Drug interactions
Buspirone + Nefazodone
Severity: Major
Buspirone and Nefazodone: 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
Nefazodone strongly inhibits CYP3A4 and raises buspirone concentrations several-fold, and both have serotonergic activity. This increases the risk of sedation, dizziness and serotonin toxicity.
What this interaction means in plain words
Buspirone and Nefazodone 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.
Why it happens
Nefazodone and its metabolites inhibit CYP3A4 metabolism of buspirone, with additive serotonergic effects.
What to do
If combined, use a much lower buspirone dose (a fraction of the usual) and titrate to response. Monitor for sedation and serotonin syndrome.
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 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 Nefazodone?
MediHelp rates the interaction as major. Buspirone and Nefazodone 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. Nefazodone strongly inhibits CYP3A4 and raises buspirone concentrations several-fold, and both have serotonergic activity. This increases the risk of sedation, dizziness and serotonin toxicity.
How serious is the interaction between Buspirone and Nefazodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If combined, use a much lower buspirone dose (a fraction of the usual) and titrate to response. Monitor for sedation and serotonin syndrome.
What other medicines interact with Buspirone?
MediHelp also lists interactions of Buspirone with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Buspirone page.
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