Buspirone BID Dosing Schedule
Buspirone should be taken twice daily with doses spaced approximately 12 hours apart, with the first dose in the morning and the second dose in the early evening, and it must be taken consistently either always with food or always without food. 1
Recommended Timing for BID Administration
- Take the first dose in the morning upon waking 2, 3
- Take the second dose approximately 12 hours later (early evening) 2, 3
- The 12-hour interval between doses maintains steady therapeutic plasma levels throughout the day 4
Critical Food Consistency Requirement
- Buspirone must be taken in a consistent manner with regard to food—either always with meals or always on an empty stomach 1
- Food increases buspirone bioavailability approximately 2-fold compared to the fasted state 1, 5
- Inconsistent food intake with doses can lead to unpredictable plasma concentrations and variable therapeutic response 5
Standard Dosing Regimen
- Start with 7.5 mg twice daily (15 mg total daily dose) 1
- Increase by 5 mg per day every 2-3 days as needed based on response and tolerability 2, 1
- Target therapeutic range is 15-30 mg/day divided into 2 doses (7.5-15 mg BID) 2, 3
- Maximum daily dose should not exceed 60 mg per day (30 mg BID) 2, 3, 1
Clinical Advantages of BID vs TID Dosing
- BID dosing (15 mg twice daily) offers equivalent efficacy and safety compared to TID dosing (10 mg three times daily) for the same total daily dose 4
- BID dosing provides improved convenience and potentially higher medication compliance without compromising the safety profile 4
- The incidence of adverse events is similar between BID and TID regimens, with only palpitations occurring slightly more frequently with BID dosing (5% vs 1%) 4
Important Timing Considerations
- Buspirone has a short elimination half-life of approximately 2.5 hours, necessitating divided dosing to maintain therapeutic levels 5, 6
- The 12-hour dosing interval for BID administration accounts for the drug's pharmacokinetic profile while providing practical convenience 4
- Patients should be counseled that therapeutic effects require 2-4 weeks to become apparent, so consistent timing and adherence are essential during the initial treatment period 2, 3
Special Population Adjustments
- Elderly patients should start with lower doses (2.5-5 mg daily) and use the same BID timing schedule once titrated 2
- Patients with hepatic impairment require dose reduction but maintain the same BID timing schedule 5
- Patients with renal impairment experience increased drug exposure but can use standard BID timing with appropriate dose adjustments 5