- edema
- elevated hepatic enzymes
- emotional lability
- encephalopathy
- exfoliative dermatitis
- fatigue
- hallucinations
- headache
- heart failure
- hyperhidrosis
- hypertension
- hypotension
- impotence (erectile dysfunction)
- increased urinary frequency
- insomnia
- iritis
- irritability
- lethargy
- libido decrease
- malaise
- muscle cramps
- myalgia
- myocardial infarction
- nausea
- nightmares
- nocturia
- orthostatic hypotension
- pallor
- palpitations
- paresis
- paresthesias
- pruritus
- purpura
- rash
- renal failure (unspecified)
- rhinitis
- seizures
- sinus tachycardia
- stroke
- syncope
- tinnitus
- tremor
- urinary incontinence
- vertigo
- vomiting
- weakness
- weight gain
- wheezing
- withdrawal
- xerostomia
Monitoring Parameters
- blood pressure
- heart rate
- laboratory monitoring not necessary
Contraindications
- abrupt discontinuation
- acute myocardial infarction
- AV block
- bradycardia
- breast-feeding
- cardiac disease
- cerebrovascular disease
- children
- coronary artery disease
- dehydration
- driving or operating machinery
- ethanol ingestion
- geriatric
- hepatic disease
- hypotension
- infants
- orthostatic hypotension
- pregnancy
- renal disease
- renal failure
- renal impairment
- syncope
Interactions
- Acebutolol
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetazolamide
- Aldesleukin, IL-2
- Alemtuzumab
- Alprazolam
- Alprostadil
- Amifostine
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine; Celecoxib
- Amobarbital
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamines
- Amyl Nitrite
- Apalutamide
- Apomorphine
- Apraclonidine
- Aprepitant, Fosaprepitant
- Aripiprazole
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atazanavir
- Atazanavir; Cobicistat
- Atenolol
- Atenolol; Chlorthalidone
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Baclofen
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bendroflumethiazide; Nadolol
- Benzodiazepines
- Beta-blockers
- Betaxolol
- Bexarotene
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Boceprevir
- Bortezomib
- Bosentan
- Brexpiprazole
- Brimonidine; Timolol
- Bupropion
- Bupropion; Naltrexone
- Butabarbital
- Cabergoline
- Cannabidiol
- Carbamazepine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbonic anhydrase inhibitors
- Cariprazine
- Carteolol
- Carvedilol
- Celecoxib
- Cenobamate
- Ceritinib
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chloramphenicol
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chloroprocaine
- Chlorpromazine
- Ciprofloxacin
- Clarithromycin
- Clomipramine
- Clonazepam
- Clorazepate
- Clozapine
- Co-Enzyme Q10, Ubiquinone
- Cobicistat
- Cocaine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Conivaptan
- Crizotinib
- Cyclosporine
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deferasirox
- Delavirdine
- Desipramine
- Dexamethasone
- Dexmethylphenidate
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazepam
- Diazoxide
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Diltiazem
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dorzolamide; Timolol
- Doxepin
- Dronedarone
- Duloxetine
- Duvelisib
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Enflurane
- Enzalutamide
- Epoprostenol
- Erythromycin
- Erythromycin; Sulfisoxazole
- Esketamine
- Eslicarbazepine
- Esmolol
- Esomeprazole; Naproxen
- Estazolam
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Ethanol
- Etodolac
- Etomidate
- Etravirine
- Famotidine; Ibuprofen
- Fedratinib
- Fenfluramine
- Fenoprofen
- Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
- Fluconazole
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurazepam
- Flurbiprofen
- Fluvoxamine
- Fosamprenavir
- Fosphenytoin
- Fospropofol
- Gabapentin
- General anesthetics
- grapefruit juice
- Haloperidol
- Halothane
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrocodone; Ibuprofen
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Idelalisib
- Iloperidone
- Iloprost
- Imatinib
- Imipramine
- Indinavir
- Indomethacin
- Intravenous Lipid Emulsions
- Isavuconazonium
- Isoflurane
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isosorbide Dinitrate, ISDN
- Isosorbide Mononitrate
- Itraconazole
- Ketamine
- Ketoconazole
- Ketoprofen
- Ketorolac
- Labetalol
- Lansoprazole; Naproxen
- Lasmiditan
- Lemborexant
- Letermovir
- Levobetaxolol
- Levobunolol
- Levocetirizine
- Levodopa
- Lofexidine
- Lopinavir; Ritonavir
- Lorazepam
- Lorlatinib
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lumateperone
- Lurasidone
- Maprotiline
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Meperidine; Promethazine
- Mephobarbital
- Mesoridazine
- Mestranol; Norethindrone
- Methazolamide
- Methylphenidate
- Metoprolol
- Midazolam
- Milrinone
- Mitotane
- Monoamine oxidase inhibitors
- Nabilone
- Nabumetone
- Nadolol
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nebivolol
- Nebivolol; Valsartan
- Nefazodone
- Nelfinavir
- Nesiritide, BNP
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nilotinib
- Nitrates
- Nitroglycerin
- Nitroprusside
- Nonsteroidal antiinflammatory drugs
- Nortriptyline
- Olanzapine
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Opiate Agonists
- Oxaprozin
- Oxazepam
- Oxymetazoline
- Paliperidone
- Penbutolol
- Pentobarbital
- Pentoxifylline
- Perphenazine
- Perphenazine; Amitriptyline
- Phenobarbital
- Phenothiazines
- Phenylephrine; Promethazine
- Phenytoin
- Pindolol
- Piroxicam
- Posaconazole
- Prazosin
- Pregabalin
- Primidone
- Procainamide
- Procaine
- Prochlorperazine
- Promethazine
- Propofol
- Propranolol
- Protriptyline
- Quazepam
- Quinidine
- Quinine
- Rasagiline
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Risperidone
- Ritonavir
- Rofecoxib
- Saquinavir
- Secobarbital
- Sevoflurane
- Silodosin
- Sotalol
- St. John’s Wort, Hypericum perforatum
- Sulindac
- Telaprevir
- Telithromycin
- Temazepam
- Tetrabenazine
- Tetracaine
- Thiethylperazine
- Thioridazine
- Thiothixene
- Timolol
- Tipranavir
- Tizanidine
- Tolmetin
- Trandolapril; Verapamil
- Trazodone
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Trimipramine
- Tucatinib
- Valdecoxib
- Verapamil
- Voriconazole
- Yohimbine
- Ziprasidone
