ADHD Medication and Treatment Reviews

Intuniv: ADHD Medication

Intuniv (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.
Generic Name: Guanfacine

What Is Intuniv (Guanfacine)?

Intuniv (generic name: guanfacine) is a once-daily, non-stimulant ADHD medication approved to treat 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.

Is Intuniv the Same As 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?

Intuniv is an extended-release tablet taken once daily in the morning or evening at approximately the same time each day. Tablets are available in 1mg, 2mg, 3mg, and 4mg dosages.

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.

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

More Information on Intuniv and Other ADHD Medications

Intuniv: Answers to Your ADHD Medication Questions
Free Download: The Complete Guide to ADHD Medications
A Parent’s Guide to ADHD Medications

 

36 Intuniv: ADHD Medication Comments & Reviews

  1. My 7-year-old son has been on 36 mg Concerta since March. It has been very good for him. He had also been taking 3 mg Intuniv up until April. I found that it lasted all day and into the night. We began a very slow taper off. We slowly noticed a facial tic as we ended the Intuniv. When we finally stopped the tic became much worse.

  2. My son is 16 and has been taking ADHD medication for several years. He now takes Focalin XR and added Intuniv about a year ago. He is doing better with his attention, but doesn’t like the way the meds make him feel. He feels like it dulls his “fun” personality. Without the meds, he is very hyper, but likes to joke and cut up with his friends. When he is taking his medicine, he is quieter but easily annoyed and angered.

  3. My 10-year-old started on 1mg Intuniv 7 days ago, so will be starting the 2nd week trial at 2mg. He has been more tired. The 3rd day headaches started, which have not lessened.

  4. I have a teenage son that just started Intuniv and is on 2mg at this time. He is taking Intuniv in place of a stimulant due to anxiety. His side effects are light-headedness upon standing too quickly and tingling of his extremities.

  5. My son was very sleepy when he started taking it. He only takes 2mg dosage between dinner and bedtime. He is still sleepy towards the end of the evenings. We are having good results in school and at home.

  6. We switched our 17 years old son from Concerta to Intuniv one month ago. He started on 1mg and then after a week went to 2 mg. He has been doing really well on the 2mg, so we don’t feel the need to go up to 3mg. Concerta was making him have horrific nightmares and he had no appetite. Since being on Intuniv, he is eating like a normal 17 years old. He has gained 5 lbs. this month and he is sleeping well and no nightmares. Only side effect was being really tired at the beginning but that has worn off.

  7. Tenex (the short-acting form of Intuniv) was added to my daughter’s mix of medications a few months ago. She is almost 11 and, clearly, takes other meds – so our experience may be less relevant than that of others. However, it has been a welcome addition. We have never had a ‘eureka’ moment with her meds but the Tenex seems to help her very much with impulse control.

  8. Our 10 years old began 2ml of short-acting Intuniv 2x/day (Guanfacine, Tenex) and continued taking it for 3.5 months. This medicine triggered the most bizarre behavior – mania, aggression, and illness. It “cured” the hyperactivity almost overnight, but it did nothing for the inattentiveness.

  9. My 9 year-old son started Intuniv about a month ago. He also takes Vyvanse. We have seen a big difference in impulsive behavior. The two weeks he had some lethargy, but his body has adjusted and he no longer has that tired feeling.

  10. My son took Intuniv with his stimulant for about 9 months a couple years ago. We finally realized his new nightmares were the Intuniv and they went away within a couple days of stopping it.

  11. My 17-year-old ADHD son is on his 4th week of Intuniv (the 2nd week of 3 mgs) & he still seems very tired. He takes it in the morning with the lowest dose of Vyvanse. He does also seem irritable a lot.

  12. One of my twin daughters (age 8-1/2) takes Guanfacine. She was started on it when she had too much of a bounce-back effect from Ritalin and then Adderall (being angry and frustrated when the meds wore off). Guanfacine definitely helped her, but it is too short acting to get her through the day. She now takes Strattera in the morning, 1/2 mg. of Guanfacine mid-afternoon, and 2 mg. Intuniv plus 25 mg. Trazadone before bed.

  13. My son is almost 6 years old and he takes Methylphenidate 10mg in the morning and Intuniv 3 mg at night. My son is a total different person with this medication. He is much less moody and has less mood swings and is much less aggressive towards others. However, I must say that if he misses one dose, all hell breaks loose.

  14. My 13-year-old son takes Concerta daily in the morning and takes Intuniv at night with dinner. He has not experienced any of the side effects. I found that the Intuniv helps with the impulsivity and frustration, too.

  15. I’m 55 years old, and have been on Intuniv for a few months now. I was hoping it would help with impulsivity. I started on 1 mg, working up to 4 mg daily (morning), and took this along with Adderall (usually 10 mg daily). I found myself in rages a few times (actually threw a glass at one point),more scattered and acting haphazardly, and also extremely tired. So, I’ve cut all the way back to the 1 mg daily dosage, and feel much better. I also stopped the Adderall, since I’ve realized it’s caused excessive hair loss.

  16. I’ve been on Intuniv for well over a year. I take 3 mg everyday, and its worked well for me. I have very bad adhd and have problems functioning without my meds. My current doctor told me not to stop taking it because on high dosages you may have a stroke. I’ve noticed that without it I can get very antsy and my emotions become a mess. The only other thing is since ive taken it my appetite has decreased. And my blood pressure raises quite a bit.

  17. As a 66 year old and recent ADD diagnosee, I was willing to try my doctor’s suggestion of Intuniv XR. After four weeks of horrible side effects and no benefits, I started some research. And the manufacturer’s Product Monograph states: ” When data were examined by age subgroups, only children aged 6 to 12 years demonstrated clinically relevant improvements.” Even the manufacturer is stating that this drug does not help for teens or adults. What a waste of people’s money and time and hopes to be offered this by a doctor who obviously is picking from some simple chart. Yuk!

  18. THANK YOU bobyvr for letting adults know that Intuniv does NOT work for adults! I was in process to ask for a prescription, when I read your post.

    Because Adults NEED something like this, you will have adults going into action to try it unless you CLEARLY STATE THAT STUDIES SHOW IT DOES NOT WORK FOR ADULTS. When we read, “for 5 – 12 yr olds” we will think adults were, once again, simply left out of the study or article.

  19. Bobyvr and Sally..
    That is actually wrong. What the insert means is that they haven’t yet (at the time of that publishing) completed trials on adults with ADHD, so there is no info either for or against it.

    However, as of late 2017, a major phase of a trial for this medication and adult ADHD is showing clinically significant improvement in those on guanfacine vs placebo.

    So just because it didn’t work for you (remember, it can take 4-6 weeks to work AFTER you’ve found the right dose, so it could take many months to find the right dose), does NOT mean it doesn’t work for other adults.

    We are individuals, not every medication works for every person.

    But yes, this medication so far in trials IS showing it does in fact work for many.

  20. My 7 year old daughter was prescribed several drugs for ADHD, Vyvanse and most recently Intuniv. After nearly a month of night terrors and animated dreaming we pulled her off Intuniv and have immediately seen improved, restful sleeping. I can’t tell you how devastating it was to see her in an inconsolable dreamlike haze lasting from 45 minutes to several hours. Her terrors consisted of things crawling on walls and macabre events, something I truly found odd as we heavily monitor her television/news/etc.l intake. Thankfully we’re all getting some rest now and can tackle the day with clarity. Intuniv may work for others but it was a nightmare of a drug for us.

  21. Coloradoful
    Thank you for the comment, my grandson is 7 and he is on the same medication. He hasn’t been sleeping well with alot of restless and talking and fighting in his sleep.he has only been on the medication for 3 weeks but now he is acting quite differently. Do they have your daughter in anything else since they took her off the intunvi.
    Thank you for posting in here

  22. Having read some of the reviews I have to say that Night terror and insomnia were a problem for my son. I was very fortunate to have changed pharmacy and the pharmacist asked how the sleep routine was going and explained insomnia was a side effect of Intuniv (1mg incresed to 2mg) medication and she suggested melatonin (5mg) to assist with sleep which I now also use. It has now been 5 months since the change and my life is transformed, After fifteen years of heartache my family can now have a normal life,my son is focused on schooling and working in a fast food restaurant all thanks to Intuniv

  23. I am 17, I have been on Intuniv for 6 years when I was diagnosed with mild ADD and never had a serious problem with it and think it does it’s job. However when I don’t take, even just one day I cant only sleep to save my life. I’m also very energetic and can’t stop my brain. it makes me hot and my face turns bright red. It’s very odd considering it’s supposed to be non addictive.

  24. I took 2mg/day Guanfacine Extended Release (Intuniv) for newly diagnosed ADHD and noticed some improvement in symptoms. I increased to 3mg/day after checking with my psychiatrist. For the first three days, my depression flared up without any obvious external triggers. For the next two days, I was grumpy and moody. On the final (and last) day I took it at 3mg, I had a bit of a meltdown and had a self-hatred spiral where I was obsessing over something I’d done wrong and trying to correct it and was becoming (passively) suicidal. It’s been YEARS since I’ve done something similar. Please be cautious with higher doses. I have since reduced to 2mg/day (which had no noticeable side effects) and added a stimulant and am doing fine.

  25. 1 to 4mg of intuniv is the dosing for children for teenagers and adults the dosing is 4 to 7 mg. Dosing is based on body weight. People who are 91 kg or more 202 pd should be on 5 to 7 mg according to the fda. In Japan intuniv 4 to 6 mg was statistically significant and superior to placebo in adults with adhd in Japan
    And intuniv 4 to 6 mg was approved in Japan for adults with adhd in 2018. So if your an adult who weighs 190 to 200 pda 3 to 4mg of intuniv probably won’t work . You need 5 to 7 mg of intuniv a day.

  26. My 19 yr old was placed on 3 mg of Guanfacine. Unfortunately, has been using it for 6 months and it hasn’t done a thing to help with ADHD. Stimulant medications have been used in the past but cannot be prescribed or tolerated because of an addictive personality. Any suggestions?

  27. My 7 year old son started taking Intuniv about 2.5 months ago after he experienced horrendous come down effects on Ritalin IR and SR. He had become suicidal, more anxious, and very aggressive (stabbed his 2 year old brothers hand with a screwdriver). Symptoms were definitely worse in the mornings just before taking his meds again. He is currently on 2mg Intuniv in the morning and takes 10mg Ritalin IR morning and lunch. We are waiting to increase his dose to 3mg as we haven’t found it to be very therapeutic yet. But we’ve had to delay the increase in dose due to it causing him to have a low heart rate. He still gets the come down in the mornings (I presume from the Ritalin) but it is definitely not as severe as it was. Plan is to get up to 3mg Intuniv and 10mg Ritalin SR daily. The stimulants definitely help him with his impulsiveness and hyperactivity but the come down with the larger doses was just too severe.

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