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Intuniv (guanfacine) Disease Interactions

There are 5 disease interactions with Intuniv (guanfacine):

Moderate

Alpha-2 agonists (central) (Includes Intuniv) ↔ bradyarrhythmia

Moderate Potential Hazard, High plausibility. Applies to: 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. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim, Ridgefield, CT.
  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. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. Golusinski LL, Blount BW "Clonidine-induced bradycardia." J Fam Pract 41 (1995): 399-401
  5. Schwartz E, Friedman E, Mouallem M, Farfel Z "Sinus arrest associated with clonidine therapy." Clin Cardiol 11 (1988): 53-4
  6. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. Byrd BF, Collins HW, Primm RK "Risk factors for severe bradycardia during oral clonidine therapy for hypertension." Arch Intern Med 148 (1988): 729-33
View all 7 references
Moderate

Alpha-2 agonists (central) (Includes Intuniv) ↔ depression

Moderate Potential Hazard, Moderate plausibility. Applies to: Depression

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. Catapres (clonidine)." Boehringer-Ingelheim, Ridgefield, CT.
  4. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  5. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 5 references
Moderate

Alpha-2 agonists (central) (Includes Intuniv) ↔ hypotension

Moderate Potential Hazard, High plausibility. Applies to: Hypotension, 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. 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
  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. Bauer JH "Effects of guanabenz therapy on renal function and body fluid composition." Arch Intern Med 143 (1983): 1163-7
  4. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  5. 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
  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. 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
  8. van Zwieten PA, Thoolen MJ, Timmermans PB "The hypotensive activity and side effects of methyldopa, clonidine, and guanfacine." Hypertension 6 (1984): 28-33
  9. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  10. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim, Ridgefield, CT.
  11. Given BD, Taylor T, Lilly LS, Dzau VJ "Symptomatic hypotension following the clonidine suppression test for pheochromocytoma." Arch Intern Med 143 (1983): 2195-6
  12. Bosanac P, Dubb J, Walker B, et al "Renal effects of guanabenz: a new antihypertensive." J Clin Pharmacol Nov-Dec (1976): 631-6
View all 12 references
Moderate

Guanfacine (Includes Intuniv) ↔ ADHD

Moderate Potential Hazard, Moderate plausibility. Applies to: 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.

Moderate

Guanfacine (Includes Intuniv) ↔ renal/liver disease

Moderate Potential Hazard, Low plausibility. Applies to: Liver Disease, 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. 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
  2. Kiechel JR "Pharmacokinetics and metabolism of guanfacine in man: a review." Br J Clin Pharmacol 10 (1980): s25-32
  3. 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
  4. Kiechel JR "Pharmacokinetics of guanfacine in patients with impaired renal function and in some elderly patients." Am J Cardiol 57 (1986): e18-21
  5. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. 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
View all 6 references

Intuniv (guanfacine) drug interactions

There are 597 drug interactions with Intuniv (guanfacine)

Intuniv (guanfacine) alcohol/food interactions

There is 1 alcohol/food interaction with Intuniv (guanfacine)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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