Intuniv (guanfacine)

ADHD in children and young people (6-17 years) when stimulants are not suitable, not tolerated, or have not been effective. Can be used alone or as an add-on to stimulants for enhanced effect. Licensed only for children/young people in the UK, though used off-label in adults in some specialist centres.

Guanfacine stimulates alpha-2A adrenergic receptors in the prefrontal cortex, strengthening the neural connections that underpin working memory, attention regulation and impulse control. Unlike stimulants, it doesn’t increase dopamine in reward pathways. It also reduces noradrenergic ‘noise’ in the brain, which is why it has a calming effect and can reduce tics, emotional reactivity and hyperarousal.

Children and young people 6-17 with ADHD when stimulants aren’t an option. Particularly effective for: ADHD with prominent hyperactivity/impulsivity, ADHD with co-existing tic disorder or Tourette syndrome (may improve both), ADHD with emotional dysregulation or oppositional behaviour, and ADHD with significant sleep difficulties (guanfacine can improve sleep). Can be combined with a stimulant for additive benefit. Lowers blood pressure - caution in patients with low BP or those on antihypertensives.

Order online and we review your request. A prescriber checks your consultation form for clinical appropriateness and contacts you if anything else is needed. Once approved, your medication is dispensed and delivered to your door.

Tracked: Tracked delivery, arrives in two working days - Free

When it arrives: Every order is sent tracked. Where this page says in post today, it goes out today. Where it says in post tomorrow, it goes out the next working day. On the rare occasions a medicine is unavailable, we will contact you to talk about timing and alternatives.

We dispense clinically equivalent generic medications where available. Prices shown are for the generic version. If you prefer the branded version, let us know in your order form and we will confirm any price difference.

Guanfacine from £69.99 per pack.

Common: decreased appetite, nausea, abdominal pain, headache, drowsiness. Atomoxetine: increased heart rate, raised blood pressure, mood changes. Guanfacine: sedation, bradycardia, hypotension.

Atomoxetine: avoid in phaeochromocytoma, severe cardiovascular disorders, narrow-angle glaucoma. Guanfacine: avoid in significant cardiac conduction disorders.

Atomoxetine: CYP2D6 inhibitors (fluoxetine, paroxetine) increase levels. MAOIs: avoid. Guanfacine: CYP3A4 inhibitors/inducers affect levels. Both: caution with QT-prolonging drugs.

Limited data in pregnancy. Stimulants may affect fetal growth. Use only if benefit clearly outweighs risk. Discuss with specialist before conception. Not recommended during breastfeeding.

Start at 1mg daily, increase by 1mg per week to optimal dose (usually 0.05-0.12 mg/kg/day). Take at the same time each day (morning or evening). Do NOT crush or chew (prolonged-release). Causes drowsiness, especially at start - this usually settles but can be beneficial for sleep. Lowers blood pressure and heart rate - monitor regularly. Do NOT stop abruptly (risk of rebound hypertension) - taper slowly. Not a controlled drug.