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Guanfacine is a presynaptic alpha-2 adrenergic receptor agonist (similar to clonidine) that is FDA approved to treat ADHD in pediatric patients 6 years of age and older. A recently published study characterized the pediatric exposure to guanfacine between 2000 and 2016.
- 10927 single exposures to guanfacine were identified.
- Guanfacine exposure increased in all age group starting 2009
- Highest exposure rate was in 6-12 years old population
Most frequently reported clinical effect (n=10927)
- Drowsiness (n=4262; 39.0%)
- Bradycardia (n=1696; 15.5%)
- Hypotension (n=1127; 10.3%)
- Dizziness (n=279; 2.6%)
- Hypertension (n=199; 1.8%)
Severe clinical effects (n=10927)
- Respiratory depression (n=47; 0.43%)
- Coma (n=24; 0.22%)
- Respiratory arrest (n=5; 0.05%)
- Cardiac arrest (n=1; 0.01%)
Duration of clinical effect
- 8 to 24 hours: > 80%
Conclusion
- Severe toxicity (respiratory depression/arrest and cardiac arrest) is rare with unintentional guanfacine exposure.
- If symptomatic, majority of the patients were asymptomatic within 24 hours.