From the Guidelines
Guanfacine extended-release (ER) tablets should not be crushed, chewed, or broken, but immediate-release tablets can be crushed and mixed with a small amount of soft food if necessary. When considering the administration of guanfacine, it's crucial to differentiate between the immediate-release and extended-release formulations due to their distinct delivery mechanisms. The extended-release formulation is designed to release the medication over a prolonged period, and altering its form by crushing or chewing could lead to the release of the entire dose at once, potentially increasing the risk of side effects such as hypotension and drowsiness 1. In contrast, immediate-release guanfacine tablets can be crushed if the patient has difficulty swallowing them, but it's recommended to mix the crushed tablet with a small amount of soft food like applesauce to facilitate easier ingestion. It's essential to consult with a healthcare provider before making any changes to the form of guanfacine or any other medication, especially for extended-release formulations, to discuss alternative options or formulations that may be more suitable for the patient's needs. The most recent and highest quality study available does not directly address the crushing of guanfacine tablets, but based on the understanding of extended-release mechanisms and the potential risks associated with altering them, the recommendation leans towards caution and consulting healthcare professionals for guidance 1. Key considerations include the potential for increased side effects with improper administration of extended-release medications and the importance of maintaining the therapeutic efficacy of the medication by using it as prescribed. Always prioritize consulting with a pharmacist or doctor before altering any medication form to ensure the safest and most effective treatment outcome.
From the Research
Guanfacine Administration
- The provided studies do not directly address whether guanfacine can be crushed 2, 3, 4, 5, 6.
- Guanfacine is typically administered as an extended-release formulation, but there is no information on the effects of crushing this formulation 2.
- The studies focus on the efficacy and safety of guanfacine in treating attention-deficit/hyperactivity disorder (ADHD) and do not discuss the physical properties of the medication or its administration 3, 4, 6.
- One study mentions the use of immediate-release guanfacine in very young children, but does not address the question of crushing the medication 5.
Pharmaceutical Considerations
- Guanfacine is an α2A-adrenergic receptor agonist, and its pharmacology may be affected by factors such as age and dosage 2, 5.
- The medication has been shown to be effective in treating ADHD, with a significant reduction in symptoms compared to placebo 3, 4, 6.
- However, the studies do not provide information on the physical properties of guanfacine or its suitability for crushing 2, 3, 4, 5, 6.