Buspirone with Nialamide Interaction Details
Brand Names Associated with Buspirone
- BuSpar®
- Buspirone
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Mar 06, 2024
Interaction Effect
Hypertensive crisis
Interaction Summary
Concurrent administration of busPIRone with the monoamine oxidase inhibitor (MAOI) nialamide is not recommended[1]. Cases of hypertensive crisis have occurred when MAOIs have been administered simultaneously with busPIRone. This interaction may be mediated by the affinity of busPIRone for serotonin receptors.
Severity
Major
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Coadministration of busPIRone with monoamine oxidase inhibitors (MAOI), including nialamide, is not recommended. Allow 14 days to elapse between withdrawal of the MAOI and administration of busPIRone.
Mechanism Of Interaction
Unknown
Literature Reports
A) Increased blood pressure has been reported in patients receiving concomitant busPIRone and monoamine oxidase inhibitors. To date, four cases have been described. In the first, a 76-year-old female with a history of labile blood pressure was receiving phenelzine 30 mg to 45 mg daily. After a single dose of busPIRone 5 mg, the patient's blood pressure increased to 170/110 mmHg, remained elevated for several hours, then returned to baseline. The second patient, a male in his 30's, was receiving tranylcypromine for approximately three weeks before initiating busPIRone 15 mg daily. Three days after beginning busPIRone, his blood pressure increased from 110/86 mmHg to 160/100 mmHg. The third patient was a 42-year-old male on tranylcypromine 10 mg three times daily. BusPIRone 5 mg daily was added after a few weeks and the patient developed flushing, headache, and elevation of blood pressure to 180/110 mmHg. In the final case, a 35-year-old male who was taking phenelzine 15 mg three times daily was given busPIRone 5 mg daily. After three days, the blood pressure increased to 160/110 mmHg. Discontinuation of busPIRone in all four patients resulted in a return of blood pressure to baseline. It is speculated that the mechanism of this interaction may be related to the affinity of busPIRone for serotonin receptors [2].
References
1 ) Product Information: BuSpar(R), buspirone. Bristol-Myers Squibb Company, Princeton, NJ, 1998.
2 ) Personal Communication: H Oliver Stoutland, MD, Associate Director, Pharmaceutical Medical Services. Mead Johnson Pharmaceuticals, March, 1989.
Buspirone Overview
-
Buspirone is used to treat anxiety disorders or in the short-term treatment of symptoms of anxiety. Buspirone is in a class of medications called anxiolytics. It works by changing the amounts of certain natural substances in the brain.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
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Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
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