Guanfacine

Identification

Summary

Guanfacine is an alpha-2A adrenergic receptor agonist used to treat ADHD.

Brand Names
Intuniv, Tenex
Generic Name
Guanfacine
DrugBank Accession Number
DB01018
Background

Guanfacine, or BS 100-141,8,9 is a selective alpha-A2 adrenergic receptor agonist initially indicated for the treatment of hypertension10 but is now indicated as an extended release tablet for the treatment of ADHD.11 Guanfacine was first described in the literature in 1974.9

Guanfacine was granted FDA approval on 27 October 1986.10

Type
Small Molecule
Groups
Approved, Investigational
Structure
Weight
Average: 246.093
Monoisotopic: 245.012267339
Chemical Formula
C9H9Cl2N3O
Synonyms
  • Guanfacina
  • Guanfacine
  • Guanfacinum
External IDs
  • SPD 503

Pharmacology

Indication

Guanfacine is indicated alone or as an adjunct with stimulants to treat ADHD.11

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Adjunct therapy in management ofAttention deficit disorder with hyperactivity (adhd)••••••••••••••••••••••• ••••••••••••••• •••••••• •••••••
Management ofAttention deficit disorder with hyperactivity (adhd)••••••••••••••••••••••• ••••••••••••••••• •• •••••••••••••••••• •••••••• •••••••
Management ofHypertension••• •••••••••••
Prophylaxis ofMigraine••• •••••
Management ofTourette syndrome••• •••••
Contraindications & Blackbox Warnings
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Pharmacodynamics

Guanfacine is a selective alpha-2A adrenergic receptor agonist but it is unclear how this translates to the treatment of ADHD.11 It has a long duration of action as it is given once daily and a wide therapeutic window as fatal overdoses have not been described in literature.11 Patients should be counselled regarding the risk of hypotension, bradycardia, and syncope.11

Mechanism of action

Guanfacine is a selective alpha-2A adrenergic receptor agonist, which reduces the effects of the sympathetic nervous system on the heart and circulatory system.11 The link between guanfacine’s molecular mechanism and it’s effect on the treatment of ADHD has not been determined.11

TargetActionsOrganism
AAlpha-2A adrenergic receptor
agonist
Humans
UAlpha-2B adrenergic receptor
binder
Humans
Absorption

Guanfacine is 80% orally bioavailable.1

1mg immediate release oral guanfacine reaches a Cmax of 2.5±0.6ng/mL with a Tmax of 3.0h and an AUC of 56±15ng*h/mL.11 1mg extended release oral guanfacine reaches a Cmax of 1.0±0.3ng/mL with a Tmax of 6.0h and an AUC of 32±9ng*h/mL.11

In adults, a 4mg oral extended release dose reaches a Cmax of 3.58±1.39ng/mL with a Tmax of 5.5h; in children, a 2mg oral extended relsease dose reaches a Cmax of 2.6±1.03ng/mL with a Tmax of 4.98h; in adolescents, a 2mg oral extended release dose reaches a Cmax of 1.7±0.43ng/mL with a Tmax of 4.96h.7

Volume of distribution

Guanfacine has a volume of distribution of 6.3L/kg.1

Protein binding

Guanfacine is approximately 70% protein bound in serum.1,11

Metabolism

Guanfacine is oxidized by CYP3A46 to it's main metabolite, 3-hydroxyguanfacine.4 3-hydroxyguanfacine is then either glucuronidated or sulphated.4,5

Hover over products below to view reaction partners

Route of elimination

Guanfacine is 57.0±32.0% eliminated in the urine in patients with normal renal function.2 Patients with a glomerular filtration rate (GFR) of 10-30mL/min eliminate 14.0±9.0% of a dose in the urine, while patients with a GFR of <1mL/min eliminate 7.5±2.4% of a dose in the urine.2

Half-life

Guanfacine has a half life of 17 hours, but this may range from 10-30 hours.1 The half life is largely independant of renal function.2

Clearance

Guanfacine has a total body cleraance of 360±262mL/min and a renal clearance of 233±245mL/min in patients with normal renal function. Patients with a glomerular filtration rate (GFR) of 10-30mL/min had a total body clearance of 308±274mL/min and a renal clearance of 34±22mL/min.2 Patients with a GFR of <1mL/min had a total body clearance of 257±187mL/min and a renal clearance of 18±15mL/min.2

Adverse Effects
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Toxicity

The oral LD50 in rats is 142mg/kg and 15.3mg/kg in mice.12 The subcutaneous LD50 in rats is 114mg/kg and 46mg/kg in mice.12

Patients experiencing and overdose may present with hypotension, drowsiness, lethargy, and bradycardia.11 Overdose should be managed by first calling local poison control. Patients may require intravenous saline to maintain blood pressure.3

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
1,2-BenzodiazepineThe risk or severity of CNS depression can be increased when Guanfacine is combined with 1,2-Benzodiazepine.
AbacavirGuanfacine may decrease the excretion rate of Abacavir which could result in a higher serum level.
AbaloparatideThe risk or severity of adverse effects can be increased when Guanfacine is combined with Abaloparatide.
AbametapirThe serum concentration of Guanfacine can be increased when it is combined with Abametapir.
AcebutololThe therapeutic efficacy of Guanfacine can be decreased when used in combination with Acebutolol.
Food Interactions
  • Avoid alcohol.
  • Do not take with or immediately after a high-fat meal. High fat meals increase drug exposure.

Products

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Product Ingredients
IngredientUNIICASInChI Key
Guanfacine hydrochloridePML56A160O29110-48-3DGFYECXYGUIODH-UHFFFAOYSA-N
Product Images
International/Other Brands
Estulic (Egis)
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
IntunivTablet, extended release2 mgOralTakeda Pharmaceuticals International Ag Ireland Branch2016-09-08Not applicableEU flag
IntunivTablet, extended release1 mgOralTakeda Pharmaceuticals International Ag Ireland Branch2016-09-08Not applicableEU flag
IntunivTablet, extended release4 mgOralTakeda Pharmaceuticals International Ag Ireland Branch2016-09-08Not applicableEU flag
IntunivTablet, extended release3 mg/1OralTakeda Pharma A/S2009-09-02Not applicableUS flag
IntunivTablet, extended release3 mgOralTakeda Pharmaceuticals International Ag Ireland Branch2016-09-08Not applicableEU flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Ag-guanfacine XRTablet, extended release1 mgOralAngita Pharma Inc.Not applicableNot applicableCanada flag
Ag-guanfacine XRTablet, extended release2 mgOralAngita Pharma Inc.Not applicableNot applicableCanada flag
Ag-guanfacine XRTablet, extended release4 mgOralAngita Pharma Inc.Not applicableNot applicableCanada flag
Ag-guanfacine XRTablet, extended release3 mgOralAngita Pharma Inc.Not applicableNot applicableCanada flag
Apo-guanfacine XRTablet, extended release2 mgOralApotex Corporation2022-01-31Not applicableCanada flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
IntunivGuanfacine hydrochloride (1 mg/1) + Guanfacine hydrochloride (2 mg/1)Kit; Tablet, extended releaseOralTakeda Pharma A/S2009-09-022015-10-29US flag
IntunivGuanfacine hydrochloride (1 mg/1) + Guanfacine hydrochloride (2 mg/1)KitOralShire US Manufacturing Inc.2009-09-022011-06-15US flag
IntunivGuanfacine hydrochloride (1 mg/1) + Guanfacine hydrochloride (2 mg/1)Kit; Tablet, extended releaseOralTakeda Pharma A/S2009-09-022015-10-29US flag
IntunivGuanfacine hydrochloride (1 mg/1) + Guanfacine hydrochloride (2 mg/1)KitOralShire US Manufacturing Inc.2009-09-022011-06-15US flag

Categories

ATC Codes
C02AC02 — Guanfacine
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as dichlorobenzenes. These are compounds containing a benzene with exactly two chlorine atoms attached to it.
Kingdom
Organic compounds
Super Class
Benzenoids
Class
Benzene and substituted derivatives
Sub Class
Halobenzenes
Direct Parent
Dichlorobenzenes
Alternative Parents
Aryl chlorides / Propargyl-type 1,3-dipolar organic compounds / Carboximidamides / Organopnictogen compounds / Organooxygen compounds / Organochlorides / Imines / Hydrocarbon derivatives
Substituents
1,3-dichlorobenzene / Aromatic homomonocyclic compound / Aryl chloride / Aryl halide / Carboximidamide / Hydrocarbon derivative / Imine / Organic 1,3-dipolar compound / Organic nitrogen compound / Organic oxygen compound
Molecular Framework
Aromatic homomonocyclic compounds
External Descriptors
acetamides (CHEBI:5558)
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
30OMY4G3MK
CAS number
29110-47-2
InChI Key
INJOMKTZOLKMBF-UHFFFAOYSA-N
InChI
InChI=1S/C9H9Cl2N3O/c10-6-2-1-3-7(11)5(6)4-8(15)14-9(12)13/h1-3H,4H2,(H4,12,13,14,15)
IUPAC Name
N-carbamimidoyl-2-(2,6-dichlorophenyl)acetamide
SMILES
NC(=N)NC(=O)CC1=C(Cl)C=CC=C1Cl

References

Synthesis Reference

U.S. Patent 3,632,645.

General References
  1. Cruz MP: Guanfacine Extended-Release Tablets (Intuniv), a Nonstimulant Selective Alpha(2A)-Adrenergic Receptor Agonist For Attention-Deficit/Hyperactivity Disorder. P T. 2010 Aug;35(8):448-51. [Article]
  2. Kirch W, Kohler H, Braun W: Elimination of guanfacine in patients with normal and impaired renal function. Br J Clin Pharmacol. 1980;10 Suppl 1:33S-35S. doi: 10.1111/j.1365-2125.1980.tb04902.x. [Article]
  3. Minns AB, Clark RF, Schneir A: Guanfacine overdose resulting in initial hypertension and subsequent delayed, persistent orthostatic hypotension. Clin Toxicol (Phila). 2010 Feb;48(2):146-8. doi: 10.3109/15563650903505174. [Article]
  4. Kiechel JR: Pharmacokinetics and metabolism of guanfacine in man: a review. Br J Clin Pharmacol. 1980;10 Suppl 1:25S-32S. doi: 10.1111/j.1365-2125.1980.tb04901.x. [Article]
  5. Guerret M, Julien-Larose C, Kiechel JR, Lavene D: Determination of 3-hydroxy-guanfacine in biological fluids by electron-capture gas-liquid chromatography. J Chromatogr. 1982 Dec 10;233:181-92. doi: 10.1016/s0378-4347(00)81745-4. [Article]
  6. Inoue Y, Morita H, Nozawa K, Kanazu T: Metabolite profiling of guanfacine in plasma and urine of healthy Japanese subjects after oral administration of guanfacine extended-release tablets. Biopharm Drug Dispos. 2019 Sep;40(8):282-293. doi: 10.1002/bdd.2201. Epub 2019 Aug 7. [Article]
  7. Martin P, Satin L, Vince BD, Padilla AF, White C, Corcoran M, Stevenson A, Ermer J: Pharmacokinetics and pharmacodynamics of guanfacine extended release in adolescents aged 13-17 years with attention-deficit/hyperactivity disorder. Clin Pharmacol Drug Dev. 2014 Jul;3(4):252-61. doi: 10.1002/cpdd.124. Epub 2014 May 17. [Article]
  8. Dubach UC, Huwyler R, Radielovic P, Singeisen M: A new centrally action antihypertensive agent guanfacine (BS 100-141). Arzneimittelforschung. 1977;27(3):674-6. [Article]
  9. Scholtysik G: Proceedings: Inhibition of effects of accelerator nerve stimulation in cats and rabbits by BS 100-141 and guanabenz. Naunyn Schmiedebergs Arch Pharmacol. 1974;282(Suppl):suppl 282:R86. [Article]
  10. FDA Approved Drug Products: Tenex Guanfacine Hydrochloride Oral Tablets (Discontinued) [Link]
  11. FDA Approved Drug Products: Intuniv Guanfacine Hydrochloride Extended Release Oral Tablets [Link]
  12. Cayman Chemical: Guanfacine MSDS [Link]
Human Metabolome Database
HMDB0015153
KEGG Drug
D08031
KEGG Compound
C07037
PubChem Compound
3519
PubChem Substance
46506169
ChemSpider
3399
BindingDB
81984
RxNav
40114
ChEBI
5558
ChEMBL
CHEMBL862
ZINC
ZINC000003872738
Therapeutic Targets Database
DAP000900
PharmGKB
PA449825
Guide to Pharmacology
GtP Drug Page
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
PDRhealth
PDRhealth Drug Page
Wikipedia
Guanfacine

Clinical Trials

Clinical Trials
Clinical Trial & Rare Diseases Add-on Data Package
Explore 4,000+ rare diseases, orphan drugs & condition pairs, clinical trial why stopped data, & more. Preview package
PhaseStatusPurposeConditionsCountStart DateWhy Stopped100+ additional columns
Not AvailableActive Not RecruitingBasic ScienceAttention Deficit Hyperactivity Disorder (ADHD)1somestatusstop reasonjust information to hide
Not AvailableActive Not RecruitingTreatmentChronic Pain1somestatusstop reasonjust information to hide
Not AvailableCompletedNot AvailableAttention Deficit Hyperactivity Disorder (ADHD)2somestatusstop reasonjust information to hide
Not AvailableCompletedNot AvailableCoronavirus Disease 2019 (COVID‑19) / COVID / Hypertension1somestatusstop reasonjust information to hide
Not AvailableCompletedBasic ScienceNMDA Receptor Function1somestatusstop reasonjust information to hide

Pharmacoeconomics

Manufacturers
  • Shire development inc
  • Amneal pharmaceutical
  • Mikah pharma llc
  • Mylan pharmaceuticals inc
  • Watson laboratories inc
  • Promius pharma llc
Packagers
  • Actavis Group
  • Advanced Pharmaceutical Services Inc.
  • Amerisource Health Services Corp.
  • Amneal Pharmaceuticals
  • Atlantic Biologicals Corporation
  • Cardinal Health
  • Industriale Chimica S.R.L.
  • Major Pharmaceuticals
  • Murfreesboro Pharmaceutical Nursing Supply
  • Mylan
  • Par Pharmaceuticals
  • Patheon Inc.
  • Pharmaceutical Utilization Management Program VA Inc.
  • Pharmedix
  • Physicians Total Care Inc.
  • Promius Pharma
  • Qualitest
  • Resource Optimization and Innovation LLC
  • Shire Inc.
  • Southwood Pharmaceuticals
  • Watson Pharmaceuticals
Dosage Forms
FormRouteStrength
Tablet, extended releaseOral
Tablet, extended releaseOral3 mg/1
Tablet, extended releaseOral4 mg/1
TabletOral1 mg/1
TabletOral2 mg/1
Tablet, film coated, extended releaseOral1 mg/1
Tablet, film coated, extended releaseOral2 mg/1
Tablet, film coated, extended releaseOral3 mg/1
Tablet, film coated, extended releaseOral4 mg/1
KitOral
Kit; tablet, extended releaseOral
Tablet, extended releaseOral1 mg/1
Tablet, extended releaseOral2 mg/1
Tablet, extended releaseOral1 mg
Tablet, extended releaseOral2 mg
Tablet, extended releaseOral3 mg
Tablet, extended releaseOral4 mg
Prices
Unit descriptionCostUnit
Intuniv 1 mg 24 Hour tablet5.72USD tablet
Intuniv 2 mg 24 Hour tablet5.72USD tablet
Intuniv 3 mg 24 Hour tablet5.72USD tablet
Intuniv 4 mg 24 Hour tablet5.72USD tablet
Intuniv er 1 mg tablet5.5USD tablet
Intuniv er 2 mg tablet5.5USD tablet
Intuniv er 3 mg tablet5.5USD tablet
Intuniv er 4 mg tablet5.5USD tablet
Tenex 2 mg tablet4.3USD tablet
Tenex 1 mg tablet2.9USD tablet
Guanfacine HCl 2 mg tablet1.22USD tablet
Guanfacine 2 mg tablet1.18USD tablet
Guanfacine HCl 1 mg tablet0.91USD tablet
Guanfacine 1 mg tablet0.87USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US5854290Yes1998-12-292016-03-21US flag
US6811794Yes2004-11-022023-01-04US flag
US6287599Yes2001-09-112021-06-20US flag

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)213-216U.S. Patent 3,632,645.
water solubility1mg/mLFDA Label
logP0.857ChemSpider
Predicted Properties
PropertyValueSource
Water Solubility0.139 mg/mLALOGPS
logP2.28ALOGPS
logP1.74Chemaxon
logS-3.2ALOGPS
pKa (Strongest Acidic)11.64Chemaxon
pKa (Strongest Basic)8.65Chemaxon
Physiological Charge1Chemaxon
Hydrogen Acceptor Count3Chemaxon
Hydrogen Donor Count3Chemaxon
Polar Surface Area78.97 Å2Chemaxon
Rotatable Bond Count2Chemaxon
Refractivity69.63 m3·mol-1Chemaxon
Polarizability22.44 Å3Chemaxon
Number of Rings1Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterYesChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleNoChemaxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption+0.9313
Blood Brain Barrier+0.9567
Caco-2 permeable-0.5101
P-glycoprotein substrateNon-substrate0.6778
P-glycoprotein inhibitor INon-inhibitor0.8782
P-glycoprotein inhibitor IINon-inhibitor0.9833
Renal organic cation transporterNon-inhibitor0.6443
CYP450 2C9 substrateNon-substrate0.7572
CYP450 2D6 substrateNon-substrate0.7948
CYP450 3A4 substrateNon-substrate0.6475
CYP450 1A2 substrateNon-inhibitor0.9046
CYP450 2C9 inhibitorNon-inhibitor0.8893
CYP450 2D6 inhibitorInhibitor0.8931
CYP450 2C19 inhibitorNon-inhibitor0.7376
CYP450 3A4 inhibitorNon-inhibitor0.831
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.6619
Ames testNon AMES toxic0.7223
CarcinogenicityNon-carcinogens0.8107
BiodegradationNot ready biodegradable0.9843
Rat acute toxicity2.7408 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9677
hERG inhibition (predictor II)Non-inhibitor0.9285
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSsplash10-0a4l-5900000000-766dd9f92ab525fb3d7f
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSsplash10-0002-0090000000-50a2b041228c1ef7c8d4
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSsplash10-0udi-0190000000-14ce6bf26b6072d3b6b3
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSsplash10-0006-9100000000-004c9a6dc06583cf69a5
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSsplash10-0006-9100000000-255a7a3dcd356cc46e1b
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSsplash10-0006-9000000000-0c3e14d9066e2d3fd1a9
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSsplash10-0006-9500000000-6e112e5aeb6150468df0
Predicted 1H NMR Spectrum1D NMRNot Applicable
Predicted 13C NMR Spectrum1D NMRNot Applicable
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-147.3237162
predicted
DarkChem Lite v0.1.0
[M-H]-147.56963
predicted
DeepCCS 1.0 (2019)
[M+H]+147.6717162
predicted
DarkChem Lite v0.1.0
[M+H]+149.92763
predicted
DeepCCS 1.0 (2019)
[M+Na]+147.1192162
predicted
DarkChem Lite v0.1.0
[M+Na]+156.22723
predicted
DeepCCS 1.0 (2019)

Targets

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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Agonist
General Function
Alpha-2 adrenergic receptors mediate the catecholamine-induced inhibition of adenylate cyclase through the action of G proteins. The rank order of potency for agonists of this receptor is oxymetazoline > clonidine > epinephrine > norepinephrine > phenylephrine > dopamine > p-synephrine > p-tyramine > serotonin = p-octopamine. For antagonists, the rank order is yohimbine > phentolamine = mianserine > chlorpromazine = spiperone = prazosin > propanolol > alprenolol = pindolol
Specific Function
alpha-1B adrenergic receptor binding
Gene Name
ADRA2A
Uniprot ID
P08913
Uniprot Name
Alpha-2A adrenergic receptor
Molecular Weight
50646.17 Da
References
  1. Avery RA, Franowicz JS, Studholme C, van Dyck CH, Arnsten AF: The alpha-2A-adrenoceptor agonist, guanfacine, increases regional cerebral blood flow in dorsolateral prefrontal cortex of monkeys performing a spatial working memory task. Neuropsychopharmacology. 2000 Sep;23(3):240-9. [Article]
  2. Sagvolden T: The alpha-2A adrenoceptor agonist guanfacine improves sustained attention and reduces overactivity and impulsiveness in an animal model of Attention-Deficit/Hyperactivity Disorder (ADHD). Behav Brain Funct. 2006 Dec 15;2:41. [Article]
  3. Yuan R, Wu Z, Kostenyuk IA, Burns JK: G-protein-coupled alpha2A-adrenoreceptor agonists differentially alter citrus leaf and fruit abscission by affecting expression of ACC synthase and ACC oxidase. J Exp Bot. 2005 Jul;56(417):1867-75. Epub 2005 May 31. [Article]
  4. Birnbaum SG, Podell DM, Arnsten AF: Noradrenergic alpha-2 receptor agonists reverse working memory deficits induced by the anxiogenic drug, FG7142, in rats. Pharmacol Biochem Behav. 2000 Nov;67(3):397-403. [Article]
  5. Millan MJ: Evidence that an alpha 2A-adrenoceptor subtype mediates antinociception in mice. Eur J Pharmacol. 1992 May 14;215(2-3):355-6. [Article]
  6. Stahl SM: Mechanism of action of alpha 2A-adrenergic agonists in attention-deficit/hyperactivity disorder with or without oppositional symptoms. J Clin Psychiatry. 2010 Mar;71(3):223-4. doi: 10.4088/JCP.09bs05899pur. [Article]
  7. Zhou Y, Zhang Y, Zhao D, Yu X, Shen X, Zhou Y, Wang S, Qiu Y, Chen Y, Zhu F: TTD: Therapeutic Target Database describing target druggability information. Nucleic Acids Res. 2024 Jan 5;52(D1):D1465-D1477. doi: 10.1093/nar/gkad751. [Article]
  8. FDA Approved Drug Products: Intuniv Guanfacine Hydrochloride Extended Release Oral Tablets [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Binder
Curator comments
Guanfacine binds to Alpha-2B adrenergic receptors with such low affinity that it is not clinically relevant.
General Function
Alpha-2 adrenergic receptors mediate the catecholamine-induced inhibition of adenylate cyclase through the action of G proteins. The rank order of potency for agonists of this receptor is clonidine > norepinephrine > epinephrine = oxymetazoline > dopamine > p-tyramine = phenylephrine > serotonin > p-synephrine / p-octopamine. For antagonists, the rank order is yohimbine > chlorpromazine > phentolamine > mianserine > spiperone > prazosin > alprenolol > propanolol > pindolol
Specific Function
alpha2-adrenergic receptor activity
Gene Name
ADRA2B
Uniprot ID
P18089
Uniprot Name
Alpha-2B adrenergic receptor
Molecular Weight
49953.145 Da
References
  1. Uhlen S, Wikberg JE: Delineation of rat kidney alpha 2A- and alpha 2B-adrenoceptors with [3H]RX821002 radioligand binding: computer modelling reveals that guanfacine is an alpha 2A-selective compound. Eur J Pharmacol. 1991 Sep 17;202(2):235-43. [Article]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
A cytochrome P450 monooxygenase involved in the metabolism of polyunsaturated fatty acids (PUFA) (PubMed:18577768, PubMed:19965576, PubMed:20972997). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase) (PubMed:18577768, PubMed:19965576, PubMed:20972997). Catalyzes the hydroxylation of carbon-hydrogen bonds. Hydroxylates PUFA specifically at the omega-1 position (PubMed:18577768). Catalyzes the epoxidation of double bonds of PUFA (PubMed:19965576, PubMed:20972997). Also metabolizes plant monoterpenes such as limonene. Oxygenates (R)- and (S)-limonene to produce carveol and perillyl alcohol (PubMed:11950794). Responsible for the metabolism of a number of therapeutic agents such as the anticonvulsant drug S-mephenytoin, omeprazole, proguanil, certain barbiturates, diazepam, propranolol, citalopram and imipramine. Hydroxylates fenbendazole at the 4' position (PubMed:23959307)
Specific Function
(R)-limonene 6-monooxygenase activity
Gene Name
CYP2C19
Uniprot ID
P33261
Uniprot Name
Cytochrome P450 2C19
Molecular Weight
55944.565 Da
References
  1. Clement B, Demesmaeker M: Microsomal catalyzed N-hydroxylation of guanfacine and reduction of N-hydroxyguanfacine. Arch Pharm (Weinheim). 1997 Oct;330(9-10):303-6. [Article]
  2. Guillouzo A, Le Bigot JF, Guguen-Guillouzo C, Kiechel JR: Presence of phase I and phase II drug metabolizing enzymes in cultured human foetal hepatocytes. Biochem Pharmacol. 1982 Jul 15;31(14):2427-30. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
A cytochrome P450 monooxygenase involved in the metabolism of sterols, steroid hormones, retinoids and fatty acids (PubMed:10681376, PubMed:11093772, PubMed:11555828, PubMed:12865317, PubMed:14559847, PubMed:15373842, PubMed:15764715, PubMed:19965576, PubMed:20702771, PubMed:21490593, PubMed:21576599). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase). Catalyzes the hydroxylation of carbon-hydrogen bonds (PubMed:12865317, PubMed:14559847, PubMed:15373842, PubMed:15764715, PubMed:21490593, PubMed:21576599, PubMed:2732228). Exhibits high catalytic activity for the formation of hydroxyestrogens from estrone (E1) and 17beta-estradiol (E2), namely 2-hydroxy E1 and E2, as well as D-ring hydroxylated E1 and E2 at the C-16 position (PubMed:11555828, PubMed:12865317, PubMed:14559847). Plays a role in the metabolism of androgens, particularly in oxidative deactivation of testosterone (PubMed:15373842, PubMed:15764715, PubMed:22773874, PubMed:2732228). Metabolizes testosterone to less biologically active 2beta- and 6beta-hydroxytestosterones (PubMed:15373842, PubMed:15764715, PubMed:2732228). Contributes to the formation of hydroxycholesterols (oxysterols), particularly A-ring hydroxylated cholesterol at the C-4beta position, and side chain hydroxylated cholesterol at the C-25 position, likely contributing to cholesterol degradation and bile acid biosynthesis (PubMed:21576599). Catalyzes bisallylic hydroxylation of polyunsaturated fatty acids (PUFA) (PubMed:9435160). Catalyzes the epoxidation of double bonds of PUFA with a preference for the last double bond (PubMed:19965576). Metabolizes endocannabinoid arachidonoylethanolamide (anandamide) to 8,9-, 11,12-, and 14,15-epoxyeicosatrienoic acid ethanolamides (EpETrE-EAs), potentially modulating endocannabinoid system signaling (PubMed:20702771). Plays a role in the metabolism of retinoids. Displays high catalytic activity for oxidation of all-trans-retinol to all-trans-retinal, a rate-limiting step for the biosynthesis of all-trans-retinoic acid (atRA) (PubMed:10681376). Further metabolizes atRA toward 4-hydroxyretinoate and may play a role in hepatic atRA clearance (PubMed:11093772). Responsible for oxidative metabolism of xenobiotics. Acts as a 2-exo-monooxygenase for plant lipid 1,8-cineole (eucalyptol) (PubMed:11159812). Metabolizes the majority of the administered drugs. Catalyzes sulfoxidation of the anthelmintics albendazole and fenbendazole (PubMed:10759686). Hydroxylates antimalarial drug quinine (PubMed:8968357). Acts as a 1,4-cineole 2-exo-monooxygenase (PubMed:11695850). Also involved in vitamin D catabolism and calcium homeostasis. Catalyzes the inactivation of the active hormone calcitriol (1-alpha,25-dihydroxyvitamin D(3)) (PubMed:29461981)
Specific Function
1,8-cineole 2-exo-monooxygenase activity
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. Clement B, Demesmaeker M: Microsomal catalyzed N-hydroxylation of guanfacine and reduction of N-hydroxyguanfacine. Arch Pharm (Weinheim). 1997 Oct;330(9-10):303-6. [Article]
  2. Guillouzo A, Le Bigot JF, Guguen-Guillouzo C, Kiechel JR: Presence of phase I and phase II drug metabolizing enzymes in cultured human foetal hepatocytes. Biochem Pharmacol. 1982 Jul 15;31(14):2427-30. [Article]
  3. FDA Approved Drug Products: Intuniv Guanfacine Hydrochloride Extended Release Oral Tablets [Link]

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Multidrug efflux pump that functions as a H(+)/organic cation antiporter (PubMed:16330770, PubMed:17509534). Plays a physiological role in the excretion of cationic compounds including endogenous metabolites, drugs, toxins through the kidney and liver, into urine and bile respectively (PubMed:16330770, PubMed:17495125, PubMed:17509534, PubMed:17582384, PubMed:18305230, PubMed:19158817, PubMed:21128598, PubMed:24961373). Mediates the efflux of endogenous compounds such as creatinine, vitamin B1/thiamine, agmatine and estrone-3-sulfate (PubMed:16330770, PubMed:17495125, PubMed:17509534, PubMed:17582384, PubMed:18305230, PubMed:19158817, PubMed:21128598, PubMed:24961373). May also contribute to regulate the transport of cationic compounds in testis across the blood-testis-barrier (Probable)
Specific Function
antiporter activity
Gene Name
SLC47A1
Uniprot ID
Q96FL8
Uniprot Name
Multidrug and toxin extrusion protein 1
Molecular Weight
61921.585 Da
References
  1. FDA Approved Drug Products: Intuniv Guanfacine Hydrochloride Extended Release Oral Tablets [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
General Function
Electrogenic voltage-dependent transporter that mediates the transport of a variety of organic cations such as endogenous bioactive amines, cationic drugs and xenobiotics (PubMed:11388889, PubMed:11408531, PubMed:12439218, PubMed:12719534, PubMed:15389554, PubMed:16263091, PubMed:16272756, PubMed:16581093, PubMed:19536068, PubMed:21128598, PubMed:23680637, PubMed:24961373, PubMed:34040533, PubMed:9187257, PubMed:9260930, PubMed:9655880). Functions as a pH- and Na(+)-independent, bidirectional transporter (By similarity). Cation cellular uptake or release is driven by the electrochemical potential (i.e. membrane potential and concentration gradient) and substrate selectivity (By similarity). Hydrophobicity is a major requirement for recognition in polyvalent substrates and inhibitors (By similarity). Primarily expressed at the basolateral membrane of hepatocytes and proximal tubules and involved in the uptake and disposition of cationic compounds by hepatic and renal clearance from the blood flow (By similarity). Most likely functions as an uptake carrier in enterocytes contributing to the intestinal elimination of organic cations from the systemic circulation (PubMed:16263091). Transports endogenous monoamines such as N-1-methylnicotinamide (NMN), guanidine, histamine, neurotransmitters dopamine, serotonin and adrenaline (PubMed:12439218, PubMed:24961373, PubMed:35469921, PubMed:9260930). Also transports natural polyamines such as spermidine, agmatine and putrescine at low affinity, but relatively high turnover (PubMed:21128598). Involved in the hepatic uptake of vitamin B1/thiamine, hence regulating hepatic lipid and energy metabolism (PubMed:24961373). Mediates the bidirectional transport of acetylcholine (ACh) at the apical membrane of ciliated cell in airway epithelium, thereby playing a role in luminal release of ACh from bronchial epithelium (PubMed:15817714). Transports dopaminergic neuromodulators cyclo(his-pro) and salsolinol with lower efficency (PubMed:17460754). Also capable of transporting non-amine endogenous compounds such as prostaglandin E2 (PGE2) and prostaglandin F2-alpha (PGF2-alpha) (PubMed:11907186). May contribute to the transport of cationic compounds in testes across the blood-testis-barrier (Probable). Also involved in the uptake of xenobiotics tributylmethylammonium (TBuMA), quinidine, N-methyl-quinine (NMQ), N-methyl-quinidine (NMQD) N-(4,4-azo-n-pentyl)-quinuclidine (APQ), azidoprocainamide methoiodide (AMP), N-(4,4-azo-n-pentyl)-21-deoxyajmalinium (APDA) and 4-(4-(dimethylamino)styryl)-N-methylpyridinium (ASP) (PubMed:11408531, PubMed:15389554, PubMed:35469921, PubMed:9260930)
Specific Function
(R)-carnitine transmembrane transporter activity
Gene Name
SLC22A1
Uniprot ID
O15245
Uniprot Name
Solute carrier family 22 member 1
Molecular Weight
61153.345 Da
References
  1. FDA Approved Drug Products: Intuniv Guanfacine Hydrochloride Extended Release Oral Tablets [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Electrogenic voltage-dependent transporter that mediates the transport of a variety of organic cations such as endogenous bioactive amines, cationic drugs and xenobiotics (PubMed:9260930, PubMed:9687576). Functions as a Na(+)-independent, bidirectional uniporter (PubMed:21128598, PubMed:9687576). Cation cellular uptake or release is driven by the electrochemical potential, i.e. membrane potential and concentration gradient (PubMed:15212162, PubMed:9260930, PubMed:9687576). However, may also engage electroneutral cation exchange when saturating concentrations of cation substrates are reached (By similarity). Predominantly expressed at the basolateral membrane of hepatocytes and proximal tubules and involved in the uptake and disposition of cationic compounds by hepatic and renal clearance from the blood flow (PubMed:15783073). Implicated in monoamine neurotransmitters uptake such as histamine, dopamine, adrenaline/epinephrine, noradrenaline/norepinephrine, serotonin and tyramine, thereby supporting a physiological role in the central nervous system by regulating interstitial concentrations of neurotransmitters (PubMed:16581093, PubMed:17460754, PubMed:9687576). Also capable of transporting dopaminergic neuromodulators cyclo(his-pro), salsolinol and N-methyl-salsolinol, thereby involved in the maintenance of dopaminergic cell integrity in the central nervous system (PubMed:17460754). Mediates the bidirectional transport of acetylcholine (ACh) at the apical membrane of ciliated cell in airway epithelium, thereby playing a role in luminal release of ACh from bronchial epithelium (PubMed:15817714). Also transports guanidine and endogenous monoamines such as vitamin B1/thiamine, creatinine and N-1-methylnicotinamide (NMN) (PubMed:12089365, PubMed:15212162, PubMed:17072098, PubMed:24961373, PubMed:9260930). Mediates the uptake and efflux of quaternary ammonium compound choline (PubMed:9260930). Mediates the bidirectional transport of polyamine agmatine and the uptake of polyamines putrescine and spermidine (PubMed:12538837, PubMed:21128598). Able to transport non-amine endogenous compounds such as prostaglandin E2 (PGE2) and prostaglandin F2-alpha (PGF2-alpha) (PubMed:11907186). Also involved in the uptake of xenobiotic 4-(4-(dimethylamino)styryl)-N-methylpyridinium (ASP) (PubMed:12395288, PubMed:16394027). May contribute to regulate the transport of organic compounds in testis across the blood-testis-barrier (Probable)
Specific Function
acetylcholine transmembrane transporter activity
Gene Name
SLC22A2
Uniprot ID
O15244
Uniprot Name
Solute carrier family 22 member 2
Molecular Weight
62579.99 Da
References
  1. FDA Approved Drug Products: Intuniv Guanfacine Hydrochloride Extended Release Oral Tablets [Link]

Drug created at June 13, 2005 13:24 / Updated at November 01, 2024 03:32