From the Guidelines
Intuniv XR (guanfacine extended-release) for adults with ADHD typically exerts its effect at doses between 1 to 7 mg/d, with a recommended target dose range of 0.05 to 0.12 mg/kg/d. The treatment usually begins with a starting dose of 1 mg once daily, with titration by 1 mg/wk based on response and as tolerated to the recommended target dose range 1. It is essential to note that the efficacy of guanfacine for the treatment of ADHD in adults is limited, and alternative agents may be preferred. The medication works by activating alpha-2A adrenergic receptors in the prefrontal cortex, improving executive functions like attention, impulse control, and working memory.
Some key points to consider when prescribing Intuniv XR for adults with ADHD include:
- Starting with a low dose and gradually increasing as needed and tolerated
- Monitoring blood pressure and heart rate regularly due to the potential for Intuniv XR to lower both parameters
- Being aware of common side effects such as drowsiness, fatigue, dry mouth, and dizziness, which often improve over time
- Avoiding abrupt cessation of the medication to prevent rebound hypertension. As noted in the study by Scoten 1, guanfacine could be considered in the treatment of ADHD following a risk-benefit discussion, acknowledging the very limited information on its safety in pregnancy and the limited data on its efficacy for the treatment of ADHD in adults.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Dosage of Intuniv XR for ADHD in Adults
- The provided studies do not specifically mention the dosage of Intuniv XR for ADHD in adults.
- However, study 2 mentions that in children and adolescents, the dosage of guanfacine extended release (GXR) was increased weekly to the highest tolerated dose (1,2,3, or 4 mg/day).
- Study 3 discusses the chemistry, pharmacokinetics, mechanism of action, and dosage of GXR, but does not provide specific information on the dosage for adults.
- Studies 4, 5, and 6 do not provide information on the specific dosage of Intuniv XR for ADHD in adults.
Available Information
- The studies provided focus on the treatment of ADHD in children and adolescents, with limited information on the treatment of adults.
- Study 2 provides information on the safety and effectiveness of coadministering GXR with psychostimulants in children and adolescents, but does not address the dosage for adults.
- Further research is needed to determine the effective dosage of Intuniv XR for ADHD in adults, as the available studies do not provide sufficient information on this topic 3, 4, 5, 6, 2.