Buspirone

Reversible MAOI that increases risk of serotonin syndrome when started with buspirone.

Intravenous reversible MAOI that increases risk of serotonin syndrome when started with buspirone.

Concomitant use or use within 14 days of stopping treatment is contraindicated due to increased risk of serotonin syndrome and/or elevated blood pressure.

Serotonergic drug that increases risk of serotonin syndrome when used concomitantly with amphetamine sulfate.

Concomitant use increases risk of serotonin syndrome.

Concomitant use increases risk of serotonin syndrome. Monitor for signs and symptoms, particularly during initiation and dosage increases.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and discontinue if serotonin syndrome occurs.

Serotonergic drug that increases risk of serotonin syndrome when combined with amphetamines. Initiate with lower doses and monitor for serotonin syndrome signs.

Serotonergic drug increasing risk of serotonin syndrome with dextroamphetamine sulfate.

CYP3A4 inhibitor that increased buspirone AUC and Cmax 5.5 and 4 fold respectively; adverse events more likely.

Diltiazem significantly increases buspirone AUC 5.5-fold and Cmax 4.1-fold, potentially enhancing effects and increasing toxicity; dose adjustments may be necessary.

Concomitant use increases risk of serotonin syndrome. Monitor for signs and symptoms, particularly during initiation and dosage increases.

Serotonergic drug that increases risk of serotonin syndrome when combined with escitalopram oxalate.

Concomitant use with fluoxetine increases the risk of serotonin syndrome.

Concomitant use increases risk of serotonin syndrome; monitor for symptoms.

Concomitant use can result in serotonin syndrome. Careful monitoring advised.

Concomitant use increases risk of serotonin syndrome. Monitor for signs and symptoms, particularly during initiation and dose increases.

Marked increases in buspirone plasma concentrations (up to 20-fold in Cmax, 50-fold in AUC) with significant decreases in metabolite. Subjects experienced lightheadedness, asthenia, dizziness, somnolence.

Concomitant use increases risk of serotonin syndrome.

Concomitant use increases risk of serotonin syndrome. Monitor patients for signs and symptoms, particularly during initiation and dosage increases.

Concomitant use increases risk of serotonin syndrome. Monitor patients for signs and symptoms, particularly during treatment initiation and dosage increases.

Concomitant use increases risk of serotonin syndrome. Monitor patients for signs and symptoms during trazodone initiation.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

CYP3A4 inhibitor that increased buspirone AUC and Cmax 3.4 fold; adverse events more likely during concomitant use.

Risk of serotonin syndrome with concomitant therapy with buspirone.

Risk of serotonin syndrome with concomitant serotonergic therapy including buspirone.

Risk of serotonin syndrome with concomitant serotonergic therapy including buspirone.

Deferasirox may induce CYP3A4 resulting in decreased buspirone concentration. Monitor for reduced effectiveness.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Increases in nordiazepam levels (~15%) with minor adverse effects including dizziness, headache, and nausea observed.

May potentiate CNS depressant effects of diphenoxylate hydrochloride and atropine sulfate. Monitor for CNS adverse reactions.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increases.

Increases haloperidol plasma concentrations; monitor for increased adverse effects including QTc prolongation and dose reduction may be necessary.

Increases haloperidol plasma concentrations, raising risk of adverse events including QTc interval prolongation.

Binds to dopamine transporter with high affinity and may interfere with Ioflupane I-123 imaging results.

Serotonergic drug that increases risk of serotonin syndrome. Monitor for symptoms and discontinue if serotonin syndrome occurs.

Additive drowsiness and CNS depression reported with concurrent use.

CYP3A4 inhibitor that may increase buspirone concentrations; use with caution.

CYP3A4 substrate; caution should be exercised when administering paclitaxel concomitantly.

Concomitant use of serotonergic drugs with paroxetine increases the risk of serotonin syndrome. Monitor for symptoms.

Concomitant use increases risk of serotonin syndrome. Monitor patients during treatment initiation and dosage increases.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Serotonergic drug that increases risk of serotonin syndrome; monitor patients for signs and symptoms during initiation.

Serotonergic drug that increases risk of serotonin syndrome when used with TRINTELLIX. Monitor for serotonin syndrome symptoms.

Addition of buspirone to amitriptyline showed no statistically significant differences in steady-state pharmacokinetic parameters.

Diazepam After addition of buspirone to the diazepam dose regimen, no statistically significant differences in the steady-state pharmacokinetic parameters (C max , AUC, and C min ) were observed for diazepam, but increases of about 15% were seen for nordiazepam, and minor adverse clinical effects (dizziness, headache, and nausea) were observed.

Coadministration did not appear to prolong or intensify sedative effects.

Coadministration did not appear to prolong or intensify sedative effects.

Erythromycin In a study in healthy volunteers, coadministration of buspirone (10 mg as a single dose) with erythromycin (1.5 g/day for 4 days) increased plasma buspirone concentrations (5 fold increase in C max and 6 fold increase in AUC).

Concomitant administration resulted in increased serum haloperidol concentrations; clinical significance unclear.

Itraconazole In a study in healthy volunteers, coadministration of buspirone (10 mg as a single dose) with itraconazole (200 mg/day for 4 days) increased plasma buspirone concentrations (13 fold increase in C max and 19 fold increase in AUC).

Other Inhibitors and Inducers of CYP3A4 Substances that inhibit CYP3A4, such as ketoconazole or ritonavir, may inhibit buspirone metabolism and increase plasma concentrations of buspirone while substances that induce CYP3A4, such as dexamethasone or certain anticonvulsants (phenytoin, phenobarbital, carbamazepine), may increase the rate of buspirone metabolism.

Protein Binding In vitro , buspirone does not displace tightly bound drugs like phenytoin, propranolol, and warfarin from serum proteins. Therapeutic levels of aspirin, desipramine, diazepam, flurazepam, ibuprofen, propranolol, thioridazine, and tolbutamide had only a limited effect on the extent of binding of buspirone to plasma proteins (see CLINICAL PHARMACOLOGY ).

Other Inhibitors and Inducers of CYP3A4 Substances that inhibit CYP3A4, such as ketoconazole or ritonavir, may inhibit buspirone metabolism and increase plasma concentrations of buspirone while substances that induce CYP3A4, such as dexamethasone or certain anticonvulsants (phenytoin, phenobarbital, carbamazepine), may increase the rate of buspirone metabolism.

Therapeutic levels of aspirin, desipramine, diazepam, flurazepam, ibuprofen, propranolol, thioridazine, and tolbutamide had only a limited effect on the extent of binding of buspirone to plasma proteins (see CLINICAL PHARMACOLOGY ).

One report suggested 3-6 fold elevations in ALT, but similar study failed to replicate the finding.