Cenobamate and Guanfacine interaction
Cenobamate and Guanfacine: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.
Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.
What the FDA labels say
From the Cenobamate (Xcopri) label · effective 2025-08-25
Concomitant use with other CNS depressants or alcohol may have additive effects.
Patients should be carefully observed for signs of central nervous system (CNS) depression, such as somnolence and sedation, when XCOPRI is used with other drugs with sedative properties because of potential additive effects.
From the Guanfacine (Intuniv) label · effective 2025-06-23
…Interactions: Effect of other Drugs on INTUNIV Concomitant Drug Name or Drug Class Clinical Rationale and Magnitude of Drug Interaction Clinical Recommendation Strong and moderate CYP3A4 inhibitors, e.g., ketoconazole, fluconazole Guanfacine is primarily metabolized by CYP3A4 and its plasma concentrations can be significantly affected resulting in an increase…
Decrease INTUNIV to 50% of target dosage when coadministered with strong and moderate CYP3A4 inhibitors ( 2.7 ).
Strong and moderate CYP3A4 inducers decrease guanfacine exposure.
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.