Clonidine vs Guanfacine: What You Need to Know

When looking at Clonidine vs guanfacine, a side‑by‑side look at two alpha‑2 agonists used for blood‑pressure control and ADHD. Also known as Clonidine/Guanfacine comparison, it helps patients and clinicians decide which drug fits a specific situation.

Both drugs belong to the alpha‑2 adrenergic agonist class, but they diverge in how they are prescribed. Clonidine, originally a hypertension medicine that also calms hyperactive symptoms is often started at a low dose and titrated slowly because it can drop blood pressure abruptly. Guanfacine, approved primarily for ADHD and sometimes for hypertension tends to have a smoother blood‑pressure impact and is available in an extended‑release form that many find easier to manage. In practice, Clonidine vs guanfacine encompasses three core aspects: approved indications, dosing schedules, and side‑effect profiles.

Key Differences and Practical Implications

For ADHD, guanfacine’s extended‑release tablet (Intuniv) is designed to support attention throughout the school day, while clonidine’s tablet (Kapvay) is often taken at night to address insomnia and aggression. The two drugs also influence heart‑rate regulation differently: clonidine can cause bradycardia, so clinicians monitor pulse regularly; guanfacine may cause a modest increase in heart rate but is less likely to cause severe dips. When it comes to hypertension, clonidine’s short‑acting formulation allows rapid adjustments, whereas guanfacine’s longer half‑life provides steadier control for patients who need once‑daily dosing.

Side‑effects are another deciding factor. Typical clonidine reactions include dry mouth, sedation, and occasional rebound hypertension if stopped abruptly. Guanfacine can cause fatigue, dizziness, and sometimes mood changes, but rebound hypertension is rare. Both drugs interact with other central nervous system depressants, so a full medication review is essential before adding them to a regimen.

Choosing the right option often depends on the patient’s age, comorbid conditions, and lifestyle. A teenager struggling with school focus may benefit from guanfacine’s once‑daily dosing, while an adult with resistant hypertension might find clonidine’s potent blood‑pressure lowering effect more useful. Insurance coverage, pill burden, and the need for titration also play a role. Below you’ll find articles that dive deeper into dosing strategies, comparison tables, safety tips, and real‑world experiences that can help you weigh the pros and cons of each medication.