Formulary
Guanfacine: Indications, Dosing, Side Effects and Interactions
Guanfacine clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Guanfacine: Indications, Dosing, Side Effects and Interactions
Guanfacine clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Attention deficit hyperactivity disorder in children**
- **Child** (By Mouth): 13-17 years (body-weight 58.5 kg and above) Initially 1 mg once daily; adjusted in steps of 1 mg every week if necessary and if tolerated; maintenance 0.05-0.12 mg/kg once daily (max. per dose 7 mg), for optimal weight-adjusted dose titrations, consult product literature.
**Attention deficit hyperactivity disorder in children for whom stimulants are not suitable, not tolerated or ineffective (initiated under specialist supervision) for guanfacine**
- **Child 6-12 years (body-weight 25 kg and above)** (By mouth): Initially 1 mg once daily; adjusted in steps of 1 mg every week if necessary and if tolerated; maintenance 0.05-0.12 mg/kg once daily (max. per dose 4 mg), for optimal weight-adjusted dose titrations, consult product literature.
- **Child 13-17 years (body-weight 34-41.4 kg)** (By mouth): Initially 1 mg once daily; adjusted in steps of 1 mg every week if necessary and if tolerated; maintenance 0.05-0.12 mg/kg once daily (max. per dose 4 mg), for optimal weight-adjusted dose titrations, consult product literature.
- **Child 13-17 years (body-weight 41.5-49.4 kg)** (By mouth): Initially 1 mg once daily; adjusted in steps of 1 mg every week if necessary and if tolerated; maintenance 0.05-0.12 mg/kg once daily (max. per dose 5 mg), for optimal weight-adjusted dose titrations, consult product literature.
- **Child 13-17 years (body-weight 49.5-58.4 kg)** (By mouth): Initially 1 mg once daily; adjusted in steps of 1 mg every week if necessary and if tolerated; maintenance 0.05-0.12 mg/kg once daily (max. per dose 6 mg), for optimal weight-adjusted dose titrations, consult product literature.
- **Child 13-17 years (body-weight 58.5 kg and above)** (By mouth): Initially 1 mg once daily; adjusted in steps of 1 mg every week if necessary and if tolerated; maintenance 0.05-0.12 mg/kg once daily (max. per dose 7 mg), for optimal weight-adjusted dose titrations, consult product literature.
Cautions
Bradycardia (risk of torsade de pointes); heart block (risk of torsade de pointes); history of cardiovascular disease; history of QT-interval prolongation; hypokalaemia (risk of torsade de pointes)
Side effects
Common or very common Anxiety; appetite decreased; arrhythmias; asthenia; constipation; depression; diarrhoea; dizziness; drowsiness; dry mouth; gastrointestinal discomfort; headache; hypotension; mood altered; nausea; skin reactions; sleep disorders; urinary disorders; vomiting; weight increased Uncommon Asthma; atrioventricular block; chest pain; hallucination; loss of consciousness; pallor; seizure; syncope Rare or very rare Hypertension; hypertensive encephalopathy; malaise Frequency not known Erectile dysfunction Side-effects, further information Somnolence and sedation may occur, predominantly during the first 2-3 weeks of treatment and with dose increases; manufacturer advises to consider dose reduction or discontinuation of treatment if symptoms are clinically significant or persistent. Overdose Features may include hypotension, initial hypertension, bradycardia, lethargy, and respiratory depression. Manufacturer advises that patients who develop lethargy should be observed for development of more serious toxicity for up to 24 hours.
Interactions
**Other interactions (2):**
- Combinations not recommended: Medicinal products which enhance the risk of torsade de pointes or could prolong the QT interval: bradycardia-inducing medicinal products such as beta-blockers,...
- There is a risk of cardiac failure in case of class Ia or Ic antiarrhythmics concomitant intravenous therapy.
Pregnancy
Manufacturer advises avoid-toxicity in animal studies.
Breast feeding
Manufacturer advises avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises caution (pharmacokinetics have not been assessed in paediatric patients with hepatic impairment). Dose adjustments Manufacturer advises consider dose reduction.
Renal impairment
Dose adjustments Dose reduction may be required in severe impairment and end-stage renal disease (no information available in children with renal impairment). M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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