Guanfacine is the cheapest thing in the ADHD medicine cabinet, and the most common mistake people make about it is assuming the extended-release version is the expensive one. It is not. Every price on this page was researched fresh on September 3, 2026, and the numbers say the opposite.
The confusion is understandable. Guanfacine comes in two forms that look like a budget version and a premium version: the immediate-release tablet, which was sold as Tenex, and the extended-release tablet, which was sold as Intuniv. What actually drives your bill is not IR versus ER. It is brand versus generic, and the gap there is enormous.
What Does Guanfacine Cost Without Insurance?
Acquisition costs come from the CMS National Average Drug Acquisition Cost survey, the federal file recording what pharmacies pay wholesalers, effective August 19, 2026. Cash prices come from the Drugs.com price guide and Cost Plus Drugs, both read September 3, 2026.
| Option | Low | Average | High |
|---|---|---|---|
| NADAC acquisition cost, one generic ER tablet | $0.13245 (1 mg) | $0.16603 (3 mg) | $0.17834 (4 mg) |
| NADAC acquisition cost, one generic IR tablet | $0.14423 (1 mg) | $0.20818 | $0.27213 (2 mg) |
| NADAC, 30 generic ER tablets at acquisition cost | $3.97 | $4.75 | $5.35 |
| Mail pharmacy, 30 generic IR tablets | $6.72 (1 mg) | $7.21 | $7.69 (2 mg) |
| Retail cash, 30 generic IR tablets of 1 mg | $16.22 | $16.22 | $16.22 |
| Retail cash, 100 generic ER tablets | $28.19 (2 mg) | $35.99 | $50.17 (3 mg) |
| NADAC acquisition cost, one brand Intuniv tablet | $9.29119 (4 mg) | $9.32389 | $9.39735 (1 mg) |
| Brand Intuniv, 30 tablets | $278.74 | $279.72 | $287.03 |
| Clonidine IR, 30 tablets (comparator) | $5.59 (0.1 mg) | $5.76 | $5.93 (0.3 mg) |
| Clonidine ER, 30 tablets (comparator) | $10.86 | $10.86 | $10.86 |
The single most useful row is the comparison between generic extended-release at $3.97 to $5.35 per 30 tablets at acquisition cost and brand Intuniv at $278.74 to $281.92 for the same count. That is a 50-fold to 70-fold spread on the identical molecule in the identical dosage form.
What Drives the Price
Brand versus generic, and nothing else comes close. The FDA drug approval database lists 14 applications for guanfacine extended-release tablets as of September 3, 2026: one new drug application from Takeda (Intuniv) and 13 abbreviated new drug applications from generic manufacturers, ten of which are still marketed. That many competing sellers is why the generic costs pennies. If your pharmacy hands you a $280 bill for a 30-day supply, you were dispensed the brand.
Not the release form. This is the counterintuitive part. At acquisition cost, extended-release guanfacine runs $0.13245 to $0.17834 per tablet, while immediate-release runs $0.14423 for the 1 mg and $0.27213 for the 2 mg. The 2 mg extended-release tablet is cheaper per tablet than the 2 mg immediate-release. At retail the two land in the same band, roughly $8 to $16 for 30 days. The forms are prescribed for different reasons and are not interchangeable, and that is a decision for your prescriber, but neither is the budget option.
Package size, not strength. The clearest lever on this page is how many tablets you buy at once. Drugs.com quotes generic ER only in 100-count bottles at $0.28 to $0.50 per tablet, while the 30-count immediate-release quote works out to $0.54 per tablet. A 90-day fill spreads the pharmacy’s dispensing fee across three times as many tablets, and on a drug this cheap that fee is most of your bill.
Supply is thinning slightly at the edges. The FDA’s drug shortage and discontinuation database records that Actavis Pharma posted a “to be discontinued” notice on November 13, 2025 for all four strengths of its guanfacine extended-release tablet, attributed to a business decision rather than a manufacturing problem. There is no active shortage, and ten other generic applications remain marketed, but it is a reason to expect some price drift and to check your own pharmacy’s stock rather than assume the lowest quoted price is available everywhere.
No retail program covers it. Walmart’s Prescription Program drug list, effective March 24, 2025, does not include guanfacine at any tier. That program has three price levels ($4/$10, $9/$24 and $15/$38), and guanfacine is on none of them. Clonidine, by contrast, sits on the $4 tier at 60 tablets for 30 days.
Cash Price vs. Insurance
Guanfacine is one of the drugs where paying cash frequently beats running the claim. If your plan has a deductible you have not met, or a copay above about $15, a mail pharmacy or a discount card will usually come in lower than your covered price, and the cash payment simply will not count toward your deductible.
The exception is brand Intuniv. At $279 to $287 for 30 tablets, no cash strategy beats a covered claim if you have coverage. If you do not, and you have specifically been prescribed the brand rather than the generic, that is a conversation worth having with your prescriber about whether the generic is acceptable for you, since a substitution decision is theirs to make and not the pharmacy’s default in every state.
One more scenario matters here: pediatric fills. Guanfacine is prescribed to children frequently, and children’s doses change often. Filling 90 days of a strength that gets changed after three weeks wastes the discount you were chasing. If the dose is still being adjusted, a 30-day fill at $7 to $16 is not much worse than a 90-day fill, and it wastes less.
How to Pay Less
1. Compare a mail pharmacy against your corner pharmacy. Cost Plus Drugs listed guanfacine immediate-release at $6.72 for 30 of the 1 mg and $7.69 for 30 of the 2 mg on September 3, 2026. That pricing model is published: their stated cost, plus a 15% markup, plus a pharmacy fee, plus shipping and taxes that vary by location and are charged once per order rather than per medication. On a drug this cheap, shipping can be a meaningful share of the total, so order multiple prescriptions together if you have them. Note that Cost Plus carried the immediate-release tablet and clonidine but no guanfacine extended-release product on the day we checked.
2. Ask for a 90-day fill. The per-tablet price drops sharply with quantity on every source we checked. Drugs.com quoted 100 immediate-release 1 mg tablets at $27.65 to $44.14 against $16.22 for 30, which is as low as roughly half the per-tablet price. Ask the pharmacy to quote both.
3. Run a discount card before you pay the counter price. Guanfacine is exactly the kind of high-competition generic where discount cards do their best work. Compare more than one, since the same drug can price differently across cards at the same pharmacy. Our comparison of GoodRx vs. SingleCare walks through how they differ and when each one wins.
4. Ask specifically for the generic if you were quoted a brand price. A $280 quote for a 30-day supply means brand Intuniv. A $7 to $16 quote means generic guanfacine. If you see the higher number, ask the pharmacy what the generic would cost before you fill, and if the prescription was written brand-necessary, call the prescriber’s office.
5. Get the prescribing visit priced separately. The medication is the cheap part of ADHD care. Follow-up visits, refills and any required monitoring add up faster than a $10 prescription. Federally qualified health centers and sliding-scale clinics charge based on income. See free clinics and sliding-scale care, and psychiatrist costs for what those visits run at market rates.
6. Check any quote you get. If a pharmacy quotes you $60 for a month of generic guanfacine, that is well outside the range every source on this page reports. Our fair price checker is a fast way to see whether a quote is in line, and if you have already been billed something that looks wrong, our guide to negotiating medical bills covers how to push back.
How This Page Differs From Its Siblings
Guanfacine is the low end of the ADHD price range, and that is the point of this page. If you are comparing across the category, the other guides cover very different situations. Qelbree cost is the brand-only non-stimulant at roughly $399 a month with no generic anywhere. Strattera cost covers atomoxetine, the other older non-stimulant. Vyvanse, Concerta and Ritalin cover the stimulants, which carry their own controlled-substance supply and refill constraints that guanfacine does not.
Nothing here is advice about which medication to take, and guanfacine immediate-release is not a cheaper stand-in for guanfacine extended-release. They are different products with different prescribing rationales, and the choice belongs to your prescriber.
The Bottom Line
Generic guanfacine costs about $7 to $16 for a 30-day supply as of September 2026 in either release form, and the underlying acquisition cost is under $6 per 30 tablets. Brand Intuniv costs $279 to $287 for the same 30 tablets. That brand-to-generic gap is the only thing on this page big enough to change your budget.
If you are paying more than about $20 a month for generic guanfacine, the fix is almost always a bigger fill, a different pharmacy, or a discount card, not a different medication.