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Guanfacine Disease Interactions

There are 5 disease interactions with guanfacine.

Moderate

Alpha-2 agonists (central) (applies to guanfacine) bradyarrhythmia

Moderate Potential Hazard, High plausibility. Applicable conditions: Heart Block, Sinus Node Dysfunction

Central alpha-2 adrenoreceptor agonists reduce sympathetic outflow from the central nervous system. Heart rate is decreased, which may lead to or exacerbate sinus bradycardia and atrioventricular block. Therapy with central alpha-2 adrenoreceptor agonists should be administered cautiously in patients with conduction disturbances such as sinus node dysfunction or AV nodal disease.

References

  1. Byrd BF, Collins HW, Primm RK "Risk factors for severe bradycardia during oral clonidine therapy for hypertension." Arch Intern Med 148 (1988): 729-33
  2. van Zwieten PA, Thoolen MJ, Timmermans PB "The hypotensive activity and side effects of methyldopa, clonidine, and guanfacine." Hypertension 6 (1984): 28-33
  3. Schwartz E, Friedman E, Mouallem M, Farfel Z "Sinus arrest associated with clonidine therapy." Clin Cardiol 11 (1988): 53-4
  4. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories PROD (2001):
  5. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories PROD (2001):
  6. Golusinski LL, Blount BW "Clonidine-induced bradycardia." J Fam Pract 41 (1995): 399-401
  7. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim PROD (2001):
View all 7 references
Moderate

Alpha-2 agonists (central) (applies to guanfacine) depression

Moderate Potential Hazard, Moderate plausibility.

Central alpha-2 adrenoreceptor agonists may occasionally cause mental depression and should be used cautiously in patients with a history of depression.

References

  1. Kostis JB, Rosen RC, Holzer BC, et al. "CNS side effects of centrally-active antihypertensive agents: a prospective, placebo-controlled study of sleep, mood state, and cognitive and sexual function in hypertensive males." Psychopharmacology (Berl) 102 (1990): 163-70
  2. Prasad A, Shotliff K "Depression and chronic clonidine therapy." Postgrad Med J 69 (1993): 327-8
  3. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories PROD (2001):
  4. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories PROD (2001):
  5. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim PROD (2001):
View all 5 references
Moderate

Alpha-2 agonists (central) (applies to guanfacine) hypotension

Moderate Potential Hazard, High plausibility. Applicable conditions: Cerebrovascular Insufficiency, Ischemic Heart Disease, Peripheral Arterial Disease

Central alpha-2 adrenoreceptor agonists reduce sympathetic outflow from the central nervous system, resulting in decreases in heart rate, peripheral and renovascular resistance, and blood pressure. Therapy with these agents should be administered cautiously in patients with hypotension or conditions that may be exacerbated by decreased blood pressure and perfusion, such as coronary insufficiency, peripheral vascular disease (e.g., Raynaud's syndrome), cerebrovascular disease, or recent myocardial infarction.

References

  1. Anavekar SN, Jarrott B, Toscano M, Louis WJ "Pharmacokinetic and pharmacodynamic studies of oral clonidine in normotensive subjects." Eur J Clin Pharmacol 23 (1982): 1-5
  2. Fruncillo RJ, Gibbons WJ, Vlasses PH, Ferguson RK "Severe hypotension associated with concurrent clonidine and antipsychotic medication." Am J Psychiatry 142 (1985): 274
  3. Bosanac P, Dubb J, Walker B, et al. "Renal effects of guanabenz: a new antihypertensive." J Clin Pharmacol Nov-Dec (1976): 631-6
  4. Bauer JH "Effects of guanabenz therapy on renal function and body fluid composition." Arch Intern Med 143 (1983): 1163-7
  5. Dziedzic SW, Elijovich F, Felton K, et al. "Effect of guanabenz on blood pressure responses to posture and exercise." Clin Pharmacol Ther 33 (1983): 151-5
  6. Mosley C, O'Connor DT, Taylor A, et al. "Comparative effects of antihypertensive therapy with guanabenz and propranolol on renal vascular resistance and left ventricular mass." J Cardiovasc Pharmacol 6 (1984): s757-61
  7. Greene CS, Gretler DD, Cervenka K, et al. "Cerebral blood flow during the acute therapy of severe hypertension with oral clonidine." Am J Emerg Med 8 (1990): 293-6
  8. Given BD, Taylor T, Lilly LS, Dzau VJ "Symptomatic hypotension following the clonidine suppression test for pheochromocytoma." Arch Intern Med 143 (1983): 2195-6
  9. van Zwieten PA, Thoolen MJ, Timmermans PB "The hypotensive activity and side effects of methyldopa, clonidine, and guanfacine." Hypertension 6 (1984): 28-33
  10. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories PROD (2001):
  11. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories PROD (2001):
  12. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim PROD (2001):
View all 12 references
Moderate

Guanfacine (applies to guanfacine) ADHD

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hyperkinetic Syndrome of Childhood

The safety and effectiveness of guanfacine in children under 12 years of age has not been demonstrated and its use in this age group is not recommended. However, there have been some spontaneous postmarketing reports of mania and aggressive behavioral changes in pediatric patients with attention- deficit hyperactivity disorder (ADHD) that received this drug. All patients had medical or family risks of bipolar disorder, and all of them recovered after treatment discontinuation. Hallucinations have also been reported in pediatric patients receiving guanfacine for the treatment of ADHD.

References

  1. "Product Information. Intuniv (guanfacine)." Shire US Inc (2009):
Moderate

Guanfacine (applies to guanfacine) renal/liver disease

Moderate Potential Hazard, Low plausibility. Applicable conditions: Renal Dysfunction

Normally, approximately 50% of a guanfacine dose is eliminated unchanged by the kidney and the rest metabolized by the liver. However, neither the parent drug nor its metabolites accumulate significantly during chronic dosing in patients with severe renal impairment due to increased hepatic metabolism of the drug in these patients. Thus, initial dosage adjustments are generally not necessary in renal impairment. Dosage titration, however, should be made cautiously if hepatic function is also compromised. The pharmacokinetics of guanfacine has not been studied in patients with liver disease. The manufacturer recommends caution when the drug is used in such patients.

References

  1. Kiechel JR "Pharmacokinetics of guanfacine in patients with impaired renal function and in some elderly patients." Am J Cardiol 57 (1986): e18-21
  2. Kirch W, Kohler H, Braun W "Elimination of guanfacine in patients with normal and impaired renal function." Br J Clin Pharmacol 10 (1980): s33-5
  3. Kiechel JR "Pharmacokinetics and metabolism of guanfacine in man: a review." Br J Clin Pharmacol 10 (1980): s25-32
  4. Kirch W, Kohler H, Braun W, von Gizycki C "The influence of renal function on plasma concentration, urinary excretion and antihypertensive effect of guanfacine." Clin Pharmacokinet 5 (1980): 476-83
  5. Carchman SH, Sica DA, Davis J, Crowe JT, Jr Wasserman AJ, Proctor JD, Wright GJ "Steady-state plasma levels and pharmacokinetics of guanfacine in patients with renal insufficiency." Nephron 53 (1989): 18-23
  6. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories PROD (2001):
View all 6 references

Guanfacine drug interactions

There are 465 drug interactions with guanfacine.

Guanfacine alcohol/food interactions

There is 1 alcohol/food interaction with guanfacine.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

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