buspirone hydrochloride

(byoo spye' rone)

BuSpar

Pregnancy Category B

Drug class
Anxiolytic

Therapeutic actions
Mechanism of action not known; lacks antiseizure, sedative, or muscle relaxant
properties; binds serotonin receptors, but the clinical significance is unclear.

Indications
• Management of anxiety disorders or short-term relief of symptoms of anxiety
• Unlabeled use: Decreasing the symptoms (aches, pains, fatigue, cramps,
irritability) of PMS

Contraindications and cautions

• Contraindicated with hypersensitivity to buspirone; marked liver or renal
impairment; lactation.
• Use cautiously with pregnancy, mild renal or hepatic impairment.

Available forms
Tablets—5, 10, 15 mg

Dosages
ADULTS
Initially, 15 mg/day PO (5 mg tid). Increase dosage 5 mg/day at intervals of 2–3 days to
achieve optimal therapeutic response. Do not exceed 60 mg/day. Divided doses of 20–
30 mg/day have been used.
PEDIATRIC PATIENTS
Safety and efficacy for children < 18 yr not established.

Pharmacokinetics
Route Onset Peak
Oral 7–10 days 40–90 min

Metabolism: Hepatic; T1/2: 3–11 hr

Distribution: May enter breast milk
Excretion: Urine

Adverse effects
• CNS: Dizziness, headache, nervousness, insomnia, light-headedness, excitement,
dream disturbances, drowsiness, decreased concentration, anger, hostility,
confusion, depression, tinnitus, blurred vision, numbness, paresthesia,
incoordination, tremor, depersonalization, dysphoria, noise intolerance, euphoria,
 akathisia, fearfulness, loss of interest, disassociative reaction, hallucinations,
suicidal ideation, seizures, altered taste and smell, involuntary movements,
slowed reaction time
• CV: Nonspecific chest pain, tachycardia or palpitations, syncope, hypotension,
hypertension
• GI: Nausea, dry mouth, vomiting, abdominal or gastric distress, diarrhea,
constipation, flatulence, anorexia, increased appetite, salivation, irritable colon
and rectal bleeding
• GU: Urinary frequency, urinary hesitancy, dysuria, increased or decreased libido,
menstrual irregularity, spotting
• Respiratory: Hyperventilation, shortness of breath, chest congestion
• Other: Musculoskeletal aches and pains, sweating, clamminess, sore throat, nasal
congestion

Interactions
Drug-drug
• Give with caution to patients taking alcohol, other CNS depressants
• Decreased effects with fluoxetine
• Increased serum levels of buspirone if taken with erythromycin, itraconazole,
netazodone; decrease buspirone dose to 2.5 mg and monitor closely if these
combinations are used
• Risk of increased haloperidol levels if combined.

Nursing considerations
Assessment
• History: Hypersensitivity to buspirone, marked liver or renal impairment,
lactation
• Physical: Weight; T; skin color, lesions; mucous membranes, throat color, lesions,
orientation, affect, reflexes, vision exam; P, BP; R, adventitious sounds; bowel
sounds, normal GI output, liver evaluation; normal urinary output, voiding
pattern; liver and kidney function tests, urinalysis, CBC and differential

Interventions
• Provide sugarless lozenges, ice chips, if dry mouth or altered taste occur.
• Arrange for analgesic for headache, musculoskeletal aches.

Teaching points
• Take this drug exactly as prescribed.
• Avoid the use of alcohol, sleep-inducing, or over-the-counter drugs; these could
cause dangerous effects.
• These side effects may occur: Drowsiness, dizziness, light-headedness (avoid
driving or operating complex machinery); GI upset (eat small, frequent meals);
dry mouth (suck ice chips or sugarless candies); dreams, nightmares, difficulty
concentrating or sleeping, confusion, excitement (reversible; will stop when the
drug is discontinued).
 • Report abnormal involuntary movements of facial or neck muscles, motor
restlessness; sore or cramped muscles; abnormal posture; yellowing of the skin or
eyes.

Adverse effects in Italic are most common; those in Bold are life-threatening.