Guanfacine (Tenex, Intuniv)

Immediate-release guanfacine (Tenex) is FDA-approved for hypertension and commonly used off-label for ADHD and anxiety-related symptoms. Extended-release guanfacine (Intuniv) is the extended-release form of guanfacine, a non-stimulant medication that is FDA-approved for treatment of ADHD.

Guanfacine activates alpha-2A pre-synaptic receptors in the prefrontal cortex, supporting impulse control, attention, planning, and emotional regulation. It does not work like stimulants and does not increase dopamine, but does typically work immediately.

No. Guanfacine is a non-stimulant medication.

• Tenex (immediate-release) is FDA-approved for hypertension but often used off-label for ADHD.
• Intuniv (extended-release) is engineered for once-daily use with steadier ADHD symptom coverage.

Guanfacine IR (Tenex) and ER (Intuniv) should not be taken together.

Guanfacine (Tenex) may be prescribed off-label to help calm anxiety by reducing hyperarousal and regulating norepinephrine in the brain, but it is not FDA-approved to treat anxiety.

Most people people notice benefits immediately, though for some people full effects emerge over a few weeks.

Tenex (immediate-release guanfacine) can be prescribed off-label for ADHD in individuals aged 13 and older, and in some cases for children as young as 6 years old. Intuniv is FDA-approved for ages 6 to 17. However, safety and effectiveness of Tenex and immediate-release guanfacine for children younger than 6 years old has not been established. Similarly, safety and effectiveness of Intuniv and extended-release guanfacine for children younger than 6 years old and adults 18 years or older has not been established.

• Sleepiness or fatigue
• Dizziness
• Low blood pressure
• Headache
• Dry mouth
• Stomach discomfort
• Irritability (less common)

Neither is typical. Guanfacine is generally considered weight-neutral.

No. It is not habit-forming and not a controlled medication.

Sometimes clinicians prescribe a combination of guanfacine with stimulants to support emotional regulation, reduce rebound symptoms, or improve sleep. Consult your prescribing clinician before starting, stopping, or combining any medications or substances with guanfacine.

Both are alpha-agonists, but they differ in the following ways:

• Guanfacine is more selective, typically causing less sedation.
• Clonidine is less selective, impacting multiple receptor subtypes, which can lead to stronger sedative effects.

Clinicians often prescribe guanfacine for daytime ADHD symptoms due to its less sedating effects.

Both are non-stimulant ADHD medications, but they work in different ways. Guanfacine is a pre-synaptic alpha-2A adrenergic agonist that typically works immediately, while Strattera is a norepinephrine reuptake inhibitor that becomes effective over 4-6 weeks.

Kapvay is extended-release clonidine, a different alpha-2 agonist. Some people respond better to one medication over the other based on symptom profile or side effect sensitivity.

Adderall is an amphetamine stimulant medication, while guanfacine is a non-stimulant that may be prescribed for people who prefer or need a non-stimulant option. Adderall works by increasing dopamine and norepinephrine, whereas guanfacine works through alpha-2A receptor activation. Guanfacine and Adderall may be prescribed alone or in combination with each other if necessary, depending on treatment goals.

Vyvanse is an amphetamine stimulant medication, while guanfacine is a non-stimulant. Vyvanse works by increasing dopamine and norepinephrine, whereas guanfacine works through alpha-2A receptor activation. Guanfacine is a non-stimulant that may be prescribed for people who prefer or need a non-stimulant option.

Ritalin is a methylphenidate stimulant medication that increases dopamine and norepinephrine. Guanfacine is a non-stimulant that works through alpha-2A receptor activation and may be prescribed for people who prefer or need a non-stimulant option.

Try to avoid alcohol while on guanfacine. Alcohol can intensify side effects such as drowsiness, dizziness, and low blood pressure, and may also increase the risk of falls and injury.

Guanfacine hydrochloride is the active ingredient in the generic medication guanfacine, a non-stimulant prescription medication used to treat both high blood pressure (hypertension) and ADHD in children and adults. It works by affecting specific receptors in the brain to reduce sympathetic nerve impulses, thereby lowering blood pressure and heart rate, and improving attention and impulse control for ADHD.

Guanfacine can interact with medications or substances that cause sedation or lower blood pressure, which may intensify dizziness, fatigue, or fainting. This includes alcohol, sleep medications, benzodiazepines, certain antihistamines, and other blood pressure-lowering drugs. Some antidepressants and grapefruit products may increase guanfacine levels in the body, making side effects stronger. Consult your prescribing clinician before starting, stopping, or combining any medications or substances with guanfacine.

Tenex is FDA-approved to treat hypertension.

As of publication date, the cost of immediate-release generic guanfacine varies by dose and pharmacy. Based on sample pricing, 1 mg guanfacine tablets start at about $16.22 for 30 tablets, and 2 mg tablets start at about $31.25 for 100 tablets.

The cost of brand-name Tenex varies by dose and pharmacy. Based on sample pricing (as of publication date), Tenex 1 mg costs around $261.46 for 100 tablets, while Tenex 2 mg costs around $385.44 for 100 tablets.

As of publication date, a 100-tablet supply of the brand-name medication Intuniv is typically $956.76 to about $1,000 total (about $9.56 to $10 per tablet) for all available strengths (1 mg, 2 mg, 3 mg, and 4 mg).

Actual costs may vary depending on pharmacy, location, and insurance coverage. If you have insurance, your out-of-pocket cost will depend on your supporting diagnosis and plan type (e.g., commercial, Medicare, Medicaid) and may include a copay or coinsurance.