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Guanfacine (Intuniv) for ADHD: How Does It Help?

Guanfacine medication for ADHD
Written by:

Rabia Khaliq

MSc in Applied Psychology

Dr. Bradley Noon



Medical Disclaimer
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs.Read more
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs.


  • Guanfacine is a non-stimulant medication used off-label for adults with ADHD.
  • It is prescribed alone or as an adjunctive treatment for ADHD when stimulant medications or other treatments are unsuitable or ineffective.
  • Intuniv affects the prefrontal cortex, which lowers blood pressure and controls impulsivity and attention span.
  • Guanfacine may cause side effects, such as lightheadedness, drowsiness, dizziness, fainting, or decreased alertness.
  • Guanfacine may interact with other medications, including over-the-counter, prescription, and vitamin supplements.

A combination of behavioral therapy and stimulant medications is frequently used to treat attention deficit hyperactivity disorder (ADHD). But occasionally, medical professionals recommend non-stimulant medicines such as Intuniv (guanfacine).

Intuniv can be used to treat ADHD along with stimulants; however, people who do not benefit from stimulants or cannot tolerate them can use guanfacine alone as a monotherapy. Read on to learn about the pros and cons of taking Intuniv, its side effects, and other features.

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What Is Intuniv (Guanfacine)?

Guanfacine medication is FDA-approved [1*] to treat attention deficit hyperactivity disorder in children and adolescents up to 17 years. However, it is frequently prescribed off-label for adults. It is not a controlled substance and has lower risks of abuse or dependence.

Intuniv is a type of medication that acts on alpha-2A adrenergic receptors [2*] . It enhances blood flow, decreases heart rate and blood pressure, and relaxes the body’s blood vessels. Additionally, guanfacine is utilized off-label to treat PTSD, anxiety disorders, and tic disorders. Doctors also prescribe it by its brand name, Tenex, to hypertensive patients to decrease blood pressure.

When Is Guanfacine Used for ADHD?

Guanfacine is a second-line treatment for ADHD. It is prescribed when stimulant medications (the first-line ADHD treatment) are not suitable or ineffective for the patient. Guanfacine extended-release tablets can be used alone or with other medications to increase efficacy.

How Does Intuniv Help With ADHD?

It was first approved for treating ADHD in adults in Japan in June 2019 [3*] . According to this double-blind, placebo-controlled trial, the extended-release tablets of guanfacine were associated with significant improvement in adult ADHD symptoms without any major safety concerns.

Unlike stimulants like Adderall, Intuniv has a different effect on the brain. It acts on the prefrontal cortex, a brain area that regulates attention span and impulsivity and decreases blood pressure. It also treats the other symptoms of ADHD, including social aggression, hyperarousal, emotional sensitivity, and rejection sensitivity. By decreasing adrenaline levels to normal, it helps manage the issues that stimulants do not adequately treat.

Adult ADHD can be managed through therapy and medicine. Consult with our medical experts online.

Intuniv Dosage

The dosage of this medication varies depending on the patient. Usually, it starts with 1 mg daily and slowly increases to 3 mg if needed. The recommended dose is usually not more than 4-5 mg. These are only the typical dosages, so do not alter your dose if it differs from the one recommended by your doctor.

A Missed Dose: What to Do

If you forget to take the medication, it’s advisable to take it as soon as possible. However, you may skip the dose if you are close to the time for your next dose and continue your routine dosage. Avoid doubling the dose to catch up. To be sure, it’s best to consult your doctor.

Storage and Disposal

Store Intuniv at room temperature, away from moisture and light. It is also essential to keep it out of the reach of children and pets. It is generally advised to properly dispose of unwanted or expired medications using a drug take-back program or bringing them to a pharmacy. Follow any other particular directions given by your pharmacist or healthcare practitioner regarding disposal.

Intuniv Side Effects

Intuniv may cause adverse reactions. The most typical ones are the following:

  • Drowsiness
  • Dizziness
  • Fatigue
  • Dry mouth
  • Constipation
  • Irritability
  • Nausea
  • Weight gain
  • Headache

Other serious side effects include the following:

  • Extreme dizziness
  • Slow heartbeat
  • Changes in mood (depression, suicidal thoughts, or hallucinations)
  • Fainting

Effects of Intuniv on Cardiovascular System

Although guanfacine is primarily used to treat high blood pressure and ADHD, it can cause changes in blood pressure and heart rate while starting or when adjusting the dosage. So, it’s important to notice any concerning symptoms or changes, such as chest pain, irregular heartbeat, or severe dizziness, to ensure the safe and effective use of Intuniv.

Speak with a medical expert if you experience any side effects to adjust your treatment accordingly.

Guanfacine Interactions

Inform your doctor about all your medications, including prescription drugs, over-the-counter medicines, vitamins, and supplements, because guanfacine may have possible drug interactions. Below are some of the medications that can interact with and reduce the benefits of Intuniv:

  • Antihypertensive Agents: Intuniv may raise the risk of hypotension (low blood pressure) when taken with other blood pressure-lowering medications.
  • Central Nervous System Depressants: Guanfacine’s sedative effects may be enhanced by other medications and substances that also have a sedative effect, such as alcohol, opioids, or benzodiazepines.
  • CYP3A4 inhibitors: Protease inhibitors, antibiotics, and antifungals can raise the body’s levels of guanfacine, which may have adverse effects [4*] .
  • Antihypertensive Agents: Intuniv may raise the risk of hypotension when taken with other blood pressure-lowering drugs.
  • Tricyclic Antidepressants (TCAs): Intuniv used in conjunction with TCAs may cause low blood pressure.

Other Risks and Warnings

Although guanfacine treatment is generally well tolerated, there are certain risks associated with using it. Important warnings about Intuniv include the following:

  • Blood pressure may drop, particularly when standing up after sitting or lying down. It can cause dizziness or fainting, especially at the beginning of the treatment of ADHD or when the dosage is increased.
  • Those who already have heart problems or are taking other medications that alter heart rate may find it problematic when Intuniv slows down their heart rate.
  • Intuniv may make you feel sleepy or drowsy, making it harder to perform mentally demanding activities like driving or operating heavy machinery.
  • In certain people, it may worsen depression [5*] or other mental health issues. Particularly for people with a history of mental illnesses, close observation is required.

Guanfacine Withdrawal Symptoms

Intuniv (guanfacine) withdrawal symptoms can include tremors, agitation, anxiety, and headaches. When stopping the medication abruptly, your blood pressure may also rise quickly. If you experience such effects or other severe withdrawal symptoms, get in touch with your doctor immediately.

Precautions for Use

Not everyone can take Intuniv, and only a healthcare professional can choose the most appropriate medication. Some precautions are the following:

  • If you have ever experienced an unusual or allergic reaction to this medication or any other medications, or if you have any other allergies, let your doctor know.
  • Tell your doctor if you are taking any additional medications to avoid dangerous interactions. Abametapir, Fedratinib, Netupitant, and Fosetupitant are medications that may interact with Intuniv.
  • Additional health issues could impact the use of this medication. Tell your doctor if you have any other medical problems.
  • Only use this medication as prescribed by your doctor. Never take it in larger amounts, more frequently, or for a longer period of time than recommended by your healthcare provider.
  • Inform your doctor if you are a breastfeeding mother or expecting a child.

Summing Up: Is Intuniv the Best Medication to Treat ADHD in Adults?

There are many ADHD medications, with stimulants usually being a first-line choice. For example, amphetamine/dextroamphetamine (Adderall), methylphenidate (Ritalin), lisdexamfetamine (Vyvanse), dexamfetamine (Dexedrine), and atomoxetine (Strattera). However, non-stimulants like Intuniv can also be prescribed when prior treatment is not as effective as expected.

Reach out to medical professionals at MEDvidi if you notice symptoms of ADHD and want to receive personalized treatment.

Frequently Asked Questions

Effects of Intuniv can vary from person to person. However, it is often reported to improve focus and reduce impulsivity.

It often takes a few weeks of continuous treatment for Intuniv to show noticeable improvements in ADHD symptoms.
Although Intuniv does not provide immediate improvement in focus like Adderall or other stimulants, it can gradually reduce impulsivity and hyperactivity while enhancing attentiveness.
The efficacy of guanfacine in treating ADHD varies from patient to patient. For increased effectiveness, it may be used in conjunction with behavioral therapy or other medications.

Intuniv helps people with ADHD by enhancing attention, lowering impulsivity, and improving behavior regulation.

Guanfacine (Intuniv) and Adderall are not the same; their modes of action and approaches to treating symptoms of ADHD differ. Moreover, Adderall is a stimulant medication while guanfacine is a non-stimulant medication.


5 sources
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  2. Mechanism of action of guanfacine: a postsynaptic differential approach to the treatment of attention deficit hyperactivity disorder (adhd)
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  3. Safety and efficacy of guanfacine extended-release in adults with attention-deficit disorder: an open-label, long-term, phase 3 extension study
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  4. Guanfacine Extended-Release Tablets (Intuniv), a Nonstimulant Selective Alpha2A-Adrenergic Receptor Agonist For Attention-Deficit and Hyperactivity Disorder
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  5. An Open-Label Study of Guanfacine Extended Release for Traumatic Stress Related Symptoms in Children and Adolescents
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Written by:

Rabia Khaliq

MSc in Applied Psychology

Dr. Bradley Noon



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This article is based on scientific evidence, written by experts and fact checked by experts.

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This article contains scientific references. The numbers
in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.