guanfacine (Tenex, Estulic, Intuniv)
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Introduction
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
- increased drowsiness & fatigue
- withdrawal symptoms may occur with abrupt discontinuation
- anxiety, nervousness
- rebound hypertension (less common than with clonidine)
- no specific taper recommendations[2][3]
- drug adverse effects of adrenergic receptor agonists
- drug adverse effects of alpha-adrenergic receptor agonists
- drug adverse effects of sympathomimetic(s)
- drug adverse effects of antihypertensive agents
Mechanism of action
- centrally acting antihypertensive agent
- a centrally acting agent like clonidine
- alpha-2-adrenergic receptor agonist
Notes
- Intuniv costs $165 per month compared to < $50 per month for generic short-acting guanfacine
More general terms
Component of
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996 pg 781
- ↑ 2.0 2.1 Prescriber's Letter 15(12): 2008 Common Oral Medications that May Need Tapering Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=241208&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 3.0 3.1 AFHS Drug Information Guanfacine (Systemic) http://www.ashp.org/mngrphs/essentials/a308013e.htm
- ↑ 4.0 4.1 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: https://www.ncbi.nlm.nih.gov/pubmed/26871297
- ↑ 5.0 5.1 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: https://www.ncbi.nlm.nih.gov/pubmed/28723227