Options for the Management of Attention Deficit/Hyperactivity (ADHD)

Marcia L. Buck, Pharm.D., FCCP, FPPAG


Pediatr Pharm. 2011;17(3) 

In This Article

Extended-release Guanfacine

Immediate release guanfacine, a selective alpha2A-agonist, has been used off-label for many years in the management of ADHD.[1–3,14] A once-daily guanfacine product, Intuniv™, became available in 2009 which provides symptom control up to 24 hours. The extended-release tablets come in 4 strengths, with a recommended starting dose of 1 mg or 0.05–0.08 mg/kg given once daily. There have been only mild changes in blood pressure with guanfacine in clinical trials; but due to the potential for hypotension, the dose should be increased by a maximum of 1 mg/week. When discontinuing therapy, the dose should be reduced by 1 mg increments every 3–7 days to prevent rebound hypertension.


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