What is the most important information I should know about Intuniv?
Caution should be used if your child:
- has certain health conditions such as low heart rate, low blood pressure, or syncope; or
- is taking certain medications such as CNS depressants, antihypertensive drugs, valproic acid, or ketoconazole.
Intuniv is a non-stimulant treatment for attention-deficit/hyperactivity disorder (ADHD). It is a long-acting form of guanfacine, which had previously been used to treat high blood pressure.
The Food and Drug Administration (FDA) approved the medication in September 2009. It was initially approved as a once-a-day treatment for children and adolescents 6 to 17 years old with ADHD. Before its approval, Guanfacine had already been used off-label to treat children with ADHD who also have tics, sleep problems, or aggression.
In 2011, Intuniv received a new indication for use as adjunctive therapy for ADHD. This meant that it could be used with a stimulant ADHD medicine such as Concerta, Focalin, Adderall XR, or Vyvanse. It may also be used alone (monotherapy) to treat ADHD.
Intuniv for ADHD
Consider these important points when taking Intuniv:
- The pill must be swallowed whole. Intuniv cannot be crushed, chewed, or broken, unlike some other ADHD medications, such as Qelbree.
- It’s not a controlled substance. Similar to other non-stimulants for ADHD, such as Strattera and Kapvay, Intuniv is not a controlled substance, making refills more accessible for parents.
- It generally does not suppress appetite significantly. Compared to other ADHD medications, especially stimulants like Adderall, Concerta, or Vyvanse, Intuniv does not typically suppress appetite. This may be beneficial for children who struggle with weight gain while on stimulants.
Intuniv Dosage
Intuniv comes in four dosage strengths:
- 1 milligram
- 2 milligrams
- 3 milligrams
- 4 milligrams
Most children will begin with a 1-milligram dose and may increase by 1 milligram each week until reaching a target dose of 3 or 4 milligrams.
Since dosage adjustments may be necessary, it might take three to four weeks to notice improvements in your child’s ADHD symptoms once Intuniv use begins.
In 2014, the FDA approved flexible pediatric dosing based on weight, with maximum doses reaching up to 7 milligrams for older teens. Weight-based target doses range from 0.05 to 0.12 milligrams per kilogram of body weight per day.
Side Effects of Intuniv
Common side effects of Intuniv include:
- Somnolence (drowsiness) in up to 38% of patients
- Headaches
- Fatigue
- Upper abdominal pain
- Nausea
- Lethargy
- Dizziness
- Irritability
- Lowered blood pressure
- Reduced appetite
Many children experience somnolence when they begin taking Intuniv, but this often improves over time. For some children, this drowsiness can be helpful in aiding sleep if the dose is administered at bedtime. Intuniv can be given either in the morning or evening.
Intuniv Warnings
Warnings about Intuniv include:
- It should be used cautiously if your child is at risk for certain health conditions. These include low blood pressure, bradycardia (low heart rate), heart block, or syncope (fainting).
- It should be used cautiously if your child is also taking certain medications. These include ketoconazole, rifampin, valproic acid, antihypertensive drugs, or CNS depressants (sedatives, antipsychotics, etc.).
- It should not be taken with a high-fat meal. It can be taken with water, milk, or other liquids.
- It should not be stopped suddenly. Instead, the medication should be discontinued slowly by decreasing or tapering the dose over several weeks.
The Pediatric Focused Safety Review by the FDA in 2018 recommended routine monitoring of Intuniv.
Should Your Child With ADHD Try Intuniv?
Intuniv may be an especially good option if your child’s current medication simply isn’t working well, they haven’t been able to tolerate other stimulants because of side effects, or if you have been wary of putting them on a stimulant.
As with Tenex, immediate-release guanfacine, Intuniv may be used to treat children with ADHD and tics, sleep problems, or aggression, either by itself or with a stimulant.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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