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Guanfacine Disease Interactions

There are 5 disease interactions with guanfacine:


Alpha-2 Agonists (Central) (Includes Guanfacine) ↔ 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.


  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
View all 7 references

Alpha-2 Agonists (Central) (Includes Guanfacine) ↔ 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.


  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, Philadelphia, PA.
View all 5 references

Alpha-2 Agonists (Central) (Includes Guanfacine) ↔ 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.


  1. "Product Information. Wytensin (guanabenz)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. Given BD, Taylor T, Lilly LS, Dzau VJ "Symptomatic hypotension following the clonidine suppression test for pheochromocytoma." Arch Intern Med 143 (1983): 2195-6
  3. 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

Guanfacine (Includes Guanfacine) ↔ 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.


Guanfacine (Includes Guanfacine) ↔ 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.


  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
View all 6 references

guanfacine drug Interactions

There are 484 drug interactions with guanfacine

guanfacine alcohol/food Interactions

There is 1 alcohol/food interaction with 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.

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