Skip to Content

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. van Zwieten PA, Thoolen MJ, Timmermans PB "The hypotensive activity and side effects of methyldopa, clonidine, and guanfacine." Hypertension 6 (1984): 28-33
  2. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim, Ridgefield, CT.
  3. Golusinski LL, Blount BW "Clonidine-induced bradycardia." J Fam Pract 41 (1995): 399-401
  4. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  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. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. Prasad A, Shotliff K "Depression and chronic clonidine therapy." Postgrad Med J 69 (1993): 327-8
  4. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  5. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim, Ridgefield, CT.
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. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. Given BD, Taylor T, Lilly LS, Dzau VJ "Symptomatic hypotension following the clonidine suppression test for pheochromocytoma." Arch Intern Med 143 (1983): 2195-6
  5. Bosanac P, Dubb J, Walker B, et al "Renal effects of guanabenz: a new antihypertensive." J Clin Pharmacol Nov-Dec (1976): 631-6
  6. Bauer JH "Effects of guanabenz therapy on renal function and body fluid composition." Arch Intern Med 143 (1983): 1163-7
  7. 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
  8. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  9. 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
  10. "Product Information. Catapres (clonidine)." Boehringer-Ingelheim, Ridgefield, CT.
  11. van Zwieten PA, Thoolen MJ, Timmermans PB "The hypotensive activity and side effects of methyldopa, clonidine, and guanfacine." Hypertension 6 (1984): 28-33
  12. 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
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. 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
  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. Kiechel JR "Pharmacokinetics of guanfacine in patients with impaired renal function and in some elderly patients." Am J Cardiol 57 (1986): e18-21
  6. "Product Information. Tenex (guanfacine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 6 references

Intuniv (guanfacine) drug Interactions

There are 580 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.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

Hide