BuSpar

Bu·spar (byspär)

A trademark for the drug buspirone hydrochloride.

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BuSpar,

trademark for an oral antianxiety drug (buspirone hydrochloride).

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buspirone hydrochloride

BuSpar

Pharmacologic class: Azaspirodecanedione

Therapeutic class: Anxiolytic

Pregnancy risk category B

Action

Unclear. Thought to bind to serotonin and dopamine receptors in CNS, increasing dopamine metabolism and impulse formation. Also thought to inhibit neuronal firing and reduce serotonin turnover.

Availability

Tablets: 5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg

⊘Indications and dosages

➣ Anxiety disorders; anxiety symptoms

Adults: 5 mg P.O. t.i.d.; increase by 5 mg/day q 2 to 3 days as needed (not to exceed 60 mg/day). Common dosage is 20 to 30 mg/day in divided doses.

Off-label uses

• Parkinsonian syndrome
• Symptomatic relief of depression

Contraindications

• Hypersensitivity to drug
• Severe renal or hepatic impairment
• MAO inhibitor use within past 14 days

Precautions

Use cautiously in:
• patients receiving concurrent anxiolytics or psychotropics
• pregnant or breastfeeding patients
• children.

Administration

• Give with food to minimize GI upset.
• Know that full benefit of drug therapy may take up to 2 weeks.

Route	Onset	Peak	Duration
P.O.	7-10 days	3-4 wk	Unknown

Adverse reactions

CNS: dizziness, drowsiness, nervousness, headache, insomnia, weakness, personality changes, numbness, paresthesia, tremor

CV: chest pain, palpitations, tachycardia, hypertension, hypotension

EENT: blurred vision, conjunctivitis, tinnitus, nasal congestion, sore throat

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dry mouth

GU: dysuria, urinary frequency or hesitancy, menstrual irregularities, menstrual spotting, libido changes

Musculoskeletal: myalgia

Respiratory: chest congestion, hyperventilation, dyspnea

Skin: rash, alopecia, blisters, pruritus, dry skin, easy bruising, edema, flushing, clammy skin, excessive sweating

Other: altered taste or smell, fever

Interactions

Drug-drug. Erythromycin, itraconazole: increased buspirone blood level

MAO inhibitors: hypertension

Trazodone: increased risk of adverse hepatic effects

Drug-food. Grapefruit juice: increased buspirone blood level and effects

Drug-herbs. Hops, kava, skullcap, valerian: increased CNS depression

Drug-behaviors. Alcohol use: increased CNS depression

Patient monitoring

• Monitor mental status closely.
• Assess hepatic and renal function regularly to detect drug toxicity.

Patient teaching

• Instruct patient to take drug with food.
• Advise patient not to use drug to manage everyday stress or tension.
• Instruct patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Caution patient to avoid alcohol because it increases CNS depression.
• Emphasize importance of keeping follow-up appointments to check progress.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, foods, herbs, and behaviors mentioned above.

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Buspar^®

Buspirone, see there