What drugs interact with hyroxyzine and buspirone?

Hydroxyzine

Hydroxyzine adds to (exaggerates) the sedating effects of alcohol and other drugs that can cause sedation such as the benzodiazepine class of anti-anxiety drugs. These drugs include:

  • diazepam (Valium)
  • lorazepam (Ativan)
  • clonazepam (Klonopin)
  • alprazolam (Xanax)

Hydroxyzine also adds to the sedating effects the narcotic class of pain medications and its derivatives, for example:

Hydroxyzine also adds to the effects of the tricyclic class of antidepressants, for example:

Hydroxyzine also adds to the effects of certain antihypertensive medications, for example:

Hydroxyzine can also intensify the drying effects of other medications with anticholinergic properties, for example:

When using these drugs, the dose of hydroxyzine may require reduction.

Busprione

Buspirone may interact with drugs called monoamine oxidase (MAO) inhibitors — such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane) — which are used in psychiatric disorders. The use of buspirone with these drugs can cause increased blood pressure. A similar reaction may occur if buspirone is combined with linezolid (Zyvox), an antibiotic that is also an MAO inhibitor. The combination of buspirone and trazodone (Desyrel), an antidepressant, may cause abnormal liver enzymes in the blood.

The combination of buspirone and warfarin (Coumadin), a blood thinner, may accentuate the effects of warfarin and increase the risk of bleeding. Patients taking buspirone should not drink grapefruit juice, since the juice (even well after a dose of buspirone is taken) can increase the amount of buspirone in the blood, possibly leading to side effects.

Inactivation and removal of buspirone is mediated by liver enzymes. Drugs that inhibit these liver enzymes — for example, erythromycin, itraconazole (Sporanox), and nefazodone (Serzone) — increase blood concentrations of buspirone. Drugs that enhance these enzymes — for example, rifampin — decrease blood concentrations of buspirone. Increased blood concentrations may increase side effects, while decreased blood concentrations may reduce efficacy.