GWAHN-fa-seen

Commonly used brand name(s):

In the U.S.

• Intuniv
• Tenex

Available Dosage Forms:

• Tablet
• Tablet, Extended Release

Therapeutic Class: Antihypertensive

Pharmacologic Class: Alpha-2 Adrenergic Agonist

Uses For guanfacine

Guanfacine belongs to the general class of medicines called antihypertensives. It is used to treat high blood pressure (hypertension).

High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Guanfacine works by controlling the nerve impulses along certain nerve pathways. As a result, it relaxes blood vessels so that blood passes through them more easily. This helps to lower blood pressure.

Guanfacine is also used to treat attention deficit hyperactivity disorder (ADHD). It works in the treatment of ADHD by increasing attention and decreasing restlessness in children and adults who are overactive, cannot concentrate for very long, or are easily distracted and impulsive. guanfacine is used as part of a total treatment program that also includes social, educational, and psychological treatment.

guanfacine is available only with your doctor’s prescription.

Before Using guanfacine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For guanfacine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to guanfacine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of guanfacine tablets in children below 12 years of age. Safety and efficacy have not been established.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of extended-release guanfacine in children. However, safety and efficacy have not been established in children below 6 years of age.

Geriatric

Appropriate studies on the relationship of age to the effects of guanfacine have not been performed in the geriatric population. However, no geriatric-specific problems have been documented to date.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	B	Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Using guanfacine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Bupropion
• Yohimbine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of guanfacine. Make sure you tell your doctor if you have any other medical problems, especially:

• Bradycardia (slow heart rate), history of or
• Dehydration or
• Heart attack, recent or
• Heart block, history of or
• Heart or blood vessel disease, history of or
• Hypotension (low blood pressure), history of or
• Stroke, history of
• Syncope (fainting), history of—Use with caution. May make these conditions worse.

• Kidney disease or
• Liver disease—Use with caution. Effects may be increased because of slower removal of guanfacine from the body.

• Mental depression—Guanfacine may cause mental depression.

Proper Use of guanfacine

Take guanfacine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

guanfacine should come with patient information insert. Read and follow these instructions carefully. Ask your doctor if you have any questions.

In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that guanfacine will not cure your high blood pressure but it does help control it. Therefore, you must continue to use it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Take your daily dose of guanfacine at bedtime. (If you are taking more than one dose a day, take your last dose at bedtime). Taking it this way will help lessen daytime drowsiness.

Swallow the extended-release tablets whole. Do not break, crush, or chew it.

You should not take the extended-release tablets with high fat meals.

Use only the brand of guanfacine that your doctor prescribed. Different brands may not work the same way.

Dosing

The dose of guanfacine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of guanfacine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For high blood pressure:
    • Adults—At first, 1 milligram (mg) once a day at bedtime. Your doctor may gradually increase your dose up to 3 mg a day, as needed.
    • Children—Use and dose must be determined by your doctor.
• For oral dosage form (extended-release tablets):
  • For attention deficit hyperactivity disorder (ADHD):
    • Adults, teenagers, and children above 6 years of age—At first, 1 milligram (mg) once a day, in the morning. Your doctor may gradually adjust your dose as needed. However, the dose is usually not more than 4 mg a day.
    • Children up to 6 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of guanfacine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss taking guanfacine for two or more days in a row, check with your doctor. If your body suddenly goes without guanfacine, some unwanted effects may occur. If you have any questions about this, check with your doctor.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using guanfacine

Your doctor should check you or your child’s progress at regular visits to make sure guanfacine is working properly and to decide if you or your child should continue to take it.

You or your child will also need to have your blood pressure and heart rate measured before starting guanfacine and while you or your child are using it. If you notice any change to you or your child’s recommended blood pressure or heart rate, call your doctor right away. If you have questions about this, talk to your doctor.

Do not stop taking guanfacine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you or your child are taking before stopping it completely.

Make sure that you have enough guanfacine on hand to last through weekends, holidays, and vacations. You should not miss any doses. You may want to ask your doctor for another written prescription for guanfacine to carry in your wallet or purse. You can then have it filled if you run out when you are away from home.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are using guanfacine.

Guanfacine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using guanfacine.

Guanfacine may cause some people to become dizzy, drowsy, faint, lightheaded, or less alert than they are normally. Make sure you know how you react to guanfacine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert. Also, standing up slowly when getting up from a lying or sitting position may also help.

Guanfacine may cause dryness of the mouth, nose, and throat. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if dry mouth continues for more than 2 weeks, check with your physician or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

guanfacine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Blurred vision
• confusion
• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
• sweating
• unusual tiredness or weakness

Less common

• Chest pain or discomfort
• cough
• difficulty with breathing
• fast, slow, or irregular heartbeat
• increased need to urinate
• lightheadedness, dizziness, or fainting
• mental depression
• noisy breathing
• passing urine more often
• pounding heartbeat
• shortness of breath
• tightness in the chest
• troubled breathing
• wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Dizziness (extreme) or faintness
• unusual tiredness or weakness (severe)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Constipation
• dizziness
• drowsiness
• dryness of the mouth
• headache
• irritability
• nausea
• sleepiness or unusual drowsiness
• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
• upper abdominal or stomach pain
• vomiting
• weight gain

Less common

• Acid or sour stomach
• belching
• decreased appetite
• decreased sexual ability
• dry, itching, or burning eyes
• headache
• heartburn
• indigestion
• lack or loss of strength
• paleness of the skin
• stomach discomfort, upset, or pain
• trouble with sleeping
• unusual tiredness or weakness

After you stop using guanfacine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

• Anxiety or tenseness
• increased salivation
• nervousness or restlessness
• shaking or trembling of the hands and fingers
• stomach cramps
• sweating

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Why is Guanabenz acetate prescribed? This drug is used in the treatment of high blood pressure. It is effective used alone or in combination with a thiazide type of diuretic. Guanabenz begins to lower blood pressure within 60 minutes after taking a single dose and may slow your pulse rate slightly. Most important fact about Guanabenz acetate You must take guanabenz regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of guanabenz; and you must continue taking it even if you are feeling well. Guanabenz does not cure high blood pressure; it merely keeps it under control. How should you take Guanabenz acetate? Guanabenz may be taken with or without food. Take it exactly as prescribed. –If you miss a dose… Take it as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at the same time. If you forget the medication 2 or more times in a row, contact your doctor. –Storage instructions… Store at room temperature, in a tightly closed container, away from light. Guanabenz acetate side effects Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking guanabenz. More common side effect may include: Dizziness, drowsiness, dry mouth, headache, weakness Why should Guanabenz acetate not be prescribed? Do not take guanabenz if you are sensitive to it or have ever had an allergic reaction to it. Special warnings about Guanabenz acetate Guanabenz can make you drowsy or less alert. Driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness is not recommended until you know how Guanabenz acetate affects you. If you have severe heart disease, stroke or related disorders, or severe liver or kidney failure, or if you have recently had a heart attack, Guanabenz acetate should be used with caution. Your doctor will monitor your blood pressure if you have disorders of the kidney or liver. Possible food and drug interactions when taking Guanabenz acetate Guanabenz may intensify the effects of alcohol. Use of alcohol should be avoided. If guanabenz is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining guanabenz with the following: Antihistamines such as Benadryl, Chlor-Trimeton, and Tavist Drugs that depress the central nervous system such as Halcion, Valium, and phenobarbital Special information if you are pregnant or breastfeeding The effects of guanabenz during pregnancy have not been adequately studied, but it may affect the fetus. If you are pregnant or plan to become pregnant, inform your doctor immediately. Guanabenz may appear in breast milk and could affect a nursing infant. If Guanabenz acetate is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished. Recommended dosage for Guanabenz acetate ADULTS Your doctor will adjust the dosage of Guanabenz acetate to meet your individual needs. The usual starting dose is 4 milligrams 2 times per day, whether guanabenz is used alone or with a thiazide type of diuretic. Your doctor may increase the dosage in increments of 4 to 8 milligrams per day every 1 to 2 weeks, depending on your response. The maximum reported dose has been 32 milligrams twice daily, but doses as high as this are rarely needed. CHILDREN The safety and effectiveness of Guanabenz acetate have not been established in children under 12 years of age. OLDER ADULTS Older adults should use Guanabenz acetate with caution. Overdosage Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately. Symptoms of guanabenz overdose may include: Excessive contraction of the pupils, irritability low blood pressure, sleepiness, slow heartbeat, sluggishness

Generic Name: guanadrel (GWAH na drel)
Brand Names: Hylorel

What is guanadrel?

Guanadrel lowers blood pressure by decreasing the levels of certain chemicals in the blood. This allows the blood vessels (veins and arteries) to relax (widen).

Guanadrel is used to treat hypertension (high blood pressure).

Guanadrel may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about guanadrel?

Do not stop taking guanadrel suddenly without first talking to your doctor. This could cause severely high blood pressure, nervousness, and anxiety. Use caution when driving, operating machinery, or performing other hazardous activities. Guanadrel may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use caution when rising from a sitting or lying position, especially first thing in the morning. Dizziness may occur while taking guanadrel and may result in a fall.

What should I discuss with my healthcare provider before taking guanadrel?

Do not take guanadrel without first talking to your doctor if you

• have congestive heart failure;

• have pheochromocytoma; or

• are taking a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate).

Before taking this medication, tell your doctor if you have

• peptic ulcer disease (stomach ulcers);

• ulcerative colitis;

• kidney disease; or

• asthma.

You may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Guanadrel is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not take guanadrel without first talking to your doctor if you are pregnant or could become pregnant during treatment. Guanadrel passes into breast milk and it may be harmful to a nursing infant. Do not take guanadrel without first talking to your doctor if you are breast-feeding a baby.

How should I take guanadrel?

Take guanadrel exactly as directed. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Take guanadrel with food or milk if it causes stomach upset.

It is important to take guanadrel regularly to get the most benefit.

Do not stop taking guanadrel suddenly without first talking to your doctor. This could cause severely high blood pressure, nervousness, and anxiety.

Your doctor may want you to have blood pressure monitoring or other medical evaluations during treatment with guanadrel to monitor progress and side effects.

Store this medication at room temperature away from moisture and heat.

See also: Guanadrel dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a guanadrel overdose include low blood pressure (fainting, dizziness, weakness); a slow pulse; low body temperature; diarrhea; and slow breathing.

What should I avoid while taking guanadrel?

Use caution when driving, operating machinery, or performing other hazardous activities. Guanadrel may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use caution when rising from a sitting or lying position, especially first thing in the morning. Dizziness may occur while taking guanadrel and may result in a fall.

Avoid alcohol while taking guanadrel. It may increase drowsiness an dizziness caused by guanadrel. Use caution even with small amounts of alcohol.

Guanadrel may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if guanadrel is taken with any of these medications. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor.

Avoid becoming overheated in hot weather or during exercise. Also avoid standing for long periods of time and use caution if you have a fever. These situations increase the effects of guanadrel in the body and may cause dizziness.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Guanadrel side effects

If you experience any of the following serious side effects, stop taking guanadrel and seek emergency medical attention or contact your doctor immediately:

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• irregular heartbeats;

• heart failure (shortness of breath, swelling of ankles or legs, sudden weight gain of 5 pounds or more); or

• chest pain.

Other, less serious side effects are more likely to occur. Continue to take guanadrel and talk to your doctor if you experience

• unusual fatigue or drowsiness;

• dizziness (avoid standing up to quickly and use caution when performing hazardous activities);

• anxiety, depression, or nightmares;

• diarrhea, nausea, or vomiting (take guanadrel with food or milk if it upsets your stomach);

• a stuffy nose or a dry mouth (sucking on ice chips or sugarless hard candy may relieve a dry mouth);

• blurred vision;

• weight gain; or

• impotence or difficulty ejaculating.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Guanadrel Dosing Information

Usual Adult Dose for Hypertension:

Initial dose: 10 mg/day orally in 1 to 2 divided doses.
Maintenance dose: 20 to 75 mg/day orally in 2 to 4 divided doses.

What other drugs will affect guanadrel?

Do not take guanadrel without first talking to your doctor if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days

Before taking guanadrel, tell your doctor if you are taking any of the following medicines:

• a respiratory medicine such as albuterol (Ventolin, Proventil, Volmax, others), pirbuterol (Maxair), salmeterol (Serevent), and others;

• a beta-blocker such as atenolol (Tenormin), acebutolol (Sectral), bisoprolol (Zebeta), carteolol (Cartrol), carvedilol (Coreg), labetalol (Trandate, Normodyne), metoprolol (Lopressor), nadolol (Corgard), propranolol (Inderal), pindolol (Visken), and timolol (Blocadren);

• a phenothiazine such as chlorpromazine (Thorazine), prochlorperazine (Compazine), perphenazine (Trilafon), fluphenazine (Prolixin), thioridazine (Mellaril), and others;

• other heart medications such as hydralazine (Apresoline) or minoxidil (Loniten); or

• a tricyclic antidepressant such as amitriptyline (Elavil, Endep), imipramine (Tofranil), doxepin (Sinequan), nortriptyline (Pamelor), and others.

You may require special monitoring or a dosage adjustment if you are taking any of the medicines listed above.

Guanadrel may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor.

Drugs other than those listed here may also interact with guanadrel or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

• Your pharmacist has additional information about guanadrel written for health professionals that you may read.

What does my medication look like?

Guanadrel is available with a prescription under the brand name Hylorel. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Hylorel 10 mg–light-orange, elliptical, scored tablets

• Hylorel 25 mg–white, elliptical, scored tablets

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 6.02. Revision Date: 2/13/04 4:00:59 PM.

GWAHN-a-drel

Commonly used brand name(s):

In the U.S.

• Hylorel

Available Dosage Forms:

• Tablet

Therapeutic Class: Antihypertensive

Pharmacologic Class: Adrenergic Blocker

Uses For guanadrel

Guanadrel belongs to the general class of medicines called antihypertensives. It is used to treat high blood pressure (hypertension).

High blood pressure adds to the work load of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Guanadrel works by controlling nerve impulses along certain nerve pathways. As a result, it relaxes the blood vessels so that blood passes through them more easily. This helps to lower blood pressure.

Guanadrel is available only with your doctor’s prescription.

Before Using guanadrel

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For guanadrel, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to guanadrel or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on guanadrel have been done only in adult patients, and there is no specific information comparing use of guanadrel in children with use in other age groups.

Geriatric

Dizziness or faintness may be more likely to occur in the elderly, who are usually more sensitive to the effects of guanadrel.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	B	Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Using guanadrel with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Brofaromine
• Clorgyline
• Furazolidone
• Iproniazid
• Isocarboxazid
• Lazabemide
• Linezolid
• Moclobemide
• Nialamide
• Pargyline
• Phenelzine
• Procarbazine
• Rasagiline
• Selegiline
• Toloxatone
• Tranylcypromine

Using guanadrel with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Yohimbine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of guanadrel. Make sure you tell your doctor if you have any other medical problems, especially:

• Asthma (history of) or
• Diarrhea or
• Pheochromocytoma or
• Stomach ulcer (history of)—Guanadrel may worsen these conditions

• Fever—Effects of guanadrel may be increased

• Heart attack or stroke (recent) or
• Heart or blood vessel disease—Lowering blood pressure may make problems resulting from these conditions worse

Proper Use of guanadrel

In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that guanadrel will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.

Dosing

The dose of guanadrel will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of guanadrel. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For high blood pressure:
    • Adults—At first, 5 milligrams (mg) two times a day. Then, your doctor may increase your dose to 20 to 75 mg a day, divided into two to four doses.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of guanadrel, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using guanadrel

It is important that your doctor check your progress at regular visits to make sure that guanadrel is working properly.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. This may be more likely to occur in the morning. Getting up slowly may help. If you feel dizzy, sit or lie down. When you get up from lying down, sit on the edge of the bed with your feet dangling for 1 or 2 minutes. Then stand up slowly. If the problem continues or gets worse, check with your doctor.

The dizziness, lightheadedness, or fainting is also more likely to occur if you drink alcohol, stand for long periods of time, exercise, or if the weather is hot. While you are taking guanadrel, be careful to limit the amount of alcohol you drink. Also, use extra care during exercise or hot weather or if you must stand for long periods of time.

Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking guanadrel.

Tell your doctor if you get a fever since that may change the amount of medicine you have to take.

guanadrel Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Get emergency help immediately if any of the following symptoms of overdose occur:

Rare

• Blurred vision
• dizziness or faintness (severe)

Check with your doctor as soon as possible if any of the following side effects occur:

More common

• Swelling of feet or lower legs

Less common or rare

• Chest pain
• shortness of breath

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Difficulty in ejaculating
• dizziness, lightheadedness, or fainting, especially when getting up from a lying or sitting position
• drowsiness
• unusual tiredness or weakness
• weight gain or loss (excessive)

Less common or rare

• Diarrhea or increase in bowel movements
• dryness of mouth
• headache
• muscle pain or tremors
• nighttime urination

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided “AS IS” and “as available” for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

Generic Name: guaifenesin and pseudoephedrine (gwye FEN e sin, soo doe e FED rin)
Brand Names: Altarussin PE, Ambifed, Biotuss PE, D-Feda II, Despec-SR, Dynex, ExeFen, Guiatex II SR, Maxifed, Maxifed-G, Medent LD, Medent-LDI, Mucinex D, Nasabid SR, Nasatab LA, Nomuc-PE, Poly-Vent IR, Poly-Vent, Jr., Pseudatex, Pseudo GG, Pseudo GG TR, Pseudo Max, Q-Tussin PE, Respaire-120 SR, Robitussin Severe Congestion, Ru-Tuss Jr., Sudafed Non Drying Sinus, SudaTex-G, Touro LA-LD, Triaminic Softchews Chest Congestion, We Mist II LA, We Mist LA

What is Guaifenex PSE 80 (guaifenesin and pseudoephedrine)?

Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.

Pseudoephedrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of guaifenesin and pseudoephedrine is used to treat nasal and sinus congestion, and to reduce chest congestion caused by the common cold, infections, or allergies.

Guaifenesin and pseudoephedrine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Guaifenex PSE 80 (guaifenesin and pseudoephedrine)?

Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body. Do not use any other over-the-counter cough or cold medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains a decongestant or expectorant.

What should I discuss with my healthcare provider before taking Guaifenex PSE 80 (guaifenesin and pseudoephedrine)?

Do not use this medication if you are allergic to guaifenesin or pseudoephedrine, or to other decongestants, diet pills, stimulants, or ADHD medications. Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body.

Before taking guaifenesin and pseudoephedrine, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease or high blood pressure;

• diabetes; or

• a thyroid disorder.

If you have any of these conditions, you may not be able to use this medication, or you may need a dosage adjustment or special tests during treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. This medication may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Artificially-sweetened liquid forms of cold medicine may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

How should I take Guaifenex PSE 80 (guaifenesin and pseudoephedrine)?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.

Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children. Do not crush, chew, break, or open a controlled-release, delayed-release, or extended-release tablet or capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication. Take guaifenesin and pseudoephedrine with food if it upsets your stomach. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.

If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.

Store this medicine at room temperature, away from heat, light, and moisture.

What happens if I miss a dose?

Since cough or cold medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, dizziness, and feeling restless or nervous.

What should I avoid while taking Guaifenex PSE 80 (guaifenesin and pseudoephedrine)?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol while you are taking this medicine.

Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor’s advice. Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.

Do not use any other over-the-counter cold, allergy, or cough medicine without first asking your doctor or pharmacist. Guaifenesin and pseudoephedrine are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains guaifenesin or pseudoephedrine.

Guaifenex PSE 80 (guaifenesin and pseudoephedrine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking this medication and call your doctor at once if you have any of these serious side effects:

• fast, pounding, or uneven heartbeat;

• severe dizziness, anxiety, restless feeling, or nervousness;

• easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms; or

• increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure).

Keep taking guaifenesin and pseudoephedrine and talk to your doctor if you have any of these less serious side effects:

• dizziness or headache;

• feeling excited or restless;

• sleep problems (insomnia);

• nausea, vomiting, or stomach upset;

• mild loss of appetite;

• warmth, tingling, or redness under your skin; or

• skin rash or itching.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Guaifenex PSE 80 (guaifenesin and pseudoephedrine)?

Before taking guaifenesin and pseudoephedrine, tell your doctor if you are using any of the following drugs:

• methyldopa (Aldomet);

• medicines to treat high blood pressure;

• a beta-blocker such as atenolol (Tenormin), carteolol (Cartrol), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), timolol (Blocadren), and others; or

• antidepressants such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and others.

This is not a complete list and there may be other drugs that can affect guaifenesin and pseudoephedrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about guaifenesin and pseudoephedrine.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 8.02. Revision Date: 4/12/2009 4:40:58 PM.

Generic Name: guaifenesin and pseudoephedrine (gwye FEN e sin, soo doe e FED rin)
Brand Names: Altarussin PE, Ambifed, Biotuss PE, D-Feda II, Despec-SR, Dynex, ExeFen, Guiatex II SR, Maxifed, Maxifed-G, Medent LD, Medent-LDI, Mucinex D, Nasabid SR, Nasatab LA, Nomuc-PE, Poly-Vent IR, Poly-Vent, Jr., Pseudatex, Pseudo GG, Pseudo GG TR, Pseudo Max, Q-Tussin PE, Respaire-120 SR, Robitussin Severe Congestion, Ru-Tuss Jr., Sudafed Non Drying Sinus, SudaTex-G, Touro LA-LD, Triaminic Softchews Chest Congestion, We Mist II LA, We Mist LA

What is Guaifenex PSE 85 (guaifenesin and pseudoephedrine)?

Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.

Pseudoephedrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of guaifenesin and pseudoephedrine is used to treat nasal and sinus congestion, and to reduce chest congestion caused by the common cold, infections, or allergies.

Guaifenesin and pseudoephedrine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Guaifenex PSE 85 (guaifenesin and pseudoephedrine)?

Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body. Do not use any other over-the-counter cough or cold medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains a decongestant or expectorant.

What should I discuss with my healthcare provider before taking Guaifenex PSE 85 (guaifenesin and pseudoephedrine)?

Do not use this medication if you are allergic to guaifenesin or pseudoephedrine, or to other decongestants, diet pills, stimulants, or ADHD medications. Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body.

Before taking guaifenesin and pseudoephedrine, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease or high blood pressure;

• diabetes; or

• a thyroid disorder.

If you have any of these conditions, you may not be able to use this medication, or you may need a dosage adjustment or special tests during treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. This medication may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Artificially-sweetened liquid forms of cold medicine may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

How should I take Guaifenex PSE 85 (guaifenesin and pseudoephedrine)?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.

Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children. Do not crush, chew, break, or open a controlled-release, delayed-release, or extended-release tablet or capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication. Take guaifenesin and pseudoephedrine with food if it upsets your stomach. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.

If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.

Store this medicine at room temperature, away from heat, light, and moisture.

What happens if I miss a dose?

Since cough or cold medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, dizziness, and feeling restless or nervous.

What should I avoid while taking Guaifenex PSE 85 (guaifenesin and pseudoephedrine)?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol while you are taking this medicine.

Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor’s advice. Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.

Do not use any other over-the-counter cold, allergy, or cough medicine without first asking your doctor or pharmacist. Guaifenesin and pseudoephedrine are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains guaifenesin or pseudoephedrine.

Guaifenex PSE 85 (guaifenesin and pseudoephedrine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking this medication and call your doctor at once if you have any of these serious side effects:

• fast, pounding, or uneven heartbeat;

• severe dizziness, anxiety, restless feeling, or nervousness;

• easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms; or

• increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure).

Keep taking guaifenesin and pseudoephedrine and talk to your doctor if you have any of these less serious side effects:

• dizziness or headache;

• feeling excited or restless;

• sleep problems (insomnia);

• nausea, vomiting, or stomach upset;

• mild loss of appetite;

• warmth, tingling, or redness under your skin; or

• skin rash or itching.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Guaifenex PSE 85 (guaifenesin and pseudoephedrine)?

Before taking guaifenesin and pseudoephedrine, tell your doctor if you are using any of the following drugs:

• methyldopa (Aldomet);

• medicines to treat high blood pressure;

• a beta-blocker such as atenolol (Tenormin), carteolol (Cartrol), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), timolol (Blocadren), and others; or

• antidepressants such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and others.

This is not a complete list and there may be other drugs that can affect guaifenesin and pseudoephedrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about guaifenesin and pseudoephedrine.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 8.02. Revision Date: 4/12/2009 4:40:58 PM.

Generic Name: Guaifenesin (gwye-FEN-eh-sin)
Brand Name: Examples include Guaituss and Robitussin Maximum Strength

Guaituss Liquid is used for:

Relieving symptoms of an unproductive cough and mucus in the chest due to colds, flu, or hay fever. It may also be used for other conditions as determined by your doctor.

Guaituss Liquid is an expectorant. It works by thinning mucus (phlegm) in the lungs and making it less sticky and easier to cough up. This reduces chest congestion by making coughs more productive.

Do NOT use Guaituss Liquid if:

• you are allergic to any ingredient in Guaituss Liquid

Contact your doctor or health care provider right away if any of these apply to you.

Before using Guaituss Liquid:

Some medical conditions may interact with Guaituss Liquid. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a chronic cough that occurs with smoking, asthma, chronic bronchitis, or emphysema, or if your cough occurs with large amounts of mucus

Some MEDICINES MAY INTERACT with Guaituss Liquid. Tell your health care provider if you are taking any other medicines. However, no specific interactions with Guaituss Liquid are known at this time.

Ask your health care provider if Guaituss Liquid may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Guaituss Liquid:

Use Guaituss Liquid as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Guaituss Liquid by mouth with or without food.
• Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure this dose.
• Drinking extra fluids while you are taking Guaituss Liquid is recommended. Check with your doctor for instructions.
• If you miss a dose of Guaituss Liquid and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose. Go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Guaituss Liquid.

Important safety information:

• If cough persists for more than 1 week or is accompanied by a fever, contact your health care provider. A persistent cough could be a sign of a serious condition.
• Some of these products contain phenylalanine. If you must have a diet that is low in phenylalanine, ask your pharmacist if it is in your product.
• Different brands of Guaituss Liquid may have different dosing instructions for CHILDREN. Follow the dosing instructions on the package labeling. If your doctor has given you instructions, follow those. If you are unsure of the dose to give a child, check with your doctor or pharmacist.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Guaituss Liquid while pregnant. It is not known if Guaituss Liquid is found in breast milk. If you are or will be breast-feeding while you are using Guaituss Liquid, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Guaituss Liquid:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately.

Proper storage of Guaituss Liquid:

Store Guaituss Liquid at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Guaituss Liquid out of the reach of children and away from pets.

General information:

• If you have any questions about Guaituss Liquid, please talk with your doctor, pharmacist, or other health care provider.
• Guaituss Liquid is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Guaituss Liquid. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Generic Name: guaifenesin and phenylpropanolamine (gwye FEN e sin/fen ill proe pa NOLE a meen)
Brand Names: Ami-Tex LA, Banex-LA, Coldloc-LA, Dayquil Sinus Pressure and Congestion, Despec, Entex LA, Exgest LA, G-Vent, Guaifenex PPA 75, Guaivent, Guiatex LA, Naldecon-EX Pediatric, Nasahist LA, Phentex-LA, Phenylfenesin LA, Poly-Vent, Profen LA, Stamoist LA, Triaminic Expectorant, Vanex-LA

What is Guaivent (guaifenesin and phenylpropanolamine)?

Guaifenesin is an expectorant. It is used to break up congestion and mucous to make breathing easier. Guaifenesin thins mucous, increases lubrication of the respiratory tract (lungs, nose and throat), and increases the removal of mucous.

Phenylpropanolamine is a decongestant. It constricts (shrinks) blood vessels (veins and arteries), which reduces swelling of mucous membranes in areas such as the nose and sinuses.

Guaifenesin and phenylpropanolamine is used to treat the symptoms of the common cold and of infections of the sinuses, lungs, and throat.

Phenylpropanolamine, an ingredient in this product, has been associated with an increased risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk. Although the risk of hemorrhagic stroke is low, the U.S. Food and Drug Administration (FDA) recommends that consumers not use any products that contain phenylpropanolamine.

Guaifenesin and phenylpropanolamine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Guaivent (guaifenesin and phenylpropanolamine)?

Phenylpropanolamine, an ingredient in this product, has been associated with an increased risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk. Although the risk of hemorrhagic stroke is low, the U.S. Food and Drug Administration (FDA) recommends that consumers not use any products that contain phenylpropanolamine.

Drink plenty of extra fluids while taking this medication. Do not crush or chew the tablets. Swallow them whole or break them in half where they are scored to make them easier to swallow if needed.

Who should not take Guaivent (guaifenesin and phenylpropanolamine)?

Do not take guaifenesin and phenylpropanolamine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Before taking this medication, tell your doctor if you have

• high blood pressure or any other type of heart disease,

• diabetes,

• a peripheral vascular disorder (poor circulation),

• glaucoma or increased pressure in the eyes,

• an overactive thyroid, or

• difficulty urinating or an enlarged prostate.

You may not be able to take guaifenesin and phenylpropanolamine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Guaifenesin and phenylpropanolamine is in the FDA pregnancy category C. This means that it is not known whether guaifenesin and phenylpropanolamine will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. This medication passes into breast milk and may harm a nursing baby. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. If you are over 65 years of age, you may be more likely to experience side effects from guaifenesin and phenylpropanolamine. You may require a lower dose of this medication. Guaifenesin and phenylpropanolamine has not been approved for use by children younger than 6 years of age.

How should I take Guaivent (guaifenesin and phenylpropanolamine)?

Take guaifenesin and phenylpropanolamine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Increasing fluid intake during the day may help relieve congestion. Take guaifenesin and phenylpropanolamine with food if it causes stomach upset. Do not crush or chew the tablets. Swallow them whole or break them in half where they are scored to make them easier to swallow if needed. Store guaifenesin and phenylpropanolamine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a guaifenesin and phenylpropanolamine overdose include vomiting, high blood pressure (headache, redness of face, blurred vision), an irregular heartbeat, and numbness of the fingers or toes.

What should I avoid while taking Guaivent (guaifenesin and phenylpropanolamine)?

Use caution when driving, operating machinery, or performing other hazardous activities. Guaifenesin and phenylpropanolamine may cause dizziness. If you experience dizziness, avoid these activities.

Guaivent (guaifenesin and phenylpropanolamine) side effects

No serious side effects from guaifenesin and phenylpropanolamine are expected. Seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

Other, less serious side effects may be more likely to occur. Continue to take guaifenesin and phenylpropanolamine and talk to your doctor if you experience

• dizziness or headache;

• nervousness, restlessness, or insomnia;

• nausea or stomach upset; or

• difficulty urinating.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Guaivent (guaifenesin and phenylpropanolamine)?

Do not take guaifenesin and phenylpropanolamine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Heart medications such as methyldopa (Aldomet), reserpine (Serpalan, Serpasil), and guanethidine (Ismelin) may have decreased effects. Talk to your doctor before taking guaifenesin and phenylpropanolamine if you are taking any of these medications.

Do not take other over-the-counter cough, cold, allergy, diet, or sleep aids while taking guaifenesin and phenylpropanolamine without first talking to your doctor or pharmacist. Other medications may also contain guaifenesin, phenylpropanolamine, or other similar drugs. You may accidentally take too much of these medicines.

Drugs other than those listed here may also interact with guaifenesin and phenylpropanolamine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

• Your pharmacist has additional information about guaifenesin and phenylpropanolamine written for health professionals that you may read.

What does my medication look like?

Guaifenesin and phenylpropanolamine is available with a prescription under several brand names. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Entex LA, 400 mg of guaifenesin and 75 mg of phenylpropanolamine–orange, scored tablets

• Exgest LA, 400 mg of guaifenesin and 75 mg of phenylpropanolamine–white, oval-shaped, scored, long-acting tablets with blue speckles

• Dura-Vent, 600 mg of guaifenesin and 75 mg of phenylpropanolamine–white, scored tablets

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 5.03. Revision Date: 2/13/04 4:04:29 PM.

Generic Name: guanabenz (GWAHN a benz)
Brand Names: Wytensin

What is guanabenz?

Guanabenz lowers blood pressure by decreasing the levels of certain chemicals in the blood. This allows the blood vessels (veins and arteries) to relax (widen).

Guanabenz is used to treat hypertension (high blood pressure).

Guanabenz may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about guanabenz?

Do not stop taking guanabenz suddenly without first talking to your doctor. This could cause severely high blood pressure, nervousness, and anxiety. Use caution when driving, operating machinery, or performing other hazardous activities. Guanabenz may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use caution when rising from a sitting or lying position, especially first thing in the morning. Dizziness may occur while taking guanabenz and may result in a fall.

What should I discuss with my healthcare provider before taking guanabenz?

Before taking guanabenz, tell your doctor if you have

• heart disease;

• had a heart attack or stroke;

• liver disease; or
• kidney disease.

You may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Guanabenz is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not take guanabenz without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether guanabenz passes into breast milk and if it will affect a nursing infant. Do not take guanabenz without first talking to your doctor if you are breast-feeding a baby. If you are over 60 years of age you may be more likely to experience side effects from guanabenz therapy. Your doctor may prescribe a lower dose.

How should I take guanabenz?

Take guanabenz exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Take guanabenz at bedtime unless otherwise directed by your doctor. It may cause drowsiness or dizziness. Taking it at bedtime may prevent falls and injuries.

It is important to take guanabenz regularly to get the most benefit.

Do not stop taking guanabenz suddenly without first talking to your doctor. This could cause severely high blood pressure, nervousness, and anxiety.

Your doctor may want you to have blood pressure monitoring or other medical evaluations during treatment with guanabenz to monitor progress and side effects.

Store this medication at room temperature away from moisture and heat.

See also: Guanabenz dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a guanabenz overdose include drowsiness, lethargy, weakness, lightheadedness, a slow heart rate, nausea, vomiting, and possibly seizures.

What should I avoid while taking guanabenz?

Use caution when driving, operating machinery, or performing other hazardous activities. Guanabenz may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use caution when rising from a sitting or lying position, especially first thing in the morning. Dizziness may occur while taking guanabenz and may result in a fall.

Avoid alcohol while taking guanabenz. It may increase drowsiness an dizziness caused by guanabenz. Use caution even with small amounts of alcohol.

Guanabenz may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if guanabenz is taken with any of these medications. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor.

Guanabenz side effects

If you experience any of the following serious side effects, stop taking guanabenz and seek emergency medical attention or contact your doctor immediately:

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• a very slow heart rate (fewer than 60 beats per minute); or

• unusually high or low blood pressure (fainting, severe headache, flushing).

Other, less serious side effects may be more likely to occur. Continue to take guanabenz and talk to your doctor if you experience any of the following:

• unusual fatigue, dizziness, or tiredness;

• headache;

• constipation, nausea, vomiting, or diarrhea;

• insomnia; or

• dry mouth (sucking on ice chips or sugarless hard candy may relieve this side effect).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Guanabenz Dosing Information

Usual Adult Dose for Hypertension:

Initial dose: 4 mg orally twice a day, whether used alone or in combination with a thiazide diuretic.
Maintenance dose: 4-8 mg orally twice a day. The maximum dose studied is 32 mg twice a day, although doses this high are rarely needed.

What other drugs will affect guanabenz?

Guanabenz may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if guanabenz is taken with any of these medications. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor.

Drugs other than those listed here may also interact with guanabenz or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

• Your pharmacist can provide more information about guanabenz.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 6.01. Revision Date: 04/02/2009 9:16:34 AM.

GWAHN-a-benz

Commonly used brand name(s):

In the U.S.

• Wytensin

Available Dosage Forms:

• Tablet

Therapeutic Class: Antihypertensive

Pharmacologic Class: Alpha-2 Adrenergic Agonist

Uses For guanabenz

Guanabenz belongs to the general class of medicines called antihypertensives. It is used to treat high blood pressure (hypertension).

High blood pressure adds to the work load of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Guanabenz works by controlling nerve impulses along certain nerve pathways. As a result, it relaxes blood vessels so that blood passes through them more easily. This helps to lower blood pressure.

Guanabenz is available only with your doctor’s prescription.

Before Using guanabenz

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For guanabenz, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to guanabenz or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on guanabenz have been done only in adult patients, and there is no specific information comparing use of guanabenz in children with use in other age groups.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of guanabenz in the elderly with use in other age groups. However, dizziness, faintness, or drowsiness may be more likely to occur in the elderly, who are usually more sensitive to the effects of guanabenz.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Using guanabenz with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Yohimbine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of guanabenz. Make sure you tell your doctor if you have any other medical problems, especially:

• Heart or blood vessel disease—Lowering blood pressure may make some conditions worse

• Kidney disease or
• Liver disease—Effects of guanabenz may be increased because of slower removal of guanabenz from the body

Proper Use of guanabenz

In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that guanabenz will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.

Dosing

The dose of guanabenz will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of guanabenz. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For high blood pressure:
    • Adults—At first, 4 milligrams (mg) two times a day. Then, your doctor may gradually increase your dose.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of guanabenz, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss two or more doses in a row, check with your doctor. If your body suddenly goes without guanabenz, some unpleasant effects may occur. If you have any questions about this, check with your doctor.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using guanabenz

It is important that your doctor check your progress at regular visits to make sure that guanabenz is working properly.

Check with your doctor before you stop taking guanabenz. Your doctor may want you to reduce gradually the amount you are taking before stopping completely.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are using guanabenz.

Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Guanabenz will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using guanabenz.

Guanabenz may cause some people to become dizzy, drowsy, or less alert than they are normally. Make sure you know how you react to guanabenz before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

Guanabenz may cause dryness of the mouth, nose, and throat. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

guanabenz Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Signs and symptoms of overdose

• Dizziness (severe)
• irritability
• nervousness
• pinpoint pupils
• slow heartbeat
• unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Dizziness
• drowsiness
• dryness of mouth
• weakness

Less common or rare

• Decreased sexual ability
• headache
• nausea

After you stop using guanabenz, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

• Anxiety or tenseness
• chest pain
• fast or irregular heartbeat
• headache
• increased salivation
• increase in sweating
• nausea or vomiting
• nervousness or restlessness
• shaking or trembling of hands or fingers
• stomach cramps
• trouble in sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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