Two medicines, side by side
Atomoxetine vs guanfacine
Atomoxetine and guanfacine are both labeled for ADHD. Drugs@FDA records approvals of atomoxetine since 2002 and of guanfacine since 1986. Pharmacies paid $0.442 per atomoxetine HCl 40 mg capsule and $0.147 per guanfacine 1 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, atomoxetine is a norepinephrine reuptake inhibitor and guanfacine a central alpha-2 adrenergic agonist.
Check it at the source: the atomoxetine FDA label on DailyMed (effective May 25, 2026); the guanfacine FDA label on DailyMed (effective June 23, 2025).
Highlights of the atomoxetine record
Atomoxetine (Strattera) · label of May 25, 2026
SUICIDAL IDEATION IN CHILDREN AND ADOLESCENTS Atomoxetine increased the risk of suicidal ideation in short-term studies in children or adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Anyone considering the use of atomoxetine in a child or adolescent must balance this risk with the clinical need. Co-morbidities occurring with ADHD may be associated with an increase in the risk of suicidal ideation and/or behavior.
Used for
From the label: indicationsAtomoxetine capsule is a selective norepinephrine reuptake inhibitor indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). ( 1.1 ) 1.1 Attention-Deficit/Hyperactivity Disorder (ADHD) Atomoxetine capsule is indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). […]
On the market
- Earliest approval on file
- November 26, 2002
- Generic labelers
- 20 labelers
- Pharmacy cost
- $0.442 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 15
Highlights of the guanfacine record
Guanfacine (Intuniv) · label of June 23, 2025
Used for
From the label: indicationsINTUNIV ® is indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) as monotherapy and as adjunctive therapy to stimulant medications [see Clinical Studies (14) ]. INTUNIV is a central alpha 2A -adrenergic receptor agonist indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) as monotherapy and as adjunctive therapy to stimulant medications ( 1 , 14 ).
On the market
- Earliest approval on file
- October 27, 1986
- Generic labelers
- 36 labelers
- Pharmacy cost
- $0.147 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 1
Source: FDA drug labels via openFDA (Atomoxetine label of May 25, 2026, Guanfacine label of June 23, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do atomoxetine and guanfacine differ on the record?
In FDA's classes, atomoxetine is a norepinephrine reuptake inhibitor and guanfacine a central alpha-2 adrenergic agonist.
How each works, in its label's words: Atomoxetine, “The precise mechanism by which atomoxetine produces its therapeutic effects in Attention-Deficit/Hyperactivity Disorder (ADHD) is unknown, but is thought to be related to selective inhibition of the …”; Guanfacine, “Guanfacine is a central alpha 2A -adrenergic receptor agonist.”
Only the atomoxetine label carries a boxed warning.
Generics: atomoxetine since 2010; guanfacine since 1995 (Drugs@FDA).
| Atomoxetine | Guanfacine | |
|---|---|---|
| Labeled for | ADHD | ADHD, High blood pressure |
| Pharmacologic class | Norepinephrine Reuptake Inhibitor | Central alpha-2 Adrenergic Agonist |
| How it works (label) | The precise mechanism by which atomoxetine produces its therapeutic effects in Attention-Deficit/Hyperactivity Disorder (ADHD) is unknown, but is thought to be related to selective inhibition of the pre-synaptic norepinephrine transporter … | Guanfacine is a central alpha 2A -adrenergic receptor agonist. Guanfacine is not a central nervous system (CNS) stimulant. The mechanism of action of guanfacine in ADHD is not known. |
| Half-life (label) | Atomoxetine has a half-life of about 5 hours. | n/a |
| Earliest approval on file (Drugs@FDA) | November 26, 2002 | October 27, 1986 |
| First generic approved | September 16, 2010 | October 17, 1995 |
| Generic labelers (NDC) | 20 labelers | 36 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.442 per capsule (Atomoxetine HCl 40 mg capsule) | $0.147 per tablet (Guanfacine 1 mg tablet) |
| 12-month price change | -27% | -5% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 15 | 1 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 26,969 | 7,825 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to atomoxetine
- every medicine labeled for the same conditions