What is Intuniv?
Intuniv is the brand name for guanfacine extended-release (ER). It is a non-stimulant medication used to treat ADHD in children and teens. It may also decrease tics. Unlike stimulant medications, Intuniv works on a different part of the brain to help improve:
- Impulse control
- Emotional regulation
- Hyperactivity
- Sleep difficulties
It is often used alongside stimulants to help manage side effects like irritability or sleep trouble, or used on its own if stimulants are not well tolerated or are not effective enough.
How Does It Work?
Intuniv affects receptors in the brain that help calm overactive responses and support better focus and self-regulation. It does not work immediately—it takes time to build up in the body, which is why it needs to be started slowly.
Titration: How to Start Intuniv Safely
Titration means gradually increasing the dose over time to minimize side effects and find the best dose for your child.
If you are starting a new medication, changing doses or a medication, or want to track side effects and benefits, use one of the Medication Tracker Sheets:
- Version 1 is best to track when you take multiple medications that affect your mood and focus.
- Version 2 is best to track when you are titrating different amounts of a single medication.
Your provider will give specific instructions, but a typical titration schedule looks like this:
| Week |
Daily Dose |
|---|---|
| Week 1 |
1 mg at bedtime |
| Week 2 |
2 mg at bedtime |
| Week 3 |
3 mg at bedtime (if needed) |
| Week 4 |
4 mg at bedtime (if needed) |
| Week 5 |
5 mg at bedtime (over 12 years , if needed) |
| Week 6 |
6 mg at bedtime (over 12 years, if needed) |
| Week 7 |
7 mg at bedtime (over 12 years, if needed) |
📝 Not all children need the maximum dose. Your provider will stop increasing the dose once benefits are seen or if side effects occur. Increases may be made at a later time if symptoms return.
Important Tips for Use
- Give Intuniv at the same time each day, preferably at night, as it can cause sleepiness.
- If it is forgotten at bedtime and easier to remember in the morning, many children will adjust to a morning dose.
- Swallow whole — Do not crush, chew, or cut the tablet.
- If your child misses a dose by more than 12 hours, do not double up — call your provider for guidance.
- If your child misses more than 2 days in a row, do not restart without medical advice — restarting at a lower dose may be needed.
Possible Side Effects
Most side effects are mild and improve over time. Common side effects include:
- Sleepiness or fatigue
- Dizziness or lightheadedness
- Lower blood pressure or slow heart rate
- Headache or stomach upset
✅ Giving the dose at night can help reduce daytime drowsiness.
✅ Offer extra water and salty foods or an electrolyte drink if tired during the day or if your child experiences dizziness when standing up.
⚠️ Encourage your child to stand up slowly
from sitting or lying down to prevent dizziness.
Most side effects are mild and temporary. If your child continues to have them after the first 3-5 days, talk with your prescriber.
When to Call Your Provider
📞 Contact your child’s provider if you notice:
- Excessive sleepiness or hard-to-wake behavior
- Fainting, dizziness, or heart pounding
- Mood changes or unusual behavior
- Trouble tolerating the medication
Monitoring and Follow-Up
- Your child’s heart rate and blood pressure should be checked regularly, especially during dose changes or if dizziness or fatigue persist after a few days.
- It may take 2–6 weeks to see the full effect of Intuniv.
- Your provider will assess your child’s behavior, sleep, focus, and side effects to adjust the dose if needed.
Why Choose Intuniv?
- Good option if your child does not tolerate stimulants
- Child or teen must be able to swallow pills. If they are not able, Tenex, a short acting of guanfacine, is preferable.
- Helpful for evening behaviors and sleep
- Can smooth out rebound effects from stimulant medications
- May reduce emotional reactivity and irritability
Questions?
If you have any questions about how to start, adjust, or monitor Intuniv, please contact your child’s prescribing provider. We are here to support you and your child every step of the way.
This information is for general educational purposes and should not replace specific medical advice from your provider.
