Combination is contraindicated within 2 weeks of MAOI use. procarbazine, buspirone. Other (see comment). Contraindicated. Comment: Concomitant use of buspirone with MAOIs can increase blood pressure; this combination should be avoided.protriptylineSerious - Use Alternative (1)protriptyline and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.quinupristin/dalfopristinMonitor Closely (1)quinupristin/dalfopristin will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rasagilineSerious - Use Alternative (1)rasagiline, buspirone. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of acute hypertensive episode. Avoid combination within 14 days of MAOI use.ribociclibMonitor Closely (1)ribociclib will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifabutinSerious - Use Alternative (1)rifabutin will decrease the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.rifampinSerious - Use Alternative (1)rifampin will decrease the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.rifapentineMonitor Closely (1)rifapentine will decrease the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ritonavirMonitor Closely (1)ritonavir will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rizatriptanMonitor Closely (1)rizatriptan and buspirone both increase serotonin levels. Modify Therapy/Monitor Closely.rucaparibMonitor Closely (1)rucaparib will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.rufinamideMonitor Closely (1)rufinamide will decrease the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.SAMeMonitor Closely (1)buspirone and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.saquinavirMonitor Closely (1)saquinavir will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital will decrease the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.selegilineSerious - Use Alternative (1)selegiline and buspirone both increase serotonin levels. Avoid or Use Alternate Drug. Concurrent use is not recommended. Risk of acute hypertensive episodes.selegiline transdermalContraindicated (1)selegiline transdermal, buspirone. Mechanism: pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.Serious - Use Alternative (1)selegiline transdermal and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.selinexorSerious - Use Alternative (1)selinexor, buspirone. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.sertralineSerious - Use Alternative (1)sertraline and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.St John's WortSerious - Use Alternative (2)buspirone and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug. St John's Wort will decrease the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.stiripentolMonitor Closely (1)stiripentol, buspirone. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.sufentanil SLSerious - Use Alternative (1)sufentanil SL, buspirone. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.sumatriptanMonitor Closely (1)sumatriptan and buspirone both increase serotonin levels. Modify Therapy/Monitor Closely.sumatriptan intranasalMonitor Closely (1)sumatriptan intranasal and buspirone both increase serotonin levels. Modify Therapy/Monitor Closely.tazemetostatMonitor Closely (1)tazemetostat will decrease the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tecovirimatMonitor Closely (1)tecovirimat will decrease the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.topiramateMonitor Closely (1)topiramate will decrease the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tramadolMonitor Closely (1)buspirone and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.tranylcypromineContraindicated (2)tranylcypromine and buspirone both increase serotonin levels. Contraindicated. tranylcypromine, buspirone. Mechanism: pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.trazodoneSerious - Use Alternative (1)trazodone and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.trimipramineSerious - Use Alternative (1)trimipramine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.tucatinibSerious - Use Alternative (1)tucatinib will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.venlafaxineSerious - Use Alternative (1)venlafaxine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.verapamilMonitor Closely (1)verapamil will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider lower buspirone doses.vilazodoneSerious - Use Alternative (1)buspirone, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .voriconazoleMonitor Closely (1)voriconazole will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.voxelotorSerious - Use Alternative (1)voxelotor will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.zafirlukastMonitor Closely (1)zafirlukast will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.zolmitriptanMonitor Closely (1)zolmitriptan and buspirone both increase serotonin levels. Modify Therapy/Monitor Closely. >10% Dizziness (12%) 1-10% Drowsiness (10%) Nausea (8%) Headache (6%) Nervousness (5%) Blurred vision (2%) Confusion (2%) Diarrhea (2%) Excitement (2%) Insomnia (2%) Myalgia (1%) Numbness (2%) Paresthesia (1%) Rash (1%) Tremor (1%) Weakness (2%) Nasal congestion (1%) Sore throat (1%) Nonspecific chest pain (1%) Tinnitus (1%) Dream disturbances (1%) <1% Akathisia Allergic reaction Anorexia Bruising Galactorrhea Heart failure Menstrual irregularity Suicidal ideation Syncope Alopecia Eosinophilia Edema Enuresis Increased ocular pressure Visual disturbances Rectal bleeding Photophobia Dystonia Contraindications Hypersensitivity Cautions Do not use PRN for anxiety Will not prevent withdrawal from other anxiolytics, such as benzodiazepine May cause cognitive motor impairment Restlessness syndrome associated with therapy Use in severe renal/hepatic impairment not recommended Use with MAO inhibitors may result in hypertensive reaction (use not recommended) Pregnancy category: B Lactation: Excretion in milk unknown/not recommendedPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Is an azaspirodecanedione; high affinity for serotonin 5HT1A and 5HT2 receptors and moderate affinity for dopamine D2 receptors, but no effect on benzodiazepine GABA receptors No anticonvulsant, muscle relaxant, or sedative effects Absorption Bioavailability: ~4% Onset: 2-4 wk (anxiolytic effects) Peak serum time: 40-90 min Peak plasma concentration: 1-6 ng/mL Distribution Protein bound: 86% Vd: 5.3 L/kg Metabolism Hepatic metabolism by CYP3A4 Metabolites: 1-pyrimidinylpiperazine (1-PP) Elimination Half-life: 2-3 hr Excretion: Urine (29-63%); feces (18-38%) Total body clearance: 28 mL/min/kg BRAND FORM. UNIT PRICE PILL IMAGE buspirone oral- 10 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 7.5 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 7.5 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 7.5 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 7.5 mg tabletbuspirone oral- 7.5 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 7.5 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 5 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 7.5 mg tabletbuspirone oral- 7.5 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 10 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 7.5 mg tabletbuspirone oral- 30 mg tabletbuspirone oral- 15 mg tabletbuspirone oral- 5 mg tabletCopyright © 2010 First DataBank, Inc.Print Patient Educationbuspirone oral BUSPIRONE - ORAL (bue-SPYE-rone) COMMON BRAND NAME(S): Buspar USES: This medication is used to treat anxiety. It may help you think more clearly, relax, worry less, and take part in everyday life. It may also help you to feel less jittery and irritable, and may control symptoms such as trouble sleeping, sweating, and pounding heartbeat. Buspirone is a medication for anxiety (anxiolytic) that works by affecting certain natural substances in the brain (neurotransmitters). HOW TO USE: Take this medication by mouth as directed by your doctor, usually 2 or 3 times a day. You may take this medication with or without food, but it is important to choose one way and always take it the same way so that the amount of drug absorbed will always be the same.Buspirone may come in a tablet that can be split to get the correct dose for you. Follow the manufacturer's Patient Instruction Sheet or ask your pharmacist how to split the tablet to get your dose.Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.Dosage is based on your medical condition and response to therapy. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day. When this medication is started, symptoms of anxiety (such as restlessness) may sometimes get worse before they improve. It may take up to a month or more to get the full effect of this medication.Inform your doctor if your symptoms last or get worse. SIDE EFFECTS: Dizziness, drowsiness, headache, nausea, nervousness, lightheadedness, restlessness, blurred vision, tiredness, and trouble sleeping may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Rarely, patients taking buspirone may develop movement disorders such as shakiness (tremors), muscle stiffness, mask-like facial expression, jerky walking movements, or a condition known as tardive dyskinesia. In some cases, these conditions may be permanent. Tell your doctor right away if you develop any unusual/uncontrolled movements (especially of the face, mouth, tongue, arms, or legs).Get medical help right away if you have any very serious side effects, including: easy bleeding/bruising, shortness of breath, chest pain, fast/irregular heartbeat.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist .In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Before taking buspirone, tell your doctor or pharmacist if you are allergic to it;