Guanfacine extended-release tablets exert their therapeutic effect through central α2A receptor agonism.During treatment,key precautions must be taken to prevent hypotension,bradycardia,drowsiness,and rebound caused by sudden discontinuation.

1.Hypotension:Monitoring and Preventing Falls When Standing Up

1.Blood pressure monitoring

During the initial dose escalation period and after each dose adjustment,blood pressure and heart rate should be measured regularly.

If dizziness,fatigue,blurred vision,or unsteadiness when standing occurs,blood pressure should be rechecked promptly.

2.Standing up and posture management

Move slowly when getting out of bed or standing up after prolonged sitting to avoid orthostatic hypotension.

Avoid standing up suddenly after prolonged hot baths,saunas,or strenuous exercise.

3.Medication coordination

Do not casually combine with alcohol,antihypertensive drugs,or other sedative medications to avoid excessively low blood pressure.

If hypotension is obvious or accompanied by syncope,contact the doctor to adjust the dose.

2.Bradycardia:Pay Attention to Heart Rate Changes

1.Heart rate monitoring

During treatment,pay attention to resting heart rate,especially after dose escalation.

If palpitations,chest tightness,fatigue,or dizziness occurs,measure the heart rate and seek medical attention.

2.Precautions for concomitant medications

Use caution when combining with heart rate-lowering drugs such as beta-blockers and digoxin,and adjust according to the doctor's advice.

Patients with cardiac conduction disorders or a slow heart rate should inform the doctor before medication.

3.Principles of management

If heart rate decreases significantly or is accompanied by symptoms,pause dose escalation and return for follow-up as soon as possible.

Do not stop the medication on your own to avoid blood pressure rebound.

3.Drowsiness:Prevent Accidents and Arrange Reasonably

1.Activity safety

Drowsiness is common in the early stage of dose escalation;avoid driving,operating machinery,or working at heights.

Schedule important tasks during periods of better mental alertness,and take short rests if necessary.

2.Medication timing

For patients with obvious daytime drowsiness,discuss with the doctor the possibility of changing to bedtime dosing.

Fix the medication time to reduce fluctuations in blood drug concentrations.

4.Rebound After Discontinuation:Stopping Suddenly Is Strictly Prohibited

1.Gradual dose reduction

Discontinuation must be done through gradual dose reduction under the doctor's guidance;do not stop abruptly.

Abrupt discontinuation can cause blood pressure rebound,tachycardia,anxiety,tremor,headache,and insomnia.

2.Recognition of rebound

If increased blood pressure,palpitations,sweating,or emotional irritability occurs during discontinuation,seek medical attention immediately.

Do not double the dose on your own after a missed dose;contact the doctor for management.

3.Long-term management

Before planning to discontinue,communicate with the doctor in advance and develop a dose reduction plan.

Continue monitoring blood pressure and heart rate during dose reduction,and return for follow-up promptly if discomfort occurs.