Comment
Author: Admin | 2025-04-28
Inhibitors. Low buspirone dosage (i.e., 2.5 mg once or twice daily) recommended in patients receiving potent CYP3A4 inhibitor; base subsequent adjustments of buspirone and CYP3A4 inhibitor dosage on clinical assessment.Possible pharmacokinetic interaction (decreased plasma buspirone concentrations) with CYP3A4 inducers. May require dosage adjustment to maintain anxiolytic effect.Protein-bound DrugsPossible displacement from binding sites of buspirone or other protein-bound drugs. One report of increased prothrombin time when buspirone was added to a regimen of warfarin, phenytoin, phenobarbital, digoxin, and levothyroxine (Synthroid); clinical importance unknown.Specific Drugs and FoodsDrug or FoodInteractionCommentsAlcoholDoes not appear to alter blood alcohol concentrations or substantially potentiate alcohol-induced impairment of psychomotor and cognitive performance Prudent to avoid concomitant useAmitriptylineNo interaction reported CimetidinePossible decrease in buspirone clearance Clinical importance not establishedCNS depressants (e.g., analgesics, antihistamines, sedative/hypnotics including benzodiazepines)Possible CNS depression, although few interactions reported to date Use with caution DiltiazemIncreased plasma buspirone concentrationsBuspirone dosage adjustment may be necessaryErythromycinIncreased plasma buspirone concentrations and increased incidence of adverse effects attributable to buspironeDecrease buspirone dosage (e.g., 2.5 mg twice daily); base subsequent adjustments of buspirone and erythromycin dosage on clinical assessmentGrapefruit juiceIncreased plasma buspirone concentrationsAvoid drinking large amounts of grapefruit juiceHaloperidolIncreased serum haloperidol concentrations Clinical importance not establishedItraconazoleIncreased plasma buspirone concentrations and increased incidence of adverse effects attributable to buspironeDecrease buspirone dosage (e.g., 2.5 mg daily); base subsequent adjustments of buspirone and itraconazole dosage on clinical assessmentMAO inhibitors (e.g., tranylcypromine)Increased blood pressure; possible contribution to a fatal case of serotonin syndrome when used concomitantly with fluoxetine and tranylcypromine Do not use concomitantly; allow 10 days between discontinuance of MAO inhibitor and administration of buspirone NefazodoneMarked increase in plasma buspirone concentration; slight increase in concentrations of nefazodone and its metaboliteUse with caution; decrease buspirone dosage (e.g., 2.5 mg daily); base subsequent adjustments of buspirone and nefazodone dosage on clinical assessmentRifampinDecreased plasma buspirone concentrationsAdjust buspirone dosage
Add Comment