- Side Effects
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
Generic Name: guanabenz (discontinued)
Brand Name: Wytensin (discontinued)
Drug Class: Alpha-2 Adrenergic Agonists, Central Acting; Antihypertensives
What is guanabenz, and what is it used for?
Guanabenz is a medication used to treat high blood pressure (hypertension), either as a single agent or with a thiazide diuretic, a type of drug that reduces blood pressure by increasing urination. Guanabenz is classified as a centrally acting alpha-2 adrenergic agonist, a medication that reduces blood pressure by slowing the activity of the sympathetic nervous system.
Currently, both guanabenz generic drug and the brand Wytensin have been discontinued and are no longer available in the U.S. Guanabenz is used as a calming agent in horses.
The sympathetic nervous system is the part of the central nervous system that increases blood pressure, heart rate, respiratory rate and pupil size. Excessive blood pressure can weaken and damage the vascular walls, increasing the risk for diseases such as heart attack and stroke. Guanabenz stimulates alpha-2 adrenergic receptors, protein molecules on nerve cells (neurons) in the sympathetic nervous system. Alpha-2 receptors slow down the sympathetic nervous system, and consequently, lower blood pressure and heart rate.
- Do not use guanabenz in patients with hypersensitivity to any component of the formulation.
- Guanabenz causes sedation and drowsiness in many patients. Exercise caution when using this medication with central nervous system (CNS) depressants such as benzodiazepines, phenothiazines and barbiturates, it can have additive effects.
- Use guanabenz with caution in patients with vascular insufficiency including:
- Severe coronary insufficiency
- Recent heart attack (myocardial infarction)
- Cerebrovascular disease
- Severe liver failure
- Severe kidney failure
- Guanabenz should be tapered gradually, abrupt discontinuation can cause rebound hypertension.
- Plasma concentration of guanabenz was found to be higher in patients with alcohol-induced liver disease than in healthy persons. Use guanabenz with caution and monitor blood pressure in hypertensive patients with chronic liver function impairment.
- Guanabenz’s half-life is prolonged and clearance is decreased in patients with impaired kidney function. Use guanabenz with caution and carefully monitor blood pressure in patients with hypertension and renal impairment.
What are the side effects of guanabenz?
Common side effects of guanabenz include:
- Dry mouth (xerostomia)
- Sleep disturbances
- Impaired coordination, balance and speech (ataxia)
- Muscle aches
- Aches in extremities
- Blurred vision
- Taste disorders
- Nasal congestion
- Shortness of breath (dyspnea)
- Irregular heart rhythm (arrhythmia)
- Atrioventricular (AV) dysfunction including complete AV block (rare)
- Chest pain
- Swelling (edema)
- Itching (pruritus)
- Epigastric pain
- Abdominal discomfort
- Urinary frequency
- Decreased libido
- Breast tissue growth in males (gynecomastia)
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
What are the dosages of guanabenz?
- 4 mg
- 8 mg
- Initial dose: 4 mg orally every 12 hours initially; may increase the dose by 4-8 mg/day at 1-2 week intervals
- The maintenance dose range is typically 4-16 mg orally every 12 hours
- Not to exceed 32 mg orally every 12 hours
- Adverse central nervous system (CNS) effects; may cause bradycardia and orthostatic hypotension; not recommended as routine treatment for hypertension (Beers criteria)
- Not drug of choice in elderly because of CNS effects
- 4 mg orally once daily, gradually increase every 1-2 weeks
- Safety and efficacy not established
- Guanabenz overdose can cause excessive contraction of the pupils (miosis), irritability, low blood pressure (hypotension), sleepiness (somnolence), slow heartbeat (bradycardia) and sluggishness.
- Overdose may be treated with symptomatic and supportive care, including administration of activated charcoal and gastric lavage to eliminate undigested drug, intravenous medications and fluids, and monitoring of vital signs until the patient is stable.
What drugs interact with guanabenz?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Guanabenz has no listed severe or serious interactions with other drugs.
- Moderate interactions of guanabenz include:
- Guanabenz has no listed mild interactions with other drugs.
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.
Pregnancy and breastfeeding
- There are no adequate and well-controlled studies on the safety of guanabenz use in pregnant women, however, animal reproductive studies indicate it can cause fetal harm. Use guanabenz during pregnancy only if benefits outweigh potential fetal risks.
- It is not known if guanabenz is present in breastmilk. Use with caution in nursing mothers because many drugs are excreted in breastmilk, and it is likely guanabenz also is excreted in breastmilk.
What else should I know about guanabenz?
- Take guanabenz exactly as prescribed.
- Do not abruptly discontinue guanabenz. It should be tapered in consultation with your physician.
- Guanabenz can cause sedation and drowsiness and impair mental abilities required for hazardous tasks. Avoid engaging in activities such as driving and operating heavy machinery until the drug’s effects can be determined.
- Avoid alcohol and other drugs that can depress the central nervous system while taking guanabenz, it can have additive effects.
- Store guanabenz safely out of reach of children.
- In case of overdose, seek immediate medical help or contact Poison Control.
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Guanabenz is a discontinued medication used to treat high blood pressure (hypertension), either as a single agent or with a thiazide diuretic, a type of drug that reduces blood pressure by increasing urination. Guanabenz is classified as a centrally acting alpha-2 adrenergic agonist, a medication that reduces blood pressure by slowing the activity of the sympathetic nervous system. Guanabenz is used as a calming agent in horses. Common side effects of guanabenz include drowsiness, sedation, dry mouth (xerostomia), dizziness, weakness, headache, sleep disturbances, anxiety, depression, and impaired coordination, balance and speech (ataxia).
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Blood pressure is the force applied by the blood over the inner walls of the arteries. Although the average blood pressure for a person remains constant, it shows minor fluctuations throughout the day—declining while relaxing and momentarily increasing while being excited or under stress. An increase in resting blood pressure can scar, stiffen, or harden the arteries.
Why Is My Bottom Blood Pressure Number High?
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High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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The American Heart Association outlines that a normal blood pressure reading of 120/80 mm Hg for adults. Here is a chart that breaks down the ideal blood pressure range by age.
What Does it Mean When the Bottom Number of Your Blood Pressure is Over 100?
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Is 150 Over 90 a Good Blood Pressure?
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Is 110/60 a Too Low Blood Pressure?
A blood pressure reading of 110/60 mmHg is usually not considered a low blood pressure.
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