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buspirone hydrochloride
BuSpar (brand discontinued; generic)
Anxiolytic (non-benzodiazepine)⚠ Unverified beta content
At a glance
- Class
- Azapirone anxiolytic (5-HT1A partial agonist)
- Black box
- None listed
- Key monitoring
- Anxiety symptoms / response
- Serotonin toxicity signs (esp. with other serotonergic drugs)
- Usual adult dose
- Anxiety (label): Start 15 mg/day (7.5 mg BID); ↑ 5 mg/day every 2–3 days; usual 20–30 mg/day divided; max 60 mg/day
- Call provider / escalate if
- Agitation, fever, sweating, tremor, muscle stiffness, diarrhea, fast heartbeat (serotonin syndrome) • Severe dizziness, fainting • Involuntary movements or severe restlessness
Built-in explanation — generated offline from this app’s structured data (no AI, no network). Still unverified beta content.
What it is
- buspirone hydrochloride (BuSpar (brand discontinued; generic)) — azapirone anxiolytic (5-HT1A partial agonist).
- Used for: Management of anxiety disorders / short-term relief of anxiety symptoms.
Usual adult dosing
- Anxiety (label): Start 15 mg/day (7.5 mg BID); ↑ 5 mg/day every 2–3 days; usual 20–30 mg/day divided; max 60 mg/day (Take consistently with or without food. With potent CYP3A4 inhibitors, follow label dose reduction.)
Boxed warning
- None listed in this entry — still review serious warnings.
Monitor
- Anxiety symptoms / response [Each visit; response may take several weeks]
- Serotonin toxicity signs (esp. with other serotonergic drugs)
Nursing priorities
- Baseline anxiety symptoms/severity, suicidality, substance use.
- Medication list: MAOIs (contraindicated within 14 days), serotonergic drugs, CYP3A4 inhibitors/inducers.
- Teach that it is scheduled, not PRN – benefit builds over weeks, not minutes.
- Give consistently with respect to food.
- Monitor for dizziness and falls, especially early.
Major interactions
- MAOIs (incl. linezolid, IV methylene blue): Contraindicated – risk of serotonin syndrome / elevated BP; 14-day separation.
- Strong CYP3A4 inhibitors (itraconazole, nefazodone, diltiazem, verapamil, erythromycin, grapefruit juice in large amounts): ↑ buspirone levels – reduce buspirone dose.
- Other serotonergic drugs (SSRIs, SNRIs, triptans, trazodone, St John’s wort): Serotonin syndrome risk.
Key teaching
- Take it every day, at the same times, and either always with food or always without. It is not a “take only when anxious” medicine.
- It may take a few weeks to feel the full effect.
- It can cause dizziness, nausea, or headache – stand up slowly and be careful driving until you know how it affects you.
Optional: AI explanation
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Other serious warnings
- Serotonin syndrome (alone or with other serotonergic drugs)
- Hypertensive reactions with MAOIs – contraindicated
- Not effective for benzodiazepine/sedative withdrawal; does not suppress it – taper the prior agent
- Dopamine-related effects: rare restlessness/movement disorders reported
- Dizziness/impaired performance – caution with driving
Sources: FDA label (DailyMed): BUSPIRONE HYDROCHLORIDE TABLET [PD-RX PHARMACEUT
- Anxiety symptoms / responseWhen: Each visit; response may take several weeks
- Dizziness / falls / sedation
- Serotonin toxicity signs (esp. with other serotonergic drugs)
- Blood pressureIf combined with MAOI (contraindicated) or symptomatic
Sources: FDA label (DailyMed): BUSPIRONE HYDROCHLORIDE TABLET [PD-RX PHARMACEUT
Assessment
- Baseline anxiety symptoms/severity, suicidality, substance use.
- Medication list: MAOIs (contraindicated within 14 days), serotonergic drugs, CYP3A4 inhibitors/inducers.
- Whether the patient is being switched from a benzodiazepine (needs taper).
Interventions
- Teach that it is scheduled, not PRN – benefit builds over weeks, not minutes.
- Give consistently with respect to food.
- Monitor for dizziness and falls, especially early.
- Avoid large amounts of grapefruit juice.
- Monitor for serotonin syndrome signs if combined with SSRIs/SNRIs/triptans.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Agitation, fever, sweating, tremor, muscle stiffness, diarrhea, fast heartbeat (serotonin syndrome)
- Severe dizziness, fainting
- Involuntary movements or severe restlessness
- Worsening anxiety or thoughts of self-harm
- Allergic reaction (rash, swelling)
Sources: FDA label (DailyMed): BUSPIRONE HYDROCHLORIDE TABLET [PD-RX PHARMACEUT · General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Dizziness
- Nausea
- Headache
- Nervousness
- Lightheadedness
- Drowsiness (less than benzodiazepines)
- Excitement / restlessness
Sources: FDA label (DailyMed): BUSPIRONE HYDROCHLORIDE TABLET [PD-RX PHARMACEUT
- MAOIs (incl. linezolid, IV methylene blue) MajorContraindicated – risk of serotonin syndrome / elevated BP; 14-day separation.
- Strong CYP3A4 inhibitors (itraconazole, nefazodone, diltiazem, verapamil, erythromycin, grapefruit juice in large amounts) Major↑ buspirone levels – reduce buspirone dose.
- CYP3A4 inducers (rifampin, carbamazepine, phenytoin)↓ buspirone levels – may need dose increase.
- Other serotonergic drugs (SSRIs, SNRIs, triptans, trazodone, St John’s wort) MajorSerotonin syndrome risk.
- HaloperidolBuspirone increased serum haloperidol concentrations in a volunteer study (clinical significance unclear).
Sources: FDA label (DailyMed): BUSPIRONE HYDROCHLORIDE TABLET [PD-RX PHARMACEUT
- Take it every day, at the same times, and either always with food or always without. It is not a “take only when anxious” medicine.
- It may take a few weeks to feel the full effect.
- It can cause dizziness, nausea, or headache – stand up slowly and be careful driving until you know how it affects you.
- Do not drink large amounts of grapefruit juice.
- Do not stop a benzodiazepine (like lorazepam or clonazepam) on your own when starting this medicine – buspirone does not prevent withdrawal.
- Tell your provider about all medicines, especially antidepressants and migraine medicines.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
Indications
- Management of anxiety disorders / short-term relief of anxiety symptoms (studied in generalized anxiety disorder)
- Common off-label: augmentation of antidepressants
Dosing
- Anxiety (label): Start 15 mg/day (7.5 mg BID); ↑ 5 mg/day every 2–3 days; usual 20–30 mg/day divided; max 60 mg/dayTake consistently with or without food. With potent CYP3A4 inhibitors, follow label dose reduction.
Sources: FDA label (DailyMed): BUSPIRONE HYDROCHLORIDE TABLET [PD-RX PHARMACEUT
Prescriber-oriented details; limited in this beta.
renal Adjustment
- Label: not recommended in severe renal or hepatic impairment (verify exact wording).
hepatic Adjustment
- Levels increased in hepatic impairment; avoid in severe impairment.
Sources: FDA label (DailyMed): BUSPIRONE HYDROCHLORIDE TABLET [PD-RX PHARMACEUT
- Verified
- No – unverified beta
- Last reviewed
- 2026-10-29 (drafted; not clinician-reviewed)
- FDA label (DailyMed): BUSPIRONE HYDROCHLORIDE TABLET [PD-RX PHARMACEUTICALS, INC.]
- General nursing drug reference conventions (e.g., Davis Drug Guide / Lexicomp nursing) - summarized from standard practice; NOT line-by-line verified
Reviewer notes – please double-check
- Source label used was a generic (PD-Rx repackager) buspirone label because BuSpar brand label is not marketed; check against RLD/manufacturer label.
- Renal/hepatic wording is generalized – verify.