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Intuniv vs Tenex
Introduction
For patients with attention deficit hyperactivity disorder (ADHD), certain drugs that alter the concentrations of compounds in the brain that are linked to impulse control and hyperactivity can aid in managing symptoms. Intuniv and Tenex are two such drugs that are prescribed for ADHD. They each impact different neurotransmitters in the brain, but both have effects in patients with ADHD. Intuniv is a long-acting form of guanfacine, affecting the prefrontal cortex, the area of the brain responsible for impulse control. Tenex, on the other hand, is a short-acting form of the same drug, guanfacine, and is often used to treat high blood pressure. However, it also has a calming effect on the neurotransmitters, making it a beneficial treatment for ADHD.
Intuniv vs Tenex Side By Side
| Attribute | Intuniv | Tenex |
|---|---|---|
| Brand Name | Intuniv | Tenex |
| Contraindications | Should not be taken if you are taking, or have been taking any medication that affects heart rhythm. Can lower your blood pressure too much when combined with certain other medications like beta-blockers or calcium channel blockers. | Should not be taken if you are taking, or have been taking any medication that affects heart rhythm. Can lower your blood pressure too much when combined with certain other medications like beta-blockers or calcium channel blockers. |
| Cost | A package of 30 tablets of Intuniv (1 mg) averages around $380, which works out to approximately $12.60/day. | The price for 30 tablets of Tenex (1mg) is about $210, or roughly $7/day. |
| Generic Name | Guanfacine | Guanfacine |
| Most Serious Side Effect | Thoughts of suicide or self-harm, signs of allergic reaction, rapid and irregular heartbeat, heart palpitations, chest pain, low blood pressure symptoms, severe nervous system reaction, symptoms indicating high blood sugar levels. | Signs of an allergic reaction, slow heart rate or a feeling like you might pass out, depression, mental confusion or hallucinations, unusual changes in mood or behavior, severe skin reactions, vision problems. |
| Severe Drug Interactions | Medications that affect heart rhythm, beta-blockers, calcium channel blockers. | Medications that affect heart rhythm, beta-blockers, calcium channel blockers. |
| Typical Dose | Oral doses range from 1-4 mg per day, with a starting dose usually at 1 mg/day. | Treatment generally starts at a dosage of 0.5 mg/day. The dose can then be increased weekly by an additional 0.5 mg per day if needed, divided into two doses and spaced 12 hours apart. The maximum recommended dose is 2 mg/day. |
What is Intuniv?
Guanfacine (the generic name for Intuniv) is a type of non-stimulant medication primarily used for the treatment of Attention Deficit Hyperactivity Disorder (ADHD), a significant step forward from the traditional stimulant medications used to manage this condition. Guanfacine was first approved by the FDA in 2009. Intuniv works by stimulating receptors in the prefrontal cortex of the brain, helping to improve memory and impulse control. It is prescribed for the management of ADHD symptoms in children and adolescents. Intuniv has a selective influence on the alpha-2A adrenergic receptor, with no significant impact on other adrenergic receptors, resulting in it having fewer side effects than other ADHD medications that have stronger effects on these other receptors. On the other hand, Tenex, also a guanfacine, is primarily used for the management of high blood pressure. Its use in ADHD has been off-label until the development of Intuniv, a longer-lasting version specifically developed and approved for ADHD.
What conditions is Intuniv approved to treat?
Intuniv is approved by the FDA for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in pediatric patients aged 6 to 17:
- As monotherapy, meaning it can be used on its own
- As adjunctive therapy to stimulant medications
Tenex, while not specifically approved for ADHD, is often utilized off-label for this condition and related symptoms. It's primarily used as an antihypertensive drug.
How does Intuniv help with these illnesses?
Intuniv operates in the brain by stimulating receptors called alpha-2A adrenergic receptors. By doing this, it can reduce hyperactivity and impulsivity and help to improve attention span. These receptors are found on the surfaces of certain brain cells and play an important role in controlling the release of neurotransmitters, chemicals that transmit signals in the brain. When Intuniv stimulates these receptors, it helps to lower the levels of norepinephrine, another neurotransmitter which is often elevated in individuals with ADHD. Therefore, by reducing norepinephrine, Intuniv can reduce the symptoms of ADHD and help patients manage their condition and improve their focus.
What is Tenex?
Tenex, the brand name for guanfacine, is a type of drug known as an alpha-2 adrenergic receptor agonist, which means it stimulates receptors in the brain that help reduce blood pressure. It also reduces nerve signals in your heart and blood vessels that cause your blood vessels to narrow or your heart to beat rapidly. Guanfacine was first approved by the FDA in 1986. It is not an ADHD medication like Intuniv, although it is sometimes used off-label to treat ADHD symptoms. Its lack of action on the brain's reward system means its side-effect profile is different to that of Intuniv, particularly in that it does not cause sedation and weight gain (common side effects of Intuniv). The effects on the heart and blood vessels can be beneficial for the treatment of high blood pressure, especially in patients who do not respond well to the "typical" blood pressure medications.
What conditions is Tenex approved to treat?
Tenex, also known as guanfacine, is approved by the FDA for treatment of:
- Hypertension (high blood pressure)
- Attention deficit hyperactivity disorder (ADHD) when used as part of a total treatment program that may include psychological, educational and social therapy.
How does Tenex help with these illnesses?
Tenex, known generically as guanfacine, is a medication that acts on the central nervous system and plays a key role in managing symptoms of attention deficit hyperactivity disorder (ADHD). By stimulating receptors in the prefrontal cortex, Tenex helps to reduce impulsivity and improve concentration, thereby alleviating some of the symptoms of ADHD. Its action on the norepinephrine system also aids in reducing blood pressure, which is why it was originally developed as an antihypertensive medication. While Intuniv, a long-acting form of guanfacine, is specifically approved for the treatment of ADHD, Tenex, although the same active ingredient, is often favored for its shorter half-life and flexibility in dosing adjustments. They can both be used alone or in combination with other ADHD medications for a more comprehensive treatment approach.
How effective are both Intuniv and Tenex?
Both Intuniv (guanfacine) and Tenex (also guanfacine), have established histories of success in treating ADHD symptoms, especially hyperactivity and impulsivity. Initially approved by the FDA for high blood pressure treatment, these drugs found their way into psychiatric medication due to their calming effects on the central nervous system. While they share an active ingredient, they are not prescribed interchangeably because of differences in formulation: Intuniv is extended release while Tenex is immediate release.
The effectiveness of both formulations was studied extensively during clinical trials; the two medications demonstrated similar efficacy in managing symptoms of ADHD as well as promising safety profiles. In these studies, no significant differences were observed between patients receiving either form of guanfacine regarding improvements in attention span or reduction in disruptive behaviors.
A 2008 review highlighted that Intuniv's extended-release formula allows for once-daily dosing which can improve compliance compared to Tenex’s multiple daily doses requirement. It also reported a favorable side effect profile over many other ADHD treatments with minimal risk of dependence or stimulant-related side effects.
In contrast, a 2016 meta-analysis indicated that while Tenex effectively treats high blood pressure, its use as an ADHD medication is less well-studied compared to Intuniv's extended-release formulation. However, it has been noted that when used responsibly and under medical supervision, both forms provide beneficial outcomes for patients struggling with hyperactivity and attention deficit disorders.
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At what dose is Intuniv typically prescribed?
Oral doses of Intuniv for the treatment of ADHD range from 1-4 mg per day, with a starting dose usually at 1 mg/day. Children and adolescents may also be initiated on this dosage. The response to the medication should be evaluated after a few weeks, and if necessary, the dose can be increased gradually by your doctor. However, under no circumstances should the maximum daily dose exceed 4 mg.
In comparison, Tenex is typically dosed at 0.5–2 mg per day when used to treat high blood pressure in adults but might differ when prescribed off-label for ADHD or other conditions in children and adolescents. Always consult a healthcare professional before adjusting any medication regimen.
At what dose is Tenex typically prescribed?
Tenex treatment generally starts at a dosage of 0.5 mg/day. The dose can then be increased weekly by an additional 0.5 mg per day if needed, divided into two doses and spaced 12 hours apart. The maximum recommended dose is 2 mg/day, which should be divided into two equal dosages of 1 mg each and taken approximately every twelve hours apart from each other. If there's no response to the treatment at the initial lower dose after a few weeks, your health provider may consider testing this higher limit under careful monitoring.
What are the most common side effects for Intuniv?
Common side effects for Intuniv and Tenex, both of which are brand names for the drug guanfacine, can include:
- Drowsiness or sleepiness
- Fatigue or general weakness
- Dry mouth
- Constipation
- Nausea and vomiting
- Stomach pain
- Slow heart rate (bradycardia)
- Low blood pressure (hypotension)
- Headache
- Irritability and mood changes
- Difficulty sleeping (insomnia)
Please note that these medications may also affect your mental health. Some patients have reported feeling more depressed when using these drugs. If you experience any change in mood or behavior, it's crucial to contact your healthcare provider immediately.
Are there any potential serious side effects for Intuniv?
While Intuniv is generally well-tolerated, in rare cases it can cause serious side effects such as:
- Thoughts of suicide or self-harm
- Signs of allergic reaction: hives, difficulty breathing, swelling in your face or throat
- Rapid and irregular heartbeat, heart palpitations, chest pain
- Low blood pressure symptoms: dizziness, feeling like you might faint;
- Severe nervous system reaction - muscle weakness or stiffness, tremors;
- Symptoms indicating high blood sugar levels: frequent urination, increased thirst and hunger;
On the other hand Tenex also known as guanfacine can have potential side effects including:
-Sudden changes in behavior with feelings of sadness or discouragement -Severe skin reactions that may include rash with peeling skin. -Vision problems such as blurred vision. -Irregular heart rate. -Low sodium levels which could result in headache confusion slurred speech severe weakness vomiting loss coordination feeling unsteady.
In both cases if these symptoms are experienced medical help should be sought immediately.
What are the most common side effects for Tenex?
Tenex, also known as guanfacine, can present the following side effects:
- Dry mouth or throat
- Drowsiness or fatigue
- Stomach discomfort including nausea and constipation
- Trouble sleeping (insomnia)
- Headache and dizziness
- Slow heartbeat rate
- Skin rash in rare cases Even though it is less likely with Tenex than with some other medications, you may experience a feeling of anxiety or restlessness. As for weight loss or increased urination, these are not typically seen with this medication. Lastly, muscle pain has been reported by a few patients. Always consult your healthcare provider about potential side effects before starting any new medication.
Are there any potential serious side effects for Tenex?
While Tenex is generally well-tolerated, it's essential to be aware of its potential side effects. These may include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Slow heart rate or a feeling like you might pass out
- Depression, mental confusion or hallucinations
- Unusual changes in mood or behavior including feelings of sadness and irritability
- Severe skin reactions with symptoms like sore throat, burning eyes, skin pain followed by a red or purple rash that spreads and causes blistering and peeling
- Vision problems including blurred vision
If these signs manifest after starting Tenex treatment, seek immediate medical attention.
Contraindications for Intuniv and Tenex?
Both Intuniv and Tenex, along with other medications for attention deficit hyperactivity disorder (ADHD) and high blood pressure, may cause a decrease in alertness or increase drowsiness in some people. If you notice excessive tiredness or reduced awareness, please seek immediate medical attention.
Neither Intuniv nor Tenex should be taken if you are taking, or have been taking any medication that affects heart rhythm. Always inform your physician which medications you are on; such drugs might require a period of several weeks to clear from the system to prevent dangerous interactions with Intuniv and Tenex.
Also, both these drugs can lower your blood pressure too much when combined with certain other medications like beta-blockers or calcium channel blockers. This could lead to symptoms like dizziness and fainting. Therefore it's essential always to communicate clearly about all medications you're currently using when prescribed either of these drugs.
How much do Intuniv and Tenex cost?
For the brand-name versions of these drugs:
- A package of 30 tablets of Intuniv (1 mg) averages around $380, which works out to approximately $12.60/day if you are on a single tablet per day.
- The price for 30 tablets of Tenex (1mg) is about $210, or roughly $7/day.
This means that if you're taking one dose per day, then Tenex is less expensive on a per-day treatment basis than Intuniv. However, it's important to note that cost should not be the primary factor in determining which drug is most suitable for your needs.
Considering generic versions can also help reduce costs:
- Guanfacine (the active ingredient in both medications), at a strength of 1 mg and in packs of 60 tablets and above, has approximate costs ranging from $0.50 to $2.00 per day depending on dosage.
While considering this information, remember that the choice between these two medicines should depend more upon their effectiveness and side-effect profile for you rather than their prices alone. Always consult your healthcare provider before making changes to your medication regimen.
Popularity of Intuniv and Tenex
Guafacine, in its extended-release form and under the brand name Intuniv, was prescribed to about 2 million people in the US in 2020. Guanfacine accounted for just over 5% of prescriptions for ADHD medications that year. It appears to be one of the most common non-stimulant alternatives used when traditional stimulant medications are not effective or cause too many side effects.
Guanfacine's immediate-release form is known as Tenex, which was traditionally used as a high blood pressure medication but has also been found effective at treating some symptoms of ADHD. In terms of prescription numbers though, it lags behind Intuniv significantly due to its shorter duration of action requiring multiple daily doses and higher incidence of side effects such as drowsiness and dry mouth. The prevalence rate for Tenex has remained approximately steady over the past decade.
Conclusion
Both Intuniv (guanfacine) and Tenex (also guanfacine, but in a different form) have established records of usage in managing symptoms of attention deficit hyperactivity disorder (ADHD), particularly for patients who may not respond well to stimulant medications. They work by stimulating receptors in the brain that help to reduce ADHD symptoms through a mechanism involving norepinephrine, similar to how Wellbutrin works on depression.
The two forms of guanfacine are prescribed differently: Intuniv is an extended-release version designed for once-daily dosing, while Tenex is immediate release and usually taken twice daily. This makes Intuniv more convenient for some patients; however, it's also typically more expensive because there's no generic equivalent yet available.
Although both versions generally share side effects including drowsiness, fatigue, dry mouth, and sometimes lowering blood pressure or heart rate too much—these tend to be mild and manageable with proper monitoring by your healthcare provider. It's important that patients closely monitor their mood changes when starting treatment with either medication due to potential withdrawal syndrome if discontinued abruptly. Seek medical assistance immediately if you notice worsening ADHD symptoms or any unusual changes in behavior.
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Refrences
- Childress, A., Hoo-Cardiel, A., & Lang, P. (2020, January 23). Evaluation of the current data on guanfacine extended release for the treatment of ADHD in children and adolescents. Expert Opinion on Pharmacotherapy. Informa UK Limited.http://doi.org/10.1080/14656566.2019.1706480