INTUNIV (guanfacine hydrochloride)

Absorption and

DistributionGuanfacine is readily absorbed and approximately 70% bound to plasma proteins independent of drug concentration. After oral administration of INTUNIV the time to peak plasma concentration is approximately 5 hours in children and adolescents with ADHD. Immediate-release guanfacine and INTUNIV have different pharmacokinetic characteristics; dose substitution on a milligram per milligram basis will result in differences in exposure. A comparison across studies suggests t...

Efficacy of INTUNIV in the treatment of ADHD was established in children and adolescents (6 to 17 years) in: Five short-term, placebo-controlled monotherapy trials (Studies 1, 2, 4, 5, and 6). One short-term, placebo-controlled adjunctive trial with psychostimulants (Study 3). One long-term, placebo-controlled monotherapy maintenance trial (Study 7). Studies 1 and 2: Fixed-dose INTUNIV Monotherapy Study 1 (301 study) was a double-blind, placebo-controlled, parallel-group, fixed-dose study, in which efficacy of once daily dosing with INTUNIV (2 mg, 3 mg, and 4 mg) was evaluated for 5 weeks (n=3...

The following serious adverse reactions are described elsewhere in the labeling: Hypotension, bradycardia, and syncope [see Warnings and Precautions (5.1) ] Sedation and somnolence [see Warnings and Precautions (5.2) ] Cardiac conduction abnormalities [see Warnings and Precautions (5.3) ] Rebound Hypertension [see Warnings and Precautions (5.4) ] Most common adverse reactions (≥5% and at least twice placebo rate) in fixed-dose monotherapy ADHD trials in children and adolescents (6 to 17 years): ...

INTUNIV is contraindicated in patients with a history of a hypersensitivity reaction to INTUNIV or its inactive ingredients, or other products containing guanfacine. Rash and pruritus have been reported. History of hypersensitivity to INTUNIV , its inactive ingredients, or other products containing guanfacine ( 4 ).

Hypotension, bradycardia, syncope: Titrate slowly and monitor vital signs frequently in patients at risk for hypotension, heart block, bradycardia, syncope, cardiovascular disease, vascular disease, cerebrovascular disease or chronic renal failure. Measure heart rate and blood pressure prior to initiation of therapy, following dose increases, and periodically while on therapy. Avoid concomitant use of drugs with additive effects unless clinically indicated. Advise patients to avoid becoming dehy...

7 DRUG INTERACTIONS Table 14 contains clinically important drug interactions with INTUNIV [see Clinical Pharmacology (12.3) ].

Table 14Clinically Important Drug Interactions: Effect of other Drugs on INTUNIV Concomitant Drug Name or Drug Class Clinical Rationale and Magnitude of Drug Interaction Clinical Recommendation Strong and moderate CYP3A4 inhibitors, e.g., ketoconazole, fluconazole Guanfa...