ADHD Medication and Treatment Reviews

Intuniv

Intuniv (generic name: guanfacine) is a once-daily, non-stimulant ADHD medication used to treat symptoms of attention deficit hyperactivity disorder in children ages 6-12, and adolescents. Learn about Intuniv side effects and dosages, plus how it differs from stimulant ADD medications like Vyvanse or Adderall.

By Janice Rodden Medically reviewed by William Dodson, M.D., LF-APA Reviewed on August 28, 2019
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What Is Intuniv (Guanfacine)? What Does Intuniv Do for ADHD?

Intuniv (generic name: guanfacine) is a once-daily, non-stimulant ADHD medication approved for treating attention deficit hyperactivity disorder (ADHD or ADD) in children ages 6-12, and adolescents. Though only studied and approved in children and adolescents, Intuniv is commonly prescribed off-label for use by all ages.

Intuniv is most commonly used to supplement a finely tuned stimulant medication. It can also be used by itself as a monotherapy by people who do not experience benefits from stimulant medications, do not tolerate stimulant medications, or choose not to use stimulant class medications.

Intuniv is a central alpha2A-adrenergic receptor agonist that is thought to address major areas of impairment and ADHD symptoms such as emotional sensitivity, hyperarousal, rejection sensitivity, and social aggression that are not addressed by stimulant medications. The alpha agonists treat the impairments that stimulants do not treat well by lowering the adrenaline side of the nervous system so that its level is the same as a person who does not have ADHD.

Intuniv has not been studied in children younger than 6. Intuniv does not have a high risk of abuse or dependence. It is not a controlled substance.

Before starting or refilling an Intuniv prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Intuniv vs. Adderall?

Intuniv is the brand name for guanfacine, Adderall is the brand name for dextroamphetamine/levoamphetamine salts. Both medications are used to treat ADHD, but Intuniv is a non stimulant whereas Adderall is a stimulant.

They also belong to different drug classes: Intuniv is an alpha-2 adrenergic agonist. Adderall is an amphetamine. Aside from ADHD, Intuniv is also prescribed to treat high blood pressure. Adderall is also prescribed to treat narcolepsy. The potential side effects shared by both Intuniv and Adderall include dizziness, nausea, headache, and dry mouth.

What Dosage of Intuniv Is Used to Treat ADHD?

The optimal dosage of Intuniv varies by patient. For updated information about dosages, interactions, and precautions, see the Intuniv drug monograph on WebMD.

Intuniv should not be taken with a high-fat meal. This can speed up the release of medication, and increase the risk of side effects. Tablets should be swallowed whole, and never crushed or chewed. As with all medications, follow your Intuniv prescription instructions exactly.

The optimal dosage varies patient by patient. Your doctor may adjust your dosage weekly by 1 mg to the dose at which you experience the greatest improvement in symptoms without side effects. Fine-tuning the dose of an alpha agonist will take several weeks. Unlike the stimulant medications that are quickly effective in just an hour or so, the benefits of alpha agonists such as Intuniv may not be apparent for up to five days; this is true each time the dose is increased. During the process of fine-tuning, the dose may not be increased more than once every six days, assuming Intuniv is taken every day. If a person misses several doses, the benefits are lost and the person has to start over again and wait 5 days for the benefits to develop once more.

Do not drink alcohol while taking this drug.

What Are the Side Effects of Intuniv?

Most people taking Intuniv do not experience side effects. That said, the most common side effects of

Intuniv are as follows:

  • sleepiness
  • dry mouth
  • tiredness
  • difficulty sleeping
  • nausea
  • stomach pain
  • dizziness
  • irritability
  • vomiting
  • slow heart rate
  • low blood pressure

Serious Side Effects:

  • low blood pressure
  • low heart rate
  • fainting
  • sleepiness
  • increased blood pressure and heart rate or other withdrawal symptoms after suddenly stopping Intuniv

In practice, three major side effects are reported by clinicians with any frequency:

Intuniv and Sleep

Alpha agonists can cause difficulty sleeping and severe irritability in a very small number of patients. Consult with your doctor if these side effects occur.

Intuniv and Driving

Taking Intuniv may impair your or your teenager’s ability to drive, operate machinery, or perform other potentially dangerous tasks. If side effects are bothersome, or do not go away, talk to your doctor. Most people taking this medication do not experience any of these side effects.

Intuniv and Heart- or Blood-Pressure Related Problems

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities, renal failure, and serious heart problems could experience complications while taking Intuniv. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experience warning signs such as chest pain, shortness of breath, or fainting while taking Intuniv.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

What Precautions Are Associated with Intuniv?

You should not take Intuniv if you have an allergy to Intuniv or any of its ingredients. You should use caution taking Intuniv if you have kidney problems, a history of fainting, heart problems, or a history of stroke.

Avoid becoming overheated or dehydrated while taking Intuniv.

If you’re thinking of having a child, discuss the use of Intuniv with your doctor. Animal studies indicate a potential risk of fetal harm. It is not known if Intuniv is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

Store Intuniv in a secure place out of the reach of children, and at room temperature. Do not share your Intuniv prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

What Interactions Are Associated with Intuniv?

Before taking Intuniv, discuss all other active prescription medications with your doctor. Intuniv can exacerbate the drowsiness created by depressants including alcohol, barbiturates, antihistamines, or other sedatives.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Intuniv before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Intuniv and Other ADHD Medications: More Information

Sources:

Label: Intuniv-guanfacine tablet. Daily Med (2019). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b972af81-3a37-40be-9fe1-3ddf59852528

Intuniv. Shire US Inc. (2019) http://pi.shirecontent.com/PI/PDFs/Intuniv_USA_ENG.pdf

van Stralen, Judy. A Controlled Trial of Extended-Release Guanfacine and Psychostimulants on Executive Function and ADHD. Journal of Attention Disorders (2018) https://journals.sagepub.com/doi/abs/10.1177/1087054717751197

Chaplin, Steve. Guanfacine to control ADHD in children and adolescents. Wiley Online Library (2016) https://onlinelibrary.wiley.com/doi/abs/10.1002/psb.1481

Intuniv vs. Adderall. RxList. https://www.rxlist.com/intuniv_vs_adderall/drugs-condition.htm