What is the usual effective dose of guanfacine (Intuniv) for adults with attention deficit hyperactivity disorder (ADHD)?

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Last updated: April 21, 2025View editorial policy

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From the Research

The usual effective dose of guanfacine for adults is 4-6 mg taken once daily, as demonstrated by the most recent and highest quality study 1.

Key Considerations

  • The medication is often taken at bedtime due to its sedative effects.
  • For attention deficit hyperactivity disorder (ADHD) in adults, the target dose is typically 4-6 mg daily, with careful titration to minimize side effects, as shown in the study 1.
  • Extended-release formulations are preferred for ADHD treatment with once-daily dosing.
  • Guanfacine works as a centrally-acting alpha-2A adrenergic receptor agonist, reducing sympathetic outflow from the brain and improving prefrontal cortex functioning.
  • Patients should be aware that abrupt discontinuation can cause rebound hypertension, so the medication should be tapered gradually when stopping treatment.

Supporting Evidence

  • A randomized, double-blind, placebo-controlled study 1 demonstrated the efficacy and safety of guanfacine extended-release in adults with ADHD, with a significant improvement in ADHD symptoms and no major safety concerns.
  • The study 1 also showed that the most common treatment-emergent adverse events were somnolence, thirst, blood pressure decrease, nasopharyngitis, postural dizziness, and constipation, with most being mild to moderate in severity.
  • Another study 2 supported the long-term safety and efficacy of guanfacine extended-release in adults with ADHD, with significant improvements in ADHD symptoms, quality of life, and executive functioning.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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