This sheet talks about exposure to guanfacine in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is guanfacine?

Guanfacine is a medication that has been approved to treat high blood pressure and attention deficit hyperactivity disorder (ADHD). It has also been used for Gilles de la Tourette’s syndrome and opioid withdrawal. Some brand names for guanfacine are Intuniv® and Tenex®.

I take guanfacine. Can it make it harder for me to get pregnant?

Studies have not been done in women to see if guanfacine could make it harder to get pregnant. Animal studies did not find that guanfacine affected fertility.

I just found out I am pregnant. Should I stop taking guanfacine?

If you have been taking this medication regularly, you should not stop taking it suddenly. Talk with your healthcare provider about this medication if you are planning a pregnancy or have found out that you are pregnant. It is important to discuss the best way to treat your medical condition during pregnancy. If you do plan to stop this medication, it should be stopped slowly under the care of your healthcare provider.

Does taking guanfacine increase the chance for miscarriage?

Miscarriage can occur in any pregnancy. Studies have not been done to see if guanfacine could increase the chance for a miscarriage.

Does taking guanfacine in the first trimester increase the chance of birth defects?

In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. Studies have not been done in women to see if guanfacine might increase this background risk. Animal studies do not suggest that guanfacine would increases the chance of birth defects.

Could taking guanfacine in the second or third trimester cause other pregnancy complications or long term health concerns for the child?

This is unknown. Guanfacine has not been well studied for use in pregnancy. One study looked at the pregnancies of 30 women who were given guanfacine to treat preeclampsia. Preeclampsia is a pregnancy related condition that can cause symptoms such as high blood pressure or fluid retention. The study on guanfacine did not find changes in the baby’s heart rate during pregnancy and no health concerns were reported after the child’s birth.

Can I breastfeed while taking guanfacine?

Guanfacine has not been studied in nursing women or their breastfeeding children. Since this medication has not been well studied, you might wish to discuss medication options with your healthcare provider to see if there are other better studied medications that could be used to treat your medical condition. Talk with your healthcare providers about all of your breastfeeding questions.

If a man takes guanfacine, could it affect his fertility (ability to get partner pregnant) or increase the chance of birth defects? 

This has not been studied. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures and Pregnancy at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.

Selected References:

• Ornoy A. 2018. Pharmacological Treatment of Attention Deficit Hyperactivity Disorder During Pregnancy and Lactation. Pharm Res; 35(3):46.
• Mylan Pharmaceuticals Inc. 2018. Guanfacine hydrochloride. Product labeling. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2d298ebe-8f68-4055-80d7-d86f5b5e6814 [Accessed October 2019].
• Philipp E. 1980. Guanfacine in the treatment of hypertension due to pre-eclamptic toxaemia in thirty women. Br J clin Pharmac 10: 137S-140S.