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Pharmacologic class: Azaspirodecanedione
Therapeutic class: Anxiolytic
Pregnancy risk category B
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.
Tablets: 5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg
⊘Indications and dosages
➣ Anxiety disorders; anxiety symptoms
Adults: 7.5 mg P.O. b.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.
• Parkinsonian syndrome
• Symptomatic relief of depression
• Hypersensitivity to drug
• Severe renal or hepatic impairment
• MAO inhibitor use within past 14 days
Use cautiously in:
• patients receiving concurrent anxi-olytics or psychotropics
• pregnant or breastfeeding patients
• Give with food to minimize GI upset.
• Know that full benefit of drug therapy may take up to 2 weeks.
CNS: dizziness, drowsiness, nervousness, headache, insomnia, weakness, personality changes, numbness, paresthesia, tremor, dream disturbances
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
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
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
• Monitor mental status closely.
• Assess hepatic and renal function regularly to detect drug toxicity.
• 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.