Adult Dosing

Hypertension

• Start with 4 mg PO bid alone or with a thiazide diuretic; may increase in increments of 4-8 mg/day q1-2 wks, depending on the patient’s response
• Max: 32 mg PO bid

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of hypertension, alone or in combination with a thiazide diuretic

• Hypersensitivity to any of the ingredients of the product
• Avoid abrupt withdrawal

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined, caution advised

Hepatic dose adjustment

• Hepatic impairment: Dose adjustments not defined, caution advised

See Supplemental Patient Information

• Guanabenz may cause sedation or drowsiness. Consider the potential for additive sedative effects when used with CNS depressants (e.g., barbiturates, benzodiazepines, phenothiazines)
• Use cautiously in patients with vascular insufficiency including severe coronary insufficiency, recent myocardial infarction, cerebrovascular disease, or severe hepatic or renal failure
• Sudden cessation of therapy may occasionally result in “overshoot” hypertension and more frequently produce an increase in serum catecholamines and subjective symptomatology
• Careful monitoring of blood pressure is recommended when guanabenz is administered to patients with coexisting hypertension and chronic hepatic dysfunction
• Consider careful monitoring of blood pressure during dose titration in patients with hypertension and coexisting renal impairment

Cautions: Use cautiously in

• Renal impairment
• Hepatic impairment

Supplemental Patient Information

• Advise patients to exercise caution when performing hazardous tasks such as operating dangerous machinery or driving motor vehicles until determined safe
• Inform patients about a drop in tolerance levels for alcohol and other CNS depressants during therapy
• Instruct patients not to discontinue therapy abruptly

Pregnancy Category:C

Breastfeeding: Other agents may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 17 March 2011). Manufacturer advises caution.

• CV: Rebound hypertension, AV block, arrhythmias, bradycardia, chest pain
• CNS: Drowsiness, sedation, dizziness, weakness, headache
• GI: Dry mouth, nausea, diarrhea, constipation
• MISC: Edema, rash

• Central alpha-2 adrenergic agonist; stimulates central alpha-2 adrenergic receptors, producing a decrease in sympathetic outflow from the brain to the heart, kidneys, and peripheral vasculature
• Absorption: Approximately 75%
• Metabolism: Unknown
• Excretion: Urine (<1% unchanged)
• Half-life: 6 hrs

US Trade Name(s)

• Only generic available

US Availability

guanabenz (generic)

• TABS: 4, 8 mg

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Cardiovascular

Antiadrenergic Agents

Centrally Acting