Can I take Buspirone (buspirone) 7.5 mg three times a day (tid)?

Buspirone 7.5 mg TID Dosing

Yes, buspirone 7.5 mg three times daily (TID) is an appropriate dosing regimen that falls within FDA-approved guidelines and is supported by clinical evidence.

Dosing Guidelines

According to the FDA drug label, buspirone's recommended initial dose is 15 mg daily, typically given as 7.5 mg twice daily (BID) 1. The dosage can be increased by 5 mg per day at intervals of 2-3 days as needed, with a maximum daily dosage not exceeding 60 mg per day 1. Therefore, a regimen of 7.5 mg TID (totaling 22.5 mg daily) falls well within these parameters.

Dosing Considerations:

• Starting dose: 15 mg daily (typically 7.5 mg BID)
• Titration: Increase by 5 mg per day every 2-3 days as needed
• Maximum daily dose: 60 mg
• Common effective dose range: 20-30 mg per day in divided doses 1

Clinical Evidence Supporting TID Dosing

Research supports both BID and TID dosing regimens for buspirone:

• A meta-analysis comparing buspirone 15 mg BID with 10 mg TID found similar safety and efficacy profiles between the two regimens 2
• The only significant difference was a slightly higher incidence of palpitations in the BID group (5%) compared to the TID group (1%) 2
• Most common side effects for both dosing schedules were dizziness, headache, and nausea 2

Pharmacokinetic Considerations

Buspirone has a relatively short half-life of approximately 2-3 hours, which supports the rationale for divided dosing throughout the day 3:

• Rapid absorption with peak plasma concentration reached in under 1 hour
• Elimination half-life of about 2.5 hours
• Extensive metabolism, including to the active metabolite 1-pyrimidinylpiperazine (1-PP)
• Linear pharmacokinetics over the dose range of 10-40 mg 3

Important Clinical Considerations

1. Food Effects: Bioavailability of buspirone increases when taken with food. Take buspirone consistently either always with or always without food 1

2. Onset of Action: Unlike benzodiazepines, buspirone has a gradual onset of action, with therapeutic effects typically developing over 1-2 weeks 4

3. Long-term Safety: Studies have demonstrated safety with long-term buspirone use for up to one year, with most patients successfully managed on daily doses ranging from 15-30 mg/day 5

4. Drug Interactions:

   • Allow at least 14 days between discontinuing MAOIs and starting buspirone 1
   • Use caution with CYP3A4 inhibitors (e.g., erythromycin, itraconazole), which can substantially increase buspirone plasma concentrations 3

Conclusion

A dosing regimen of buspirone 7.5 mg TID is appropriate and falls within established guidelines. This regimen provides a total daily dose of 22.5 mg, which is within the common effective range of 20-30 mg per day. The TID schedule may offer slightly better tolerability regarding palpitations compared to BID dosing while maintaining similar efficacy.