Maximum Daily Dose for Buspirone (BuSpar)
The maximum daily dose for buspirone (BuSpar) is 60 mg per day, typically administered as 20 mg three times daily. 1
Dosing Guidelines
Buspirone dosing follows a structured approach:
- Initial dosing: Start with 5 mg twice daily
- Titration: Increase gradually using increments of the initial dose every 5-7 days
- Therapeutic range: Most patients are effectively managed on 15-30 mg per day 2
- Maximum dose: 20 mg three times daily (60 mg total daily dose) 1
- Administration: Can be given as divided doses or as a single daily dose at bedtime or with the main meal
Clinical Considerations
Efficacy Timeline
- Buspirone may take 2-4 weeks to become effective 1
- This delayed onset of action is important to communicate to patients to ensure compliance 3
Patient Population Considerations
- Buspirone is most useful in patients with mild to moderate agitation 1
- No dosage adjustments based on age or gender are required 4
Special Populations
- Hepatic impairment: Significant dose reduction needed as plasma concentrations can be 15-fold higher and half-life doubles in patients with liver impairment 4
- Renal impairment: Dose adjustment recommended as concentrations can be 2-fold higher in patients with kidney dysfunction 4
Drug Interactions
Important interactions to monitor:
- CYP3A4 inhibitors (verapamil, diltiazem, erythromycin, itraconazole): Can substantially increase buspirone plasma concentrations 4
- CYP3A4 inducers (rifampicin): Can decrease buspirone plasma concentrations up to 10-fold 4
- Food: Taking with food can increase peak concentration and bioavailability 2-fold 4
Safety Profile
- Long-term studies have demonstrated safety for treatment periods up to one year 2
- No withdrawal syndrome observed when discontinued after 6+ months of therapy 2
- Common side effects include nausea and dizziness rather than sedation 3
- Unlike benzodiazepines, buspirone has limited potential for abuse and dependence 3
- Does not typically impair psychomotor or cognitive function 3
Clinical Monitoring
- Periodic reevaluation of the need for continued therapy is recommended when used for several months or longer 2
- Monitor for side effects, particularly when initiating therapy or adjusting doses
- For long-term therapy, consider periodic drug holidays to reassess continued need for medication