Drug interactions
Buspirone + Itraconazole
Severity: Major
Buspirone and Itraconazole: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Itraconazole markedly increases buspirone concentrations, leading to dizziness, drowsiness, nausea and potentially excessive serotonergic effects. Buspirone undergoes extensive first-pass CYP3A4 metabolism, so exposure rises substantially.
What this interaction means in plain words
Buspirone and Itraconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Buspirone belongs to Central Nervous System; Itraconazole belongs to Anti Fungals.
Why it happens
Itraconazole inhibits intestinal and hepatic CYP3A4, reducing first-pass metabolism of buspirone.
What to do
Start with a low buspirone dose and titrate by clinical response, keeping the daily dose low. Monitor for sedation and dizziness, or choose a non-interacting anxiolytic.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Other interactions of Buspirone
- Buspirone + Isocarboxazid Contraindicated
- Buspirone + Linezolid Contraindicated
- Buspirone + Phenelzine Contraindicated
- Buspirone + Procarbazine Contraindicated
- Buspirone + Selegiline Contraindicated
- Buspirone + Selegiline transdermal Contraindicated
Frequently asked questions
Can I take Buspirone with Itraconazole?
MediHelp rates the interaction as major. Buspirone and Itraconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Itraconazole markedly increases buspirone concentrations, leading to dizziness, drowsiness, nausea and potentially excessive serotonergic effects. Buspirone undergoes extensive first-pass CYP3A4 metabolism, so exposure rises substantially.
How serious is the interaction between Buspirone and Itraconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with a low buspirone dose and titrate by clinical response, keeping the daily dose low. Monitor for sedation and dizziness, or choose a non-interacting anxiolytic.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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