What the FDA labels say about taking them together
Esmolol and guanfacine
Esmolol's FDA label of March 14, 2025 names guanfacine in its drug interactions section; the guanfacine label PlainMeds reads does not name esmolol. The esmolol label: “Antihypertensive agents clonidine or guanfacine: Beta-blockers also increase the risk of clonidine-, or guanfacine-withdrawal rebound hypertension.”
Check it at the source: the esmolol FDA label on DailyMed (effective March 14, 2025, Baxter Healthcare Company); the guanfacine FDA label on DailyMed (effective June 23, 2025, Takeda Pharmaceuticals America, Inc.).
What does the esmolol label say about guanfacine?
Esmolol label, drug interactionsIn addition, with some drugs, beta blockade may precipitate increased withdrawal effects. (See clonidine, guanfacine, and moxonidine below.) BREVIBLOC injection should therefore be used only after careful individual assessment of the risks and expected benefits in patients receiving drugs that can cause these types of pharmacodynamic interactions, including but not limited to:
Esmolol Hydrochloride In Water label (WG Critical Care, LLC, May 31, 2024), drug interactionsAntihypertensive agents clonidine or guanfacine: Beta-blockers also increase the risk of clonidine-, or guanfacine-withdrawal rebound hypertension.
Source: FDA drug label (Esmolol Hydrochloride In Water, NDA205703), WG Critical Care, LLC, effective May 31, 2024 (SPL set 60b10020-f802-4fef-a487-0f11eca246c5), via openFDA
Source: FDA drug label (Brevibloc), Baxter Healthcare Company, effective March 14, 2025 (SPL set 595cc3d5-1306-4828-aefa-5595219ffd62), via openFDA; the full label on DailyMed
What does the guanfacine label say about esmolol?
Guanfacine's label (effective June 23, 2025) does not name esmolol in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (Intuniv), Takeda Pharmaceuticals America, Inc., effective June 23, 2025 (SPL set b972af81-3a37-40be-9fe1-3ddf59852528), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Esmolol | Guanfacine | |
|---|---|---|
| Labeled for | High blood pressure, Atrial fibrillation | ADHD, High blood pressure |
| Boxed warning | No | No |
| Pharmacy cost (NADAC) | n/a | $0.147 per tablet 1 mg tablet |
| Shortage now | No current entry | A presentation being discontinued |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once