ADHD Treatment How the Non-Stimulant Treatment Intuniv Can Help Children With ADHD By Vincent Iannelli, MD Vincent Iannelli, MD Facebook Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years. Learn about our editorial process Updated on May 19, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Aron Janssen, MD Medically reviewed by Aron Janssen, MD LinkedIn Aron Janssen, MD is board certified in child, adolescent, and adult psychiatry and is the vice chair of child and adolescent psychiatry Northwestern University. Learn about our Medical Review Board Print Hinterhaus Productions / Getty Images Table of Contents View All Table of Contents Intuniv for ADHD Dosage Side Effects Warnings Should Your Child Try It? Intuniv is a non-stimulant treatment for attention-deficit/hyperactivity disorder (ADHD). It is a long-acting form of guanfacine, which had previously been used to treat high blood pressure. The medication was approved by the Food and Drug Administration (FDA) in September 2009. It was initially approved as a once-a-day treatment for children and adolescents 6 to 17 years old who have ADHD. Guanfacine had already been used off-label to treat children with ADHD who also have tics, sleep problems, or aggression. In 2011, Intuniv received a new indication for use as adjunctive therapy for ADHD. This meant that it could be used with a stimulant ADHD medicine such as Concerta, Focalin, Adderall XR, or Vyvanse, etc. It may also be used alone (monotherapy) to treat ADHD. Intuniv for ADHD Important factors to consider about taking Intuniv include: The pill must be swallowed whole. Intuniv is a pill, but unlike some other ADHD medications, like Qelbree, it cannot be crushed, chewed, or broken. It's not a controlled substance. Like Strattera and Kapvay, other non-stimulants for ADHD, Intuniv is not a controlled substance, which can make getting refills easier for parents. It does not cause much appetite suppression. Unlike other ADHD medications—especially stimulants like Adderall, Concerta, or Vyvanse—a benefit of Intuniv is that it does not cause much appetite suppression. This can make it a good choice for children who have problems gaining weight when taking a stimulant. Dosage Intuniv is available in four dosage strengths: 1 milligram2 milligrams3 milligrams4 milligrams Most children will start Intuniv at the 1 milligram dosage and then increase by 1 milligram each week until they get to a target dose of 3 milligrams or 4 milligrams. Keep in mind that since you may have to increase the dosage, it could take three or four weeks to see an improvement in your child's ADHD symptoms once they start to take Intuniv. In 2014, the FDA allowed more weight-based, flexible pediatric dosing, with maximum doses up to 7 milligrams for older teens. Weight-based target doses range from 0.05 to 0.12 milligram/kilogram/day. Side Effects Side effects of Intuniv most commonly include: Somnolence (which can occur in up to 38% of patients)HeadachesFatigueUpper abdominal painNauseaLethargyDizzinessIrritabilityDecreased blood pressureDecreased appetite Although somnolence occurs in a large number of children when they start taking Intuniv, it seems to get better as they continue to take it. For some children this is a benefit as it helps them fall asleep if they are given their dose at bedtime. (Intuniv can either be given in the morning or the evening.) Warnings Warnings about Intuniv include: It should be used cautiously if your child is at risk for certain health conditions. These include low blood pressure, bradycardia (low heart rate), heart block, or syncope (fainting).It should be used cautiously if your child is also taking certain medications. These include ketoconazole, rifampin, valproic acid, antihypertensive drugs, or CNS depressants (sedatives, antipsychotics, etc.).It should not be taken with a high-fat meal. It can be taken with water, milk, or other liquids.It should not be stopped suddenly. Instead, the medication should be discontinued slowly, by decreasing or tapering the dose over several weeks. The Pediatric Focused Safety Review by the FDA in 2018 recommended routine monitoring of Intuniv. Should Your Child With ADHD Try Intuniv? Intuniv may be an especially good option if your child's current medication simply isn't working well, they haven't been able to tolerate other stimulants because of side effects, or if you have been wary of putting them on a stimulant. As with Tenex, immediate-release guanfacine, Intuniv may be used to treat children with ADHD and tics, sleep problems, or aggression, either by itself or with a stimulant. 4 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Department of Health and Human Services. Pediatric postmarketing pharmacovigilance and drug utilization review. Published December 1, 2017. MedlinePlus. Guanfacine. Revised August 15, 2018. Food and Drug Administration. Pediatric focused safety review Intuniv® (guanfacine ER) pediatric advisory committee meeting. Published September 20, 2018. Cincinnati Children’s. Tics, Tourette syndrome and medications. Updated July 2018. Additional Reading Childress AC. Guanfacine extended release as adjunctive therapy to psychostimulants in children and adolescents with attention-deficit/hyperactivity disorder. Adv Therapy. 2012;29(5):385-400. doi:10.1007/s12325-012-0020-1 Elbe D, Reddy D. Focus on guanfacine extended-release: a review of its use in child and adolescent psychiatry. J Can Acad Child Adolesc Psychiatry. 2014;23(1):48-60. Food and Drug Administration. Intuniv highlights of prescribing information. Revised August 2020. Huss M, Dirks B, Gu J, Robertson B, Newcorn JH, Ramos-Quiroga JA. Long-term safety and efficacy of guanfacine extended release in children and adolescents with ADHD. Eur Child Adolesc Psychiatry. 2018;27(10):1283-1294. doi:10.1007/s00787-018-1113-4 By Vincent Iannelli, MD Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for ADHD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.