It is not known whether these deaths were due to the combination of drugs, but caution should be exercised whenever such combinations are used. Careful screening for heart rhythm irregularities and regular monitoring of blood pressure and electrocardiograms help reduce these risks. If your doctor thinks that combining these two treatments offers more benefits than risks, it may be a good option.

Who Should Not Take High Blood Pressure Drugs?

Clonidine and guanfacine may be ruled out if there is a history of low blood pressure or other personal or family history of a significant heart problem.

What Are the Side Effects of High Blood Pressure Drugs?

The most common side effects seen with high blood pressure drugs include:

• Drowsiness
• Lowered blood pressure
• Headache
• Sinus congestion
• Dizziness
• Stomach upset

The drugs can rarely cause irregular heartbeats.

High Blood Pressure Drugs: Tips and Precautions

When taking one of these high blood pressure drugs for ADHD, be sure to tell your doctor:

• If you are nursing, pregnant, or plan to become pregnant.
• If you are taking or plan to take any dietary supplements, herbal medicines, or nonprescription medications.
• If you have any past or present medical problems, including low blood pressure, seizures, heart rhythm disturbances, and urinary problems.
• If you develop irregular heartbeats (heart palpitations) or fainting spells.

The following are useful guidelines to keep in mind when taking clonidine or guanfacine or giving them to your child for ADHD:

• Always take or give the medication exactly as prescribed. If there are any problems or questions, call your doctor. It is best not to miss doses or patches as this may cause the blood pressure to rise quickly, which may cause headaches and other symptoms.
• Your health care provider will probably want to start the medication at a low dose and increase gradually until symptoms are controlled.
• Clonidine patches come in various sizes. Rotate the placement of the patch to avoid skin irritation.
• For very young children, clonidine tablets can be formulated into a liquid by a compounding pharmacy to make it easier to give the medication. Tablets can be crushed and mixed with food if necessary.
• Do not stop clonidine or guanfacine suddenly since this can cause rebound increase in blood pressure. These medications must be tapered off gradually.

SOURCES:

Strattera web site.

Kapvay web site: "Monthly Prescribing Reference."

Food and Drug Administration.

American Academy of Childhood and Adolescent Psychiatry.

Medscape web site: "Once-Daily Guanfacine Approved to Treat ADHD."

Intuniv web site.

Attention Deficit Disorder Resources web site: "Medication Management for Adults with ADHD."

WebMD Medical Reference: "Should My Child Take Stimulant Medications for ADHD?"

National Institute of Mental Health web site: "Questions Raised about Stimulants and Sudden Death."

HelpGuide.org web site: "ADD & ADHD Medications."

Reviewed by Brunilda Nazario, MD on October 19, 2011

© 2009 WebMD, LLC. All rights reserved.