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Name: Chris
[ Original Post ]
My son is 7 and was given Guanfacine to help his adhd. It is a medication that is usually used for treatment of high blood pressure but dr's are giving it to children with adhd because it doen't have all of the side effects that normal adhd stimulants have. I am just concerned that my son's blood pressure may drop. I wanted to know if anyone else has tried it. It's also known as Tenex.
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Name: Googled It For Ya!!! HTH | Date: Oct 10th, 2005 5:48 AM
Guanfacine (GWAHN-fa-seen) belongs to the general class of medicines called antihypertensives. It is used to treat high blood pressure (hypertension).

High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Guanfacine works by controlling nerve impulses along certain nerve pathways. As a result, it relaxes blood vessels so that blood passes through them more easily. This helps to lower blood pressure.

Guanfacine is available only with your doctor's prescription, in the following dosage form:

Tablets (U.S.)

Before Using This MedicineReturn to top
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For guanfacine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to guanfacine. Also tell your health care professional if you are allergic to any other substance, such as foods, preservatives, or dyes.

Pregnancy—Guanfacine has not been studied in pregnant women. However, guanfacine has not been shown to cause birth defects or other problems in rats or rabbits given many times the human dose. In rats and rabbits given extremely high doses (up to 200 times the human dose), there was an increase in deaths of the animal fetus.

Breast-feeding—It is not known whether guanfacine passes into breast milk. However, this medicine has not been reported to cause problems in nursing babies.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of guanfacine in children with use in other age groups.

Older adults—Dizziness, drowsiness, or faintness may be more likely to occur in the elderly, who are more sensitive to the effects of guanfacine.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of guanfacine. Make sure you tell your doctor if you have any other medical problems, especially:
Heart disease or
Heart attack or stroke (recent)—Lowering blood pressure may make problems resulting from these conditions worse
Liver disease—Effects may be increased because of slower removal of guanfacine from the body
Mental depression—Guanfacine may cause mental depression

Proper Use of This MedicineReturn to top
In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to use it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Take your daily dose of guanfacine at bedtime. (If you are taking more than one dose a day, take your last dose at bedtime.) Taking it this way will help lessen daytime drowsiness.


The dose of guanfacine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of guanfacine. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine.

For oral dosage form (tablets):
For high blood pressure:
Adults—At first, 1 milligram (mg) once a day at bedtime. Then, your doctor may gradually increase your dose up to 3 mg a day, if needed.
Children—Dose must be determined by your doctor.
Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. If you miss taking guanfacine for two or more days in a row, check with your doctor. If your body suddenly goes without this medicine, some unwanted effects may occur. If you have any questions about this, check with your doctor.


To store this medicine:

Keep out of the reach of children.
Store away from heat and direct light.
Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
Do not keep outdated medicine or medicine no longer needed. Be sure any discarded medicine is out of the reach of children.

Precautions While Using This MedicineReturn to top
It is important that your doctor check your progress at regular visits to make sure this medicine is working properly.

Check with your doctor before you stop taking guanfacine. Your doctor may want you to reduce gradually the amount you are taking before stopping completely.

Make sure that you have enough guanfacine on hand to last through weekends, holidays, and vacations. You should not miss any doses. You may want to ask your doctor for another written prescription for guanfacine to carry in your wallet or purse. You can then have it filled if you run out when you are away from home.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Guanfacine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

Guanfacine may cause some people to become dizzy, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

Guanfacine may cause dryness of the mouth, nose, and throat. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if dry mouth continues for more than 2 weeks, check with your physician or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Side Effects of This MedicineReturn to top
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common
Confusion; mental depression

Signs and symptoms of overdose
Difficulty in breathing; dizziness (extreme) or faintness; slow heartbeat; unusual tiredness or weakness (severe)

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common
Constipation; dizziness; drowsiness; dryness of mouth

Less common
Decreased sexual ability; dry, itching, or burning eyes; headache; nausea or vomiting; trouble in sleeping; unusual tiredness or weakness

After you have been using this medicine for a while, unwanted effects may occur if you stop taking it too suddenly. After you stop taking this medicine, check with your doctor if any of the following side effects occur:

Anxiety or tenseness; chest pain; fast or irregular heartbeat; headache ; increased salivation; nausea or vomiting; nervousness or restlessness; shaking or trembling of hands and fingers; stomach cramps; sweating; trouble in sleeping

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor 

Name: MSN says! HTH | Date: Oct 10th, 2005 5:50 AM
Guanfacine to treat ADHD
Can provide for 24/7 modulation of impulsivity, hyperactivity, aggression and sensory hypersensitivity. This covers most out of school problems, so stiumlant use can be limited to school and homework hours. Improves appetite. Less sedating than clonidine. 

Name: Angie Jones | Date: Oct 19th, 2005 12:42 AM
Hello, I teach first grade in Tennessee. I have a little girl who is on guanfacine. She is bipolar and adhd. It works wonders for her. Without it, I usually have to send her home because of her inability to even concentrate or complete assignments. 

Name: caroline | Date: Nov 14th, 2005 6:23 AM
hello my son is 8 years old and he is on ritalin and he does have high blood pressure . i have not been told he has got it but i can tell he has it . his ears gets really red when he plays like they are on fire and ive taken him to the docs and they have seen him like that so i need some help tring to figure out how i can help my child.thank you 

Name: Megan | Date: Mar 24th, 2006 11:42 PM
I used to have my daughter on guanfacine and it worked for only a few months. She was always tired. It didn't really help with the ADHD just made her sleepy. 

Name: Susan | Date: Apr 26th, 2006 2:17 AM
My son was on Tenex for nearly 5 years until we recently were able to take him off of it. His drs weaned him off so his BP would remain steady. Its been nearly a yr since we stopped the med and he is doing find. Besides getting prescriptions, he was regularly being seen for BP checks and monitering each month. Afterwards, it was a three-month visit for the Adderall XR. His drs had hoped as he grew he would need less medication and not having Tenex was a step in the right direction. It along with the Adderall changed him. He is now a straight A and B student who, although has outbursts every now and again, will listen and actually do as he is told. We never had a problem with the medication but it is one less pill he has to take. 

Name: Sonja | Date: May 19th, 2006 7:46 AM
My son (6) who has adhd started out taking Staterra. It did nothing. Dr. then put him on Concertta 18 mg. It helped, but still had some problems. He uped it to 27 mg. It worked great for 8 mo. then started showing attention problems and increased hyperactivity again. Dr. then uped it to 36 mg. I see no difference after 3 wks. I just found out he also has Asberger's Syndrome. I heard it could be why the meds are not working correctly. Any knowledge about this or suggestions? 

Name: Marie | Date: Jun 16th, 2006 3:44 PM
My son, 12 years old, was also given Guanfacine for ADHD but I did not see where it helped him. It seemed to make him more irritable.

Good luck! 

Name: Kristie | Date: Jun 17th, 2006 12:29 AM
Yes my son greg has been on it for three days. I to worry that it may drop my son's blood pressure. My son is adhd also the medication seems to make him very sleepy. He only 6 i hate seeing him this way. 

Name: kstevars | Date: Oct 28th, 2006 1:36 AM
my son took tenex for a while but dr. took him off of it because it wasn't working after awhile. he never had a problem with his blood pressure. 

Name: flamom | Date: Oct 28th, 2006 9:44 PM
Hi. I have not heard of Guanfacine. My 10 yr old started Focalin three weeks ago and is doing well with behavior in school. What I like is; appetite is good (eats lunch and snack) not tired and does not have the "glazed eye" look. It is stronger than Adderall. Taking only 2.5mg and it's strong and works for 6 hrs. Good luck to everyone. 

Name: DeeDee | Date: Nov 11th, 2006 3:56 AM
My son takes texex with his Adderrall. A lot of doctors use it with Adderrall, it kind of goes hand in hand. The affect for it is that sometimes the Adderrall does not last through the afternoon and I don't want to give him more in the afternoon for the fear that he may not sleep at night. The tenex comes in as a "cover" for the last few hours of the afternoon when the adderrall wears off. It lasts throught the day and I give them both in the a.m. 

Name: A concerned mom | Date: Sep 27th, 2007 4:30 AM
My daughter is 13 and she was given guanfacine (aka tenex) to help her adhd. It doesn't help her it makes her feel shaky. And she stays up at night. And she doesn't eat as much as she use too. Does your son also take concerta or ritalin? Does your son hallucinate? 

Name: Michelle | Date: Sep 27th, 2007 4:30 PM
Excuse me. I have a question for hth. Did you have to type all of that, or is there some way to transfer it without having to type it?
Sorry to interrupt the subject. 

Name: Leigh Ann | Date: Oct 1st, 2007 4:50 AM
Yes, my child takes that along with strattera, mostly the guanfacine is only to calm them to sleep. It really doesn't help mine as much. 

Name: malejr | Date: Oct 2nd, 2007 12:47 AM
I just watched a segment on 20/20 last night about a 4 year old who was givin blood pressure medication for adhd. The parents gave her a half a pill one evening, tucked her in and the next morning she was dead. I dont want to scare you but I think I would question this treatment if I were you. My son is having alot of problems right now with medications, and I have to say that when I watched that program it scared me. I think maybe if you go to CBS website maybe you could find something on this segment from September 30th . Good Luck and God Bless 

Name: Helene furst | Date: Oct 21st, 2007 10:17 PM
My 10 !/2 year old has also been prescribed Tenex to treat ADHD -the pediatrician believes it the safest course as most of his issues lie in irritability and hyperactivity. He is very bright and the meds have not hindered his academic performance at all. We have not seen any drop in blood pressure, however if the dose is too high, we noticed that our son becomes drowsy and unfocused - much like a "zombie". Upon lowering the dose, he seems a bit better- we may need to bring it down anothe 1/2 mg. The psych. said that there is no higher dose of Tenex than 4 mg, so keep an eye on this regarding your child. It seems to be the least offensive and the least invasive of all the other drug options we were offered.
- we are new to this, but I have been doing alot of research about the drug and how it interacts within the child's body...it seems OK, at least for now. 

Name: confused about ADHD treatment | Date: Nov 30th, 2007 10:19 PM
My son who just turned 3 in Nov. was prescribed Guanfacine for his ADHD...I am just wondering, how long is it going to take before his body gets used to the meds and he will be the fun loving child who loves to play and laugh again...His behavior is much better but he just stays so tired...he has only been on the meds for about 3 full days... 

Name: carol | Date: Dec 7th, 2007 7:59 PM
My son is 9 and started on tenex several weeks ago. I was giving it to him at night, but recently started in a.m., doesn't seem to make him very tired, no side effects. But can't say I notice any better focus, maybe a little less hyper. He takes 1mg.Blood pressure seems fine. 

Name: Holly | Date: Dec 12th, 2007 6:11 AM
Yes my daughter takes that, has been for 2 years and blood pressure is normal(just make sure the doc is checking it regularly). She cant take adderall without it, she is so mean otherwise 

Name: Nichole | Date: Dec 29th, 2007 4:40 AM
My son is 11 and has been on ADHD medication for 6 years now. Just recently they put him on guanfacine. I too was concerned about the HBP medication. After doing a lot of research myself, they are unclear of the exact reason that it works, they just know it works. With the blood pressure that your son has now, with the ADHD it is highly unlikely that his pressure will become too low. I myself would watch closely, if it is affecting it, you will notice him getting tired just after the dose. I am not a doctor, but after years of going through this I am willing to lend a helping hand!! 

Name: [email protected] | Date: Jan 6th, 2008 9:58 PM
yes I have heard that it does help ADHD.
Does it help OCD? 

Name: mercia123 | Date: Jan 31st, 2008 3:52 AM
Hi Chis,

My son is 5 years old and he started Guanfacine yesterday. I am wondering too if his blood pressure may drop...He was on Risperdal before because of his aggressive behavior, but after 4 months it stopping working. 

Name: vivian | Date: Feb 15th, 2008 4:55 AM
my son was prescibed guanfacine when he was 7 and has been taking it for about 10 months now. At first he was always cold even in the summer. BP was a little low but dr not concerned. But after maybe 6 months that went away w/ BP remaining low. The recommendation I found on WebMD is to get a baseline BP at the beginning and monitor it. We give it in the morning and he has fallen asleep in class 2 or 3 times but then we adjusted it down a 1/4 mg. That worked. My son doesnt have adhd but does have trichotillomania. 

Name: Melissa | Date: Mar 11th, 2008 3:26 AM
This is a response to malejr's comment about the 20/20 show. 20/20 airs on ABC not CBS and I looked it up at the girl was over medicated by her parents. It wasn't a simple dose of blood pressure medicine. She was on clonidine, depakote, cough medicine and an antihistamine. They said the clonidine alone would have killed her. Here is the link to the story http://abcnews.go.com/US/wireStory?id=2976660 

Name: Gail | Date: Sep 17th, 2008 1:14 PM
My son started taking the medication a month ago. He is sleeping in class from 1 to 2 hours. The doctor told me that this side effect will wear off, but it has not. But when my son stops taking the medication he is horrible to deal with. My son take 1/4 of a 1 mg pill in the morning and at night. But as I said it makes his behavior torable, but he is sleepy all the time. 

Name: [email protected] | Date: Jan 9th, 2009 8:41 PM

Yes, we started our son on it the last few weeks to help with what some Dr's that he seen, with ADHD.

We have noticed a small change in the evenings, but during the morning and throught the day he's tired. His teacher has been asked if he's been getting enough sleep.

Thinking we might lower the dose.... not sure we are 100% comfortable wiht whats happening. 

Name: ejohnny | Date: Jan 9th, 2009 9:01 PM
Does any one have opinions on dosage amounts? ANy information on lowerin gor increasing the dose? Currently, he takes 1/2 teaspoon at night. and 1/4 teaspoon in the morning. Mornings are when he's tired. Also when he sleeps, there's been more deam recall, talking in his sleep, and waking up.

I'm thikning about lowering his dose as I don't like his tired appearence. His teacher said he seemed to b ein a "drunk" llike state. 

Name: elaine | Date: Jan 11th, 2009 1:11 AM
My son uses clonidine, 1/2 of 0.1 tablet 4 times a day. It has been very effective and his has held steady. 

Name: Steph | Date: Jan 23rd, 2009 11:24 PM
My son has been on Guanfacine for almost 15 years. We had tried Clonidine when he was younger (3 1/2) and it made him very sleepy and extremely irritable. He has autism but is high functioning. Guanfacine slows down his motor activity while the stimulent medication ( Ritalin LA) allows him to focus on the task at hand. I have monitored his blood pressure thru out the years and it has never been a problem. 

Name: Tito Rodriguez | Date: Oct 6th, 2009 3:37 PM
Your son should get initial blood pressures and thereafter probably in a week to see how is he reacting to the medication and to make sure hypotension won't present. It is a medication used usually in combination with psychostimulants whenever oppossitional defiant disorder is present or questioned..it wont help as psychostimulants in reference to the control of focusing. 

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