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.
