ADHD Medication and Treatment Reviews

Intuniv

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 the ADHD Medication 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. Although only studied and approved in children and adolescents, Intuniv is commonly used off-label by all ages.

Intuniv is most commonly used as an add-on to a finely tuned stimulant medication.  It can be used by itself as a monotherapy when people do not get benefits from the stimulant medications, do not tolerate the stimulant medications, or decline the use of stimulant class medications.

How Does Intuniv (Guanfacine) Work to Treat ADHD Symptoms?

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 . Thus, non-stimulant medications like Intuniv sometimes help patients with ADHD who can’t take or don’t experience benefits from stimulants.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.

The two alpha agonists available in the United States were originally brought to the market in the early 1980’s as medications to lower blood pressure.  In practice, the alpha agonists are not very effective for blood pressure so low blood pressure is rarely a major side effect of this category of medications.  Their primary FDA-approved use now is to treat the hyperarousal component of ADHD.

How Do You Use Intuniv (Guanfacine) to Treat ADHD?

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.

What Dosage of Intuniv Is Used to Treat ADHD?

As with all medications, follow your Intuniv prescription instructions exactly. 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.

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 either alpha agonist will take several weeks.  Unlike the stimulant medications that are immediately effective in just an hour or so, the alpha agonists such as Intuniv take 5 days for their benefits to develop each time the dose is increased.  During the process of fine-tuning the dose the fastest that each step can be taken is every 5th day.  This also means that Intuniv must be 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.

As with all medications, drugs like Intuniv should not be stopped suddenly or without prior consultation with a clinician.

What Are the Side Effects of Intuniv?

The FDA cites the following side effects of Intuniv :

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

Other serious side effects of Intuniv include

  • low blood pressure
  • low heart rate
  • fainting
  • sleepiness
  • increased blood pressure and heart rate or other withdrawal symptoms after suddenly stopping IntunIn practice, three major side effects are reported by clinicians with any frequency:
    1. Mild sedation / sleepiness in about 25% of people
    2. Dry mouth that usually goes away in about 2 weeks in about 20% of people
    3. An accentuation of the experience  of standing up quickly and getting lightheaded, dizzy, and vision turning somewhat gray. This universal experience can increase in frequency in about 10% of people who take Intuniv.

    Paradoxically both of the alpha agonists can cause difficulty sleeping and severe irritability in about 1-2% of people.  Neither of these side effects go away with time so, if they occur, the Intuniv will need to be stopped.”

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.

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?

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.

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.

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:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b972af81-3a37-40be-9fe1-3ddf59852528
http://pi.shirecontent.com/PI/PDFs/Intuniv_USA_ENG.pdf

36 Intuniv Related Links

  1. 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.

  2. 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!

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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?

  12. 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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