Drug interactions between Concerta and Intuniv
| Results for the following 2 drugs: |
|---|
| Concerta (methylphenidate) |
| Intuniv (guanfacine) |
Interactions between your selected drugs
guanfacine ↔ methylphenidate
Applies to:Intuniv (guanfacine) and Concerta (methylphenidate)
MONITOR: According to the manufacturer, serious adverse events have been reported during concomitant use of methylphenidate with clonidine. The mechanism of interaction, if any, is unknown, and a causal relationship has not been established. The use of clonidine, with or without methylphenidate, has been associated with rare cases of sudden death and cardiotoxicity including sinus bradycardia and heart block. Electrocardiographic (ECG) abnormalities have also been demonstrated in patients treated with clonidine, even at low dosages. However, some investigators suggest these findings may reflect the pharmacologic effects of the drug and not necessarily cardiotoxic effects. Although the existence of a methylphenidate-clonidine interaction is questionable, it is possible that the combination may be more dangerous than either drug alone with respect to drug discontinuation. Specifically, methylphenidate may exacerbate the rebound hypertension and hyperadrenergic state associated with abrupt withdrawal of clonidine, and methylphenidate withdrawal may aggravate the bradycardia and hypotension associated with clonidine use.
MANAGEMENT: The safety of using methylphenidate (racemic) or dexmethylphenidate (the more pharmacologically active d-enantiomer) in combination with clonidine or other centrally-acting alpha-2 agonists has not been established. Patients being considered for alpha-2 agonist therapy, alone or with methylphenidate or dexmethylphenidate, should have cardiovascular status and history evaluated. Vital signs, including pulse and blood pressure, should be monitored prior to and during therapy. The routine use of ECGs in patients being treated for behavioral disorders is controversial, since it is uncertain what findings may indicate actual risk for sudden death. However, ECG monitoring may be appropriate in cases of preexisting cardiac disease or abnormal finding on physical examination. Finally, patients should be advised not to abruptly discontinue the alpha-2 agonist, methylphenidate, or dexmethylphenidate following chronic use unless otherwise directed by their physician.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| 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. |
Do not stop taking any medications without consulting your healthcare provider.
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