Guanfacine is primarily used to treat two main conditions: attention deficit hyperactivity disorder (ADHD) and high blood pressure (hypertension).[1]
For ADHD, guanfacine extended-release (brand name Intuniv) is indicated for use in children and adolescents, either alone or alongside stimulant medications. It helps improve attention, reduce distractibility and impulsivity, and may also lessen oppositional or aggressive behaviors.[1] Guanfacine is considered particularly useful for patients who cannot tolerate stimulant medications.[1] Its mechanism involves acting on alpha-2A adrenergic receptors in the brain, which are thought to play a role in attention and impulse control, though the precise mechanism for ADHD is not fully understood.[6] It is important to note that stimulant medications remain the first-line treatment for ADHD, and guanfacine is generally used as an alternative or adjunct.[1]
For high blood pressure, immediate-release guanfacine (brand name Tenex) is FDA-approved and works by decreasing heart rate and relaxing the blood vessels, allowing blood to flow more easily and reducing the workload on the heart.[3] This can help lower the risk of complications associated with chronic high blood pressure, such as heart attacks and stroke.[4]
Guanfacine may also be prescribed for other off-label uses at the discretion of a healthcare provider, but its main approved roles are for ADHD (extended-release) and hypertension (immediate-release).[2]