Two medicines, side by side
Guanfacine vs lisinopril
Guanfacine and lisinopril are both labeled for high blood pressure. Drugs@FDA records approvals of guanfacine since 1986 and of lisinopril since 1987. Pharmacies paid $0.147 per guanfacine 1 mg tablet and $0.0254 per lisinopril 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Lisinopril's other strengths are brand-only: $4.50 per mL (Qbrelis 1 mg/mL solution). In FDA's classes, guanfacine is a central alpha-2 adrenergic agonist and lisinopril an angiotensin converting enzyme inhibitor.
Check it at the source: the guanfacine FDA label on DailyMed (effective June 23, 2025); the lisinopril FDA label on DailyMed (effective January 2, 2025).
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
Highlights of the lisinopril record
Lisinopril (Zestril) · label of January 2, 2025
FETAL TOXICITY When pregnancy is detected, discontinue ZESTRIL as soon as possible [see Warnings and Precautions ( 5.1 )]. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus [see Warnings and Precautions (5.1)]. WARNING: FETAL TOXICITY See full prescribing information for complete boxed warning. When pregnancy is detected, discontinue Zestril as soon as possible.
Used for
From the label: indicationsZestril is an angiotensin converting enzyme (ACE) inhibitor indicated for: Treatment of hypertension in adults and pediatric patients 6 years of age and older ( 1.1 ) Adjunct therapy for heart failure ( 1.2 ) Treatment of Acute Myocardial Infarction ( 1.3 ) 1.1 Hypertension Zestril is indicated for the treatment of hypertension in adult patients and pediatric patients 6 years of age and older to lower blood pressure. […]
On the market
- Earliest approval on file
- December 29, 1987
- Generic labelers
- 36 labelers
- Pharmacy cost
- $0.0254 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 28
Source: FDA drug labels via openFDA (Guanfacine label of June 23, 2025, Lisinopril label of January 2, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do guanfacine and lisinopril differ on the record?
In FDA's classes, guanfacine is a central alpha-2 adrenergic agonist and lisinopril an angiotensin converting enzyme inhibitor.
How each works, in its label's words: Guanfacine, “Guanfacine is a central alpha 2A -adrenergic receptor agonist.”; Lisinopril, “Lisinopril inhibits angiotensin-converting enzyme (ACE) in human subjects and animals.”
Only the lisinopril label carries a boxed warning.
Generics: guanfacine since 1995; lisinopril since 2002 (Drugs@FDA).
| Guanfacine | Lisinopril | |
|---|---|---|
| Labeled for | ADHD, High blood pressure | High blood pressure, Heart attack and coronary artery disease, Heart failure |
| Pharmacologic class | Central alpha-2 Adrenergic Agonist | Angiotensin Converting Enzyme Inhibitor |
| How it works (label) | 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. | Lisinopril inhibits angiotensin-converting enzyme (ACE) in human subjects and animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. |
| Half-life (label) | n/a | Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours. |
| Earliest approval on file (Drugs@FDA) | October 27, 1986 | December 29, 1987 |
| First generic approved | October 17, 1995 | July 1, 2002 |
| Generic labelers (NDC) | 36 labelers | 36 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.147 per tablet (Guanfacine 1 mg tablet) | $0.0254 per tablet (Lisinopril 20 mg tablet) |
| 12-month price change | -5% | -3% |
| Boxed warning | No | Yes |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 1 | 28 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 7,825 | 304,309 |
| 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 guanfacine
- every medicine labeled for the same conditions