*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Intuniv is the extended-release version of guanfacine, which is a non-stimulant medication indicated for the treatment of ADHD. It can be used alone or in combination with other ADHD medications like Adderall. Side effects seen with this medication involve sleepiness and lower blood pressure symptoms. These are common side effects and are often tolerable for patients.
If you’re considering Intuniv, online psychiatry platforms such as Talkiatry and Brightside Health can connect you with a provider quickly. They offer assessments and can provide a prescription if they determine Intuniv or another medication may help your symptoms.
Get Personalized, Affordable ADHD Treatment
The providers on Klarity offer comprehensive, personalized ADHD treatment. From diagnosis to therapy to medication management, a Klarity provider will be there for you. And, if needed, they’re able to prescribe controlled substances, like Adderall and Concerta.
What Is Intuniv?
Intuniv, also referred to by its generic name Guanfacine, is a non-stimulant medication used to treat attention deficit hyperactivity disorder (ADHD). It belongs to a class of medications called alpha 2A-adrenergic receptor agonists, and it can be used alone or added to other ADHD medications. As it works on the body, it can lower blood pressure and regulate one’s attention and behavior.1, 2, 3
How Does Intuniv Work?
It’s not entirely known how Intuniv works, but we do know that Intuniv can help improve ADHD symptoms. It is thought to work on the prefrontal cortex, helping with disorders that can impair your functioning, like ADHD and stress-related disorders. In animal studies, they saw that Intuniv worked on this part of the brain, helping it to produce more of a response. (1: mechanism of action)4
Is Intuniv Similar to Adderall?
Intuniv and Adderall are common medications used to control the symptoms of ADHD. Both medications have extended-release formulations, releasing over a long period of time, as well as an immediate-release version. The main difference is that Intuniv is a non-stimulant while Adderall is a stimulant, and the different formulations for Intuniv have different indications, unlike Adderall, which both can be used for ADHD. Since they work differently, they can potentially be used at the same time.1, 5
What Is Intuniv Used to Treat?
Intuniv is a medication FDA-approved for the treatment of attention-deficit hyperactivity disorder (ADHD). FDA-approved means that a medication has gone through extensive research, and the FDA has recognized that it is safe and effective for its given indication. Intuniv has off-label uses as well and has been used, for example, in nightmares associated with PTSD, tic disorders, and anxiety disorders.6, 7, 8 An off-label use is a use that is not FDA-approved, where a prescriber can decide to use a medication if they believe it may offer a benefit to someone.
Guanfacine is approved for other non-mental health conditions. The immediate release version of Guanfacine goes by the brand name Tenex which is used for high blood pressure. The focus of this article is on its use as an ADHD medication.
Side Effects of Intuniv
All medications have the potential for side effects. It is not guaranteed that a person will experience side effects associated with Intuniv. Side effects a person might experience while taking Intuniv would be symptoms involving low blood pressure, such as dizziness and fatigue. Most side effects go away with consistent usage of the medication as the body adjusts to it, but sometimes side effects may be prolonged or get worse, which may require medical care.
Common Side Effects of Intuniv
Common side effects with Intuniv are associated with symptoms of low blood pressure and being sleepy. These side effects were found to have occurred at twice the rate than that of placebo. These side effects are typically seen within the first week of taking the medication but should get better with consistent medication usage. If these symptoms impact your ability to go about your daily life or get worse, then contact your doctor.
Common side effects of Intuniv include:*1, 2
- Drowsiness
- Fatigue
- Sedation
- Low blood pressure issues
- Dizziness
- Nausea
- Dry Mouth
- Abdominal pain
- Decreased appetite
*All medications, including Intuniv, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Mild Side Effects of Intuniv
Mild side effects of Intuniv are typically side effects that are commonly seen in patients. Intuniv can cause a person to become tired, change their mood, and cause changes in bodily function. These side effects are typically dependent on the dose, being more likely to happen the higher the dose. Some of these side effects can become serious depending on the severity of the reaction.
Mild side effects of Intuniv include:*1, 2
- Fatigue
- Drowsiness
- Irritability
- Decreased appetite
- Inability to control urination
- Headache
*All medications, including Intuniv, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Serious Side Effects of Intuniv1, 2
Serious side effects that a person can experience with Intuniv involve its effect on blood pressure as well as its side effect of sedation. These side effects could be potentially serious when they affect a person’s daily life. Intuniv could potentially worsen heart conditions, cause excessive sedation, or excessively lower blood pressure. A person who experiences these side effects needs to seek immediate care.
Serious side effects of Intuniv may include:*(1, 2: adverse reactions)
- Fainting
- Blurred vision
- Rash or hives
- Slow heart rate
- Excessive sedation
*All medications, including Intuniv, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Allergic Reactions to Intuniv
As with all medications, some may be allergic to Intuniv. If a person has an allergy to Intuniv or the ingredients within Intuniv, they should avoid using the medication. Allergic reactions can be a serious medical event. If you or a person you know experience an allergic reaction, seek appropriate medical care.
Allergic reactions to Intuniv may include:9
- Difficulty breathing
- Wheezing and coughing
- Fast heart rate
- Itching
- Abnormally low blood pressure
- Hives
- Swelling of lips, face, or throat
If you experience any of these symptoms, seek immediate medical care. This can be a life-threatening event which may require medical intervention. A reaction to Intuniv means that you will have to switch to a new medication to manage your ADHD. There are other options both in the stimulant and non-stimulant class of medications, like Adderall and Strattera, respectively. Discuss with your doctor what options are right for you.
Get Personalized, Affordable ADHD Treatment
The providers on Klarity offer comprehensive, personalized ADHD treatment. From diagnosis to therapy to medication management, a Klarity provider will be there for you. And, if needed, they’re able to prescribe controlled substances, like Adderall and Concerta.
Intuniv Warnings & Precautions
Intuniv has warnings and precautions associated with the medication. These are warnings that a patient should discuss with their doctor, especially if they have prior conditions that may be affected by Intuniv. Medical attention may be necessary to address these side effects should a person experience them. It should be noted that these are warnings, and it is not guaranteed that a person will experience these problems should they take Intuniv.
Precautions for taking Intuniv address:1, 2
- Taking Intuniv during pregnancy or breastfeeding: Available data with Intuniv has not identified a drug-associated risk of major birth defects, miscarriage or adverse outcomes to the mother or child. However, there may be potential for reduced fetal survival and toxicity in the mother at higher doses.
- Low blood pressure, slow heart rate, and fainting: Intuniv can lower a person’s blood pressure and slow a person’s heart rate, which may cause fainting. This is a dose-dependent side effect, and decreases in blood pressure and heart rate was less pronounced over the time of treatment.
- Sedation and excessive sleepiness: These are commonly reported adverse reactions in clinical studies, especially when other substances with depressive effects are taken.
- Cardiac conduction abnormalities: Intuniv can worsen the electrical pattern of preexisting heart conditions, like atrioventricular (AV) block, especially in patients taking other sympatholytic drugs.
- Rebound hypertension: When Intuniv when abruptly stopped, a persistent rebound of high blood pressure can occur where blood pressure can rise above baseline levels and increase heart rate.
Does Intuniv Have a Black Box Warning?
Intuniv does not have any Black Box Warnings. A Black Box Warning is a warning issued by the FDA and is the strictest and most serious type of warning that can be issued for a medication. This warning is meant to draw attention to a medication’s serious or life-threatening side effects. A boxed warning on a medication does not mean it can’t be a good or effective treatment.
Interactions With Intuniv
All medications have possible harmful interactions that can occur when taken with other medications, substances, and herbs. Intuniv has a couple of interactions that should be noted. If you are starting Intuniv, discuss with your doctor and pharmacist about the substances you take to make sure no serious reactions will occur. Medical professionals are trained to assess the risks and benefits of therapies, so you should be honest with your doctor about what substances you take.
6 substances you should avoid while taking Intuniv include: (1, 2: drug interactions)
- Alcohol: This substance may increase the side effect of drowsiness in people who take Intuniv.
- Benadryl (diphenhydramine): Benadryl is an antihistamine that is sometimes used as a sleeping aid. Its main side effect is drowsiness and combined with Intuniv, could cause excessive sedation.
- Sedatives: Sedatives could worsen the side effects of sleepiness and drowsiness in Intuniv patients.
- Benzodiazepines: A main side effect of benzodiazepines, like Xanax or Valium, is sedation. Combining this medication with Intuniv may worsen the side effect.
- Fluconazole: This medication interacts with Intuniv, causing a patient to have more than intended exposure to Intuniv.
- HIV medications: Combined with Intuniv, HIV medications can cause a decreased exposure to Intuniv in patients.
Intuniv Dosages for FDA-Approved Treatment
There are several dosages available for Intuniv. This medication is provided only as an extended-release tablet. This medication is typically increased in dosage no more than 1 mg per week to avoid side effects. The target dose range is dependent on your weight for Intuniv.
Intuniv is taken once daily by mouth, either in the morning or evening, starting at 1 mg per day, and can increase up to 7 mg per day depending on the weight and response of the patient. Dosages above 4 mg per day have not been evaluated in children aged 6 through 12 years, and above 7 mg per day in adolescents aged 13 to 17 years.1, 2
Intuniv Forms & Strengths
The most appropriate strength of Intuniv for an individual is determined by their individual factors. A prescriber will consider your symptoms, your existing conditions, and what other medications you are on for what strength of Intuniv you need. Due to the factors differing from person to person, dosages may vary. There is an immediate-release version of guanfacine, but that is a different brand called Tenex, and it is FDA-approved for high blood pressure.
Intuniv is available in the following forms and strengths:
- 1 milligrams (mg) extended-release oral tablet
- 2 milligrams (mg) extended-release oral tablet
- 3 milligrams (mg) extended-release oral tablet
- 4 milligrams (mg) extended-release oral tablet
How Should I Take Intuniv?
To take Intuniv, you should swallow the tablets whole by mouth. Do not crush, chew, or break tablets because this is an extended-release formulation of guanfacine, and doing so will increase the rate of release of the medication. This medication should not be administered with high-fat meals because it can increase the exposure you have to medication. It is important to take Intuniv as directed by your doctor. (1, 2– Dosage and administration)
What Happens If I Miss a Dose of Intuniv?
If you missed a dose of Intuniv, then take your dose as soon as you remember it. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. You should not double dose to make up for your missed one. It is important not to miss your doses, as abruptly stopping Intuniv may cause complications like rebound hypertension. If you missed two or more doses, then contact your doctor or pharmacist for advice.
Can You Overdose on Intuniv?
Yes, it is possible to overdose on Intuniv. Signs and symptoms of an overdose on Intuniv are low blood pressure, drowsiness, lethargy, and slow heart rate. Initially, high blood pressure may develop early and then it may be followed by low blood pressure. Small, pinprick pupils may also show in someone who is overdosing on Intuniv. No fatal overdoses of Intuniv have been reported in published literature, but that does not eliminate the potential of one, so overdose victims should seek medical care.1, 2– Overdosage
What Should You Do If You Take Too Much Intuniv?
If you have taken too much Intuniv, seek immediate medical advice. If you are not displaying symptoms, contact the Poison Control Center (1-800-222-1222) for advice and follow medical instructions as given. If you display any symptoms, overdose or otherwise, then seek immediate medical attention or call 911 to receive treatment to prevent any serious complications from occurring.
Questions to Ask Your Healthcare Provider About Intuniv (Guanfacine)
If you are considering taking Intuniv for ADHD, you should meet your doctor with a list of questions to ask. Questions you should ask your doctor or psychiatrist are the expectations with Intuniv, what side effects to expect, and how this medication works in your overall therapy. If it is burdensome to meet with a doctor in person, online psychiatry services may be a good option if you need to change prescribers.
Questions to ask your care team about Intuniv include:
- How long will it take for me to adjust to taking Intuniv?
- Am I at risk for more serious symptoms if I am already taking medication treatments for other mental health disorders?
- What is the best dosage to ensure fewer side effects?
- When should I reach out to you if I am experiencing sexual side effects?
- Is there anything I should tell my therapist about this new medication?
- What are the signs of a serious side effect?
- Can I take this medication with my other ADHD medications?
- How long until I see this medication take effect?
In My Experience
In my experience, Intuniv is a medication that is often used in the treatment of ADHD. I typically saw the usage in children and adolescents, but it can be used in the treatment of adults as well. It is a well-tolerated medication that can help with the symptoms of ADHD, like hyperactivity. Side effects generally occur within two to three weeks of starting Intuniv and tend to decrease over time, with most patients reporting not having these effects by the end of eight to nine weeks of treatment.
It is also a relatively affordable medication that is often covered by insurance and can be a good option for those who do not wish to use a stimulant or need a cheaper medication alternative. Of course, you should discuss with your doctor to see if this medication is right for you and your individual needs.
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
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