Guanfacine vs Intuniv - Comparison of Uses & Side Effects

Guanfacine

It is a sympatholytic medication used to treat attention deficit hyperactivity disorder (ADHD) and hypertension.

The medication belongs to a class of medications called centrally acting alpha2A-adrenergic receptor agonists. It can be found under the following brand names – Estulic, Tenex, and Intuniv.

It works by affecting the activity of the brain chemical called norepinephrine. This neurotransmitter normally influences heart rate, blood pressure, and anxiety in the human body, however, norepinephrine also affects arousal and attention.

Note – unlike other medicines used to treat ADHD, this alpha2A-adrenergic receptor agonist is not a stimulant.

Uses

This prescription medication is used to treat high blood pressure. Also, it is used to treat deficit hyperactivity disorder, as part of a total treatment or a monotherapy plan including social, educational, and psychological measures.

Attention deficit hyperactivity disorder is listed as a neurodevelopmental disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), the set of guidelines established by psychiatrists for diagnosing mental illness.

ADHD Symptoms

An estimated 1 in 20 children is diagnosed with ADHD at some point during their school life.

Young children usually tend to experience hyperactivity-impulsivity. As they start elementary school, their symptoms may shift to inattention. As adolescents, they typically become less hyperactive, however, they may struggle with feelings of inattention, restlessness, and impulsivity.

Dosage

The recommended dose for treating attention deficit hyperactivity disorder symptoms is 1 to 4 mg per day.

Side Effects And Precautions

Common side effects may include:

  • dry mouth;
  • constipation;
  • headaches;
  • drowsiness;
  • nausea;
  • tiredness;
  • weight gain;
  • dizziness;
  • irritability;
  • stomach pain.

Less common side effects may include:

  • problems breathing;
  • increased need to urinate;
  • noisy breathing;
  • chest discomfort;
  • chest pain;
  • irregular heartbeat;
  • passing urine more than usual;
  • lightheadedness;
  • a cough;
  • fainting;
  • pounding heartbeat;
  • mental depression;
  • tightness in the chest.

Pregnancy & Breastfeeding

There are no well-done studies in women for determining infant risk when using this alpha2A-adrenergic receptor agonist during pregnancy. If you are pregnant or plant to fall pregnant, weigh the potential benefits against the potential risks before taking it.

Also, it is not known exactly whether this medication passes into breast milk and harms the infant. Contact your doctor if you plan to breastfeed while using this alpha2A-adrenergic receptor agonist.

Contraindications

Before taking this alpha2A-adrenergic receptor agonist, tell your doctor if you have:

  • heart block;
  • liver disease;
  • heart disease;
  • coronary artery disease;
  • kidney disease;
  • stroke;
  • low blood pressure.

Alcohol

Avoid consuming alcoholic beverages during treatment with this medication since alcohol may increase blood sugar levels and effects of the drug. Also, this medication may substantially reduce your tolerance to alcohol.

Drug Interactions

It may negatively interact with other medications, especially:

  • Benadryl (diphenhydramine);
  • Abilify (aripiprazole);
  • Concerta (methylphenidate);
  • Adderall (amphetamine/dextroamphetamine);
  • Focalin XR (dexmethylphenidate);
  • Adderall XR (amphetamine/dextroamphetamine);
  • Lamictal (lamotrigine);
  • aspirin;
  • invocana;
  • Lyrica (pregabalin);
  • clonidine;
  • methylphenidate;
  • codeine;
  • Motrin (ibuprofen);
  • fish oil (omega-3 polyunsaturated fatty acids);
  • Prozac (fluoxetine);
  • Focalin (dexmethylphenidate);
  • MiraLax (polyethylene glycol 3350);
  • melatonin;
  • Lexapro (escitalopram).

Intuniv

It is the brand name of a medication called guanfacine that belongs to a group of drugs called centrally acting alpha 2A -adrenergic receptor agonists.

Mechanism of Action

The medication works by affecting receptors in the brain in a way which helps the patient deal with symptoms of attention deficit hyperactivity disorder, like – hyperarousal, emotional sensitivity, and social aggression.

Also, it works somewhat less than the stimulants, such as – Adderall and Ritalin, and somewhat more than the traditional non-stimulants, such as – Strattera. It may be helpful to the estimated 25 to 30 percent of children with attention deficit hyperactivity disorder who do not benefit from stimulant medications.

More importantly, unlike other attention deficit hyperactivity disorder medications, this alpha 2A -adrenergic receptor agonist is said to be safer since it is not a central nervous system stimulant medication.

Uses

It is used to treat attention deficit hyperactivity disorder in children who are at least 6 years old. The medication should be used as part of a comprehensive treatment program that typically includes educational, psychological, and social therapy.

Additionally, it is used to treat high blood pressure. It is occasionally given together with other blood pressure drugs.

Dosage

It is given usually anywhere from 1-4mg a day. A dose lasts for 12 hours, however, it may have some effect for up to 24 hours.

Notes – this medication is found in the form of a pill, however, unlike some other attention deficit hyperactivity disorder medications, it cannot be chewed, crushed, or broken and must be swallowed whole.

Its effectiveness and safety in children younger than 6 years have not been established. Therefore, do not give this medicine to a child under the age of 6 years.

Side Effects and Precautions

Common side effects may include:

  • dry mouth;
  • mild drowsiness;
  • slow heart rate;
  • mild dizziness ;
  • vomiting;
  • irritability.

Rare side effects may include:

  • weakness;
  • dry mouth;
  • stomach pain;
  • constipation;
  • nausea;
  • low blood pressure;
  • hallucinations;
  • difficulty sleeping;
  • a light-headed feeling like you might pass out;
  • tiredness;
  • fast heartbeats;
  • sedation;
  • chest pain.

Drug Interactions

It may affect the way other medicines work, and other medicines may affect how this alpha 2A – adrenergic receptor agonist. Tell your healthcare provider if you take:

  • antipsychotics;
  • ketoconazole;
  • barbiturates;
  • benzodiazepines;
  • sedatives;
  • high blood pressure medicines;
  • valproic acid;
  • medicines which can affect enzyme metabolism.

Pregnancy & Breastfeeding

It is not known exactly whether this medication passes into breast milk or if it could negatively affect a nursing baby. Tell your healthcare provider if you are breast-feeding a baby.

It belongs to FDA pregnancy category B. This means that this medication is not expected to be harmful to an unborn baby. Tell your healthcare provider if you are pregnant or plan to fall pregnant during treatment with this alpha 2A -adrenergic receptor agonist.

Contraindications

To make sure you can safely take this medication, tell your healthcare provider if you have any of these other conditions:

  • kidney disease;
  • heart block;
  • liver disease;
  • heart disease ;
  • if you have recently had a heart attack;
  • low blood pressure;
  • a history of stroke;
  • coronary artery disease.

Alcohol

Avoid consuming alcohol while taking this medication since alcohol can increase the risk of side effects, especially drowsiness.

Bottom Line – Guanfacine vs Intuniv

Guanfacine is an α 2-adrenergic agonist which is used (alone or in combination with other drugs) to treat hypertension. It can also be prescribed, alone or with other medications, for people suffering from ADHD.

Intuniv (active ingredient guanfacine) is a non-stimulant treatment for ADHD. It is actually a long-acting form of guanfacine.

References

http://www.ema.europa.eu/docs/en_GB/document_library/Presentation/2016/02/WC50
http://www.ajmc.com/newsroom/positive-results-from-phase-3-study-of-intuniv
https://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/Development

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