Wellbutrin (bupropion) Disease Interactions

There are 5 disease interactions with Wellbutrin (bupropion):

Bupropion (Includes Wellbutrin) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Bupropion is primarily metabolized by the liver. The systemic exposure and half-life of bupropion and its metabolites may be increased in patients with hepatic impairment, and drug accumulation may occur to a greater extent than usual. Therapy with bupropion should be administered cautiously in patients with impaired hepatic function, including mild to moderate hepatic cirrhosis. A reduced dose and/or dosing frequency should be considered. Extreme caution is advised in patients with severe hepatic cirrhosis. A dosage reduction is required in these patients, and the dosage should not exceed 75 mg once a day. All patients with hepatic impairment should be closely monitored for possible adverse effects that could indicate high drug or metabolite levels.

References

  1. DeVane CL, Laizure SC, Stewart JT, et al. "Disposition of bupropion in healthy volunteers and subjects with alcoholic liver disease." J Clin Psychopharmacol 10 (1990): 328-32
  2. Findlay JW, Van Wyck Fleet J, Smith PG, et al. "Pharmacokinetics of bupropion, a novel antidepressant agent, following oral administration to healthy subjects." Eur J Clin Pharmacol 21 (1981): 127-35
  3. "Product Information. Zyban (bupropion)." Glaxo Wellcome, Research Triangle Park, NC.
View all 5 references

Bupropion (Includes Wellbutrin) ↔ Seizure Disorders

Severe Potential Hazard, High plausibility

Applies to: Bulimia, Anorexia Nervosa, Alcoholism, Drug Abuse/Dependence, CNS Disorder, Diabetes Mellitus

The use of bupropion is contraindicated in patients with a seizure disorder. Bupropion may trigger seizures in a dose-dependent manner up to a frequency of 0.4% at 450 mg/day, the maximum recommended dosage. The incidence of seizures increases dramatically at higher dosages (almost 10-fold at 600 mg/day). Because of the wide variability in individual capacity to metabolize drugs and the disproportionate increase in seizure incidence with dosage escalation, bupropion should not be used in patients with underlying seizure disorders. The use of bupropion is also contraindicated in patients with a current or prior diagnosis of bulimia or anorexia because of a higher reported incidence of seizures in such patients treated with the drug. Therapy with bupropion should be administered extremely cautiously in patients with other predisposing factors for seizures, including underlying neurologic abnormalities such as head trauma, brain damage or CNS tumor; excessive use of or abrupt withdrawal from alcohol; addiction to opiates, cocaine, or stimulants; diabetes treated with oral hypoglycemic agents or insulin; and concomitant use of medications that lower seizure threshold. A more gradual titration may be appropriate.

References

  1. Dufresne RL, Weber SS, Becker RE "Bupropion hydrochloride." Drug Intell Clin Pharm 18 (1984): 957-64
  2. "Product Information. Zyban (bupropion)." Glaxo Wellcome, Research Triangle Park, NC.
  3. "Product Information. Wellbutrin (bupropion)." Glaxo Wellcome, Research Triangle Park, NC.
View all 9 references

Bupropion (Includes Wellbutrin) ↔ Psychoses

Moderate Potential Hazard, Moderate plausibility

Applies to: Psychosis

Bupropion may precipitate or aggravate psychotic symptoms, including delusions, hallucinations, confusion, and paranoia. Depressed patients, usually those with bipolar disorder, may experience a switch from depression to mania or hypomania. Patients with psychotic disorders should be monitored for exacerbation of symptoms during bupropion therapy, and the dosing reduced or discontinued and/or additional medications (e.g., tranquilizers) administered as necessary.

References

  1. Dager SR, Heritch AJ "A case of bupropion-associated delirium." J Clin Psychiatry 51 (1990): 307-8
  2. Liberzon I, Dequardo JR, Silk KR "Bupropion and delirium." Am J Psychiatry 147 (1990): 1689-90
  3. Golden RN, James SP, Sherer MA, Rudorfer MV, Sack DA, Potter WZ "Psychoses associated with bupropion treatment." Am J Psychiatry 142 (1985): 1459-62
View all 9 references

Bupropion (Includes Wellbutrin) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Bupropion metabolites, some of which are pharmacologically active with one-fifth to one-half the potency of the parent drug, are excreted by the kidney. Although pharmacokinetic studies have not been conducted in patients with renal impairment, it is conceivable that bupropion and its metabolites may accumulate in such patients to a greater extent than usual. Therefore, therapy with bupropion should be administered cautiously in the presence of significant renal impairment. A reduced dose and/or dosing frequency should be considered, and patients should be closely monitored for possible adverse effects that could indicate high drug or metabolite levels.

References

  1. "Product Information. Zyban (bupropion)." Glaxo Wellcome, Research Triangle Park, NC.
  2. "Product Information. Wellbutrin (bupropion)." Glaxo Wellcome, Research Triangle Park, NC.

Bupropion (Includes Wellbutrin) ↔ Weight Loss

Minor Potential Hazard, High plausibility

Applies to: Anorexia/Feeding Problems, Malnourished, Weight Loss/Failure to Thrive

The use of bupropion is associated with weight alterations. Both weight gain and weight loss may occur, although the latter is much more common. The incidence of weight loss greater than 5 pounds is approximately 28%, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. Weight change should be monitored during therapy if bupropion is used in these patients.

References

  1. "Product Information. Zyban (bupropion)." Glaxo Wellcome, Research Triangle Park, NC.
  2. Dufresne RL, Weber SS, Becker RE "Bupropion hydrochloride." Drug Intell Clin Pharm 18 (1984): 957-64
  3. "Product Information. Wellbutrin (bupropion)." Glaxo Wellcome, Research Triangle Park, NC.

You should also know about...

Wellbutrin (bupropion) drug Interactions

There are 724 drug interactions with Wellbutrin (bupropion)

Wellbutrin (bupropion) alcohol/food Interactions

There are 3 alcohol/food interactions with Wellbutrin (bupropion)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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