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Intuniv Review – 14 Essential Things to Know

By Sasha de Beausset Aparicio, MSc

Reviewed by Rebecca Williams, MD, MA, MB, BChir

Last Updated:

Evidence Based | Summary | Nutrition Info | Benefits | Adverse Effects | Cautions | Price | Suggested Use | Conclusion

Intuniv (brand name) is a once-daily, extended-release formulation of guanfacine hydrochloride (HCl).[1] This prescription medication is usually indicated for the treatment of attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) in adolescents and children who are at least six years old, as monotherapy and as adjunctive treatment to stimulant medications.[2]

Summary

1) What is Intuniv?

Intuniv-Guanfacine-Sandoz-Facts

Intuniv (Guanfacine) is a central alpha2A-adrenergic receptor agonist that is thought to address significant areas of impairment and ADHD symptoms such as emotional sensitivity, hyperarousal, rejection sensitivity, and social aggression that are not treated by stimulant medications.[3]

Thus, non-stimulant medications like Intuniv sometimes help patients with ADHD who can’t take or don’t experience benefits from stimulants. The alpha agonists treat the impairments that stimulants do not treat well by lowering the adrenaline side of the nervous system so that its level is the same as a person who does not have ADHD.

2) How Did Sandoz Start?

Guanfacine, sold under the brand names Estulic, Tenex, Afken, and, in the extended-release form, Intuniv, is a substance commonly prescribed to treat attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and, in some cases, high blood pressure.

The FDA first approved Guanfacine hydrochloride for treating ADHD in 1986 under the brand name Tenex.[4] In 2010, the substance was approved by the FDA to treat ADHD for patients 6–17 years old.

Five years later, in 2015, the European Medicines Agency approved the use of guanfacine hydrochloride (under the brand name Intuniv) for the treatment of ADD/ADHD.[5] It was added to the Australian Pharmaceutical Benefits Scheme for the treatment of ADD/ADHD in 2018.[6][7]

Intuniv is made by Sandoz, a division of the Novartis Group and a global leader in generic pharmaceuticals and biosimilars.[8]

Sandoz contact information:

  • Phone: +1 609 627 8500 (United States) / +49 8024 476 0 (Internationally)
  • Address: 100 College Rd. West, Princeton, NJ 08540, United States
  • Website: sandoz.com
Nutrition Info

3) Ingredients of Intuniv

Intuniv contains one active ingredient: guanfacine hydrochloride.

Other (inactive) ingredients: methacrylic acid copolymer, hypromellose, lactose, crospovidone, povidone, fumaric acid, microcrystalline cellulose, and glyceryl behenate.

4) Does Intuniv Work?

Guanfacine hydrochloride is prescribed alone or with stimulants to treat individuals with ADD/ADHD, and high blood pressure.[9][10] The substance has also been analyzed as a potential treatment for posttraumatic stress disorder (PTSD).

While proof of efficacy in adults is insufficient, one clinical trial found good results in children with comorbid ADHD.[11] Regardless of the lack of clinical evidence, guanfacine hydrochloride may still be prescribed in adult PTSD patients who do not respond to SSRIs.[12]

Intuniv (Guanfacine) is usually prescribed to treat attention deficit hyperactivity disorder (ADHD) and attention deficit disorder (ADD) in children who are at least six years old.

Intuniv-Guanfacine-Sandoz-Treated-Symptoms

As with most prescription medications, numerous safety and efficacy studies have been conducted on this product. Some of the most relevant clinical studies include:

  • Guanfacine hydrochloride for attention deficit hyperactivity disorder [13]
  • A Study to Assess the Safety and Efficacy of Guanfacine Hydrochloride Prolonged Release (SPD503) in Children and Adolescents Aged 6 to 17 Years With Attention-Deficit/Hyperactivity Disorder (ADHD)[14]
  • Efficacy and Safety Eval of Guanfacine Hydrochloride in Combination With Psychostimulants in Adults (18-65)[15]
Benefits

5) Intuniv Benefits & Results

Intuniv (Guanfacine) claimed benefits include the following:

  • It’s a non-stimulant prescription medicine;
  • It’s not a controlled substance, which can make getting refills easier for parents;
  • It’s available in different dosage strengths;
  • Unlike other ADD/ADHD medications, it does not cause much appetite suppression.
Adverse Effects

6) Potential Intuniv Adverse Effects

As with all prescription drugs, Intuniv (Guanfacine) is also associated with a wide range of potential adverse effects.[16][17][18]

Common side effects of Intuniv may include:

  • Irritability
  • Constipation
  • Drowsiness
  • Tiredness
  • Dizziness
  • Nausea
  • Dry mouth
  • Stomach pain
  • Weight gain
  • Headache

Rare but more dangerous side effects may include:

  • Slow heartbeat
  • Severe dizziness
  • Severe mental or mood changes (such as hallucinations, depression, or thoughts of suicide)
  • Rash, itching, swelling of the tongue
  • Fainting
  • Difficulty breathing
  • Severe allergic reaction
  • Slow heart rate
Cautions

7) What You Need to Know Before Taking Intuniv

Intuniv (Guanfacine) should be used cautiously if your child is at risk for bradycardia (low heart rate), low blood pressure, syncope (fainting), or heart block. Patients under treatment with ketoconazole, valproic acid, antihypertensive drugs, rifampin, or CNS depressants (i.e., antipsychotics and sedatives) should also avoid taking Intuniv.

Using Intuniv (Guanfacine) with any of the following prescription drugs is not recommended. Your physician may choose not to prescribe you with this medication or change some of the other medicines you take.

  • Strattera (atomoxetine)
  • Adderall (amphetamine / dextroamphetamine)
  • Trazodone
  • Zoloft (sertraline)
  • Tylenol (acetaminophen)
  • Adderall XR (amphetamine / dextroamphetamine)
  • Risperidone
  • Zyrtec (cetirizine)
  • Seroquel (quetiapine)
  • Prozac (fluoxetine)
  • Risperdal (risperidone)
  • Ritalin (methylphenidate)
  • Singulair (montelukast)
  • Claritin (loratadine)
  • Focalin (dexmethylphenidate)
  • Clonidine
  • Focalin XR (dexmethylphenidate)
  • Ibuprofen
  • Melatonin
  • Lexapro (escitalopram)
  • Lamictal (lamotrigine)
  • Abilify (aripiprazole)
  • Vyvanse (lisdexamfetamine)
  • Benadryl (diphenhydramine)
  • Concerta (methylphenidate)
Where to Buy?

8) Where to Buy Intuniv?

As a prescription medication, Intuniv is available for purchase in most drugstores across the United States. Some online pharmacies (i.e., PharmStore, DrugSmart, PharmaLive, PlanetDrugDirect) may also offer free shipping worldwide.

Price

9) Intuniv Price

Prices below are for cash paying buyers only and are not accurate with insurance plans.

The cost for Intuniv oral, extended-release, 1 mg tablet could go up to $1,024 for a supply of 100 tablets ($3.99 – $10.24 per pill or unit), depending on the pharmacy.

A generic version of Intuniv is also available at more affordable prices. However, some users have reported worse results with the generic version.

10) Other Similar Products

Medication for attention deficit hyperactivity disorder (ADHD) and attention deficit disorder (ADD) has progressed by leaps and bounds over the last few decades.

This means that adults and parents, in general, have a lot more alternatives than ever when it comes to treatments for ADD/ADHD. However, it also means that the overabundance of medication choices can be time-consuming, bewildering, and overwhelming, to sort through when you’re trying to design your ideal treatment plan.

However, despite many prescriptions claiming to help relieve ADD/ADHD symptoms, there are only two non-stimulant drugs approved by the FDA to treat ADD/ADHD in adults.

Strattera (generic: Atomoxetine Hydrochloride) is an alternative to the stimulant ADHD medications most commonly prescribed to treat symptoms of attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) in children ages 6-12, adolescents, and adults.[19] It is a selective norepinephrine reuptake inhibitor (SNRI) drug. Strattera is not classified as a controlled substance by the Drug Enforcement Agency (DEA).[20][21]

Kapvay (generic: Clonidine Hydrochloride) is an alpha agonist medication primarily used to treat hypertension. It may also lessen the hyperactivity associated with attention deficit hyperactivity disorder (ADHD) in children ages 6-12, adolescents, and adults.[22] For better results, Kapvay is sometimes prescribed in association with more potent stimulant medications.

Wellbutrin is another potential alternative to Intuniv. Wellbutrin (generic: Bupropion HCL) is an antidepressant medication primarily used to treat depression, major depressive disorder, and seasonal affective disorder in adults. Wellbutrin has been neither studied nor approved to treat attention deficit hyperactivity disorder (ADHD).

Physicians sometimes prescribe it “off-label” to treat symptoms. However, the clinical evidence for bupropion for ADHD “far weaker” than for FDA-approved treatments, according to the American Academy of Child & Adolescent Psychiatry.[23]

Suggested Use

11) Suggested Use

Intuniv should be taken as a tablet by mouth. Unlike other similar prescriptions, the tablets shouldn’t be broken, chewed, or crushed before swallowing. The typical starting dose for a child is 1 milligram (mg) once per day.

12) Of the Same Product Line

Intuniv is available as 1 mg, 2 mg, 3 mg, and 4 mg extended-release tablets.

13) What Users Are Saying

"I have a 9 yr old HF autistic that is mixed with some ADD and ODD. He used to have massive meltdowns at school to the point he was harming himself and whoever was in the way. " [Read full review]

---TruJB

"My son has anxiety and mild ADHD. He had about three months on Ritalin and Concerta, and after coming off it, I know he is far worse than he was before. Intuniv is a better option for him and helps him when struggling to focus at school. He is also on Lexapro for anxiety. " [Read full review]

---Aussie Mum

"So far, so good. My 14 year old just started this drug. He has ADD and has had significant setbacks in life because of it." [Read full review]

---Ann

Conclusion

14) Conclusion

Because Intuniv is one of the few non-stimulant medications for ADD/ADHD, it may be a particularly good alternative if your child hasn’t been able to tolerate other stimulants because of side effects, he’s current prescription simply isn’t working well, or if you have been wary of putting your child on a stimulant.

As with other similar drugs (i.e., Tenex), we may also see Intuniv used to treat children with sleep problems, ADD/ADHD and tics, or aggression, either by itself or with a stimulant.

3/5 - (5 votes)

Reference Sources

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Rocketman

I’m a 36-year-old male who has been diagnosed with ADHD since childhood. I’ve been taking Adderall XR 15 and Adderall IR 10 for about 2 years with decent success. I felt as though I was in a stressed out/anxiety mentality so I talked to my Dr. and he prescribed me guanfacine 1mg as a supplement to calm my mind a little. Just to add for reference, as a younger man, I self-medicated with all types of drugs and psychedelics, and not one of those experiences I had compared to the effects of this drug. The first couple of days I was just kind of tired but felt ok overall. On the third and fourth days, I felt amazing.

That’s when the bottom fell out. I could not sleep for several days, heart rate increased with arrhythmia, disassociation, lightheadedness, and essentially hallucination. My wife ended up taking me to the ER after I nearly collapsed going to the restroom one night. Of course, all of my tests came back negative with the exception of an abnormal EKG.

The nurse administered an IV of 2mg Ativan just so I could get some sleep. It has taken me several days to get back to feeling like I’m not losing my mind. I’ve heard it works for some but be intently observant if you know someone taking this garbage. The only positive that I received from this, was visiting a cardiologist who said I may have some apnea issues. I can’t prove the guanfacine induced this or amplified the response, but I’m inclined to stay far far away from this medication.

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Serious complications with this medication
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