guanfacine

[Kikimonkey]

Hi we just switched from IR 1 mg to ER 1mg 5 days ago and it doesn't seem to be working as well as the IR did or it's taking longer to peak where the hyperactivity calms down. Anyone else had this issue with the Er 7 yr taking on morning I thought it was a 24 hour dose? Guanfacine

[Alt49]

the er didn’t work for us so we had to switch back to ir. My then 6 year old became very emotional

[Kikimonkey in reply to Alt49]

Ok thanks

[arrh121]

ER works better for us than IR but our psychiatrist needed to change his dose (our son takes a higher dose of ER than his total IR dose was, though he’s also older than he was then) and we experienced a 1-2 week adjustment period.

[Kikimonkey in reply to arrh121]

Yes I am thinking this is probably the case also. She needs a higher dose for the Er version

[Elijah1]

The ER medication is not really a 24 hour effect . It lasts a few more hours than the IR (more like 18 hours versus 16 hours for the IR). The peak blood level for the ER is lower than the IR. You may need a higher ER dose or a return to the IR.

[Kikimonkey in reply to Elijah1]

Yes I think so too. Thank you for responding.

[Kikimonkey]

thank you!

[Mamamichl]

ok. So 1mg instant release goes the same amount of med over a shorter period of time than the ER. Usually when you go from ir to er, you need to up the dose so the same amount of med goes in in the same increment of time. With my stimulant I was taking at the time, when I went from ir to er, they doubled the dose to make sure I had the same effect over a longer period of time.

[Kikimonkey in reply to Mamamichl]

That makes sense. It makes me wonder why to doctor wouldn't know that! Ugh. Thanks for your reply

[Mamamichl in reply to Kikimonkey]

Many docs don’t deal with ir and er specific meds, or specifically adhd meds. They can help manage, but changes should be psychiatrist specific. They deal with that stuff more. The gene sight test lists all mental health meds. Psychiatrists only work with them.