bupropion

Pronunciation

Generic Name: bupropion (byoo PRO pee on)
Brand Name: Aplenzin, Budeprion SR, Buproban, Forfivo XL, Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban, Zyban Advantage Pack, Budeprion XL

What is bupropion?

Bupropion is an antidepressant medication used to treat major depressive disorder and seasonal affective disorder. The Zyban brand of bupropion is used to help people stop smoking by reducing cravings and other withdrawal effects.

Bupropion may also be used for purposes not listed in this medication guide.

What is the most important information I should know about bupropion?

Do not use bupropion if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

You should not take bupropion if you have seizures, an eating disorder, or if you have suddenly stopped using alcohol, seizure medication, or sedatives. If you take Wellbutrin for depression, do not also take Zyban to quit smoking.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Bupropion may cause seizures, especially in people with certain medical conditions or when using certain drugs. Tell your doctor about all of your medical conditions and the drugs you use.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using bupropion. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

What should I discuss with my healthcare provider before taking bupropion?

Do not use bupropion if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

You should not take bupropion if you are allergic to it, or if you have:

  • epilepsy or a seizure disorder;

  • an eating disorder such as anorexia or bulimia; or

  • if you have suddenly stopped using alcohol, seizure medication, or a sedative (Valium, Nembutal, Seconal, Solfoton, and others).

Bupropion may cause seizures, especially in people with certain medical conditions. Tell your doctor about all of your medical conditions.

Do not take bupropion to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking.

To make sure bupropion is safe for you, tell your doctor if you have:

  • a history of head injury, seizures, or brain or spinal cord tumor;

  • heart disease, high blood pressure, history of heart attack;

  • kidney or liver disease (especially cirrhosis); or

  • bipolar disorder (manic depression).

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using bupropion. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. It is not known whether bupropion will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Bupropion can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How should I take bupropion?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Too much of this medicine can increase your risk of a seizure.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

If you take Zyban to help you stop smoking, you may continue to smoke for about 1 week after you start the medicine. Set a date to quit smoking during the second week of treatment. Talk to your doctor if you are having trouble quitting after you have used Zyban for at least 7 weeks.

Your doctor may prescribe nicotine patches or gum to help support your smoking cessation treatment. Read all directions and safety information for the nicotine product. Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.

Do not stop using bupropion suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using bupropion.

This medication can cause you to have a false positive drug screening test. If you provide a urine sample for drug screening, tell the laboratory staff that you are taking bupropion.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of bupropion can be fatal. Overdose symptoms may include muscle stiffness, hallucinations, fast or uneven heartbeat, shallow breathing, or fainting.

What should I avoid while taking bupropion?

Drinking alcohol may increase your risk of seizures. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Bupropion can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.

Bupropion may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Bupropion side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • seizure (convulsions);

  • fast heartbeats;

  • fever, swollen glands, rash or itching, joint pain, or general ill feeling;

  • confusion, trouble concentrating, hallucinations, unusual thoughts or behavior; or

  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

  • dry mouth, nausea, stomach pain;

  • headache, dizziness, ringing in your ears;

  • loss of interest in sex;

  • sore throat, muscle pain;

  • mild itching or skin rash, increased sweating, increased urination; or

  • changes in appetite, weight loss or gain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Bupropion dosing information

Usual Adult Dose for Depression:

Immediate release tablets:
Initial dose: 100 mg orally twice a day.
Maintenance dose: The dosage may be increased in 75 to 100 mg/day increments not more often than every 3 days up to the usual maintenance dose of 100 mg orally 3 times a day. The maximum dose is 450 mg/day, given in 4 divided doses; bupropion should be discontinued if there is not an adequate response to this dose. Single doses should not exceed 150 mg.

Sustained release tablets:
Initial dose: 150 mg orally once a day in the morning.
Maintenance dose: After at least 4 days, the dose may be increased to 100 to 150 mg twice a day. If there is not adequate improvement after several weeks, the dose may be increased to a maximum of 200 mg twice a day.

Extended release tablets (Wellbutrin XL):
Initial dose: 150 mg orally once a day in the morning.
Maintenance dose: After at least 4 days, the dose may be increased to 300 mg once a day. If there is not adequate improvement after several weeks, the dose may be increased to a maximum of 450 mg once a day in the morning.

Extended release tablets (Aplenzin):
Initial dose: 174 mg orally once a day in the morning (equivalent to 150 mg bupropion HCl).
Maintenance dose: After at least 4 days, the dose may be increased to 348 mg once a day (equivalent to 300 mg bupropion HCl). If there is not adequate improvement after several weeks, the dose may be increased to a maximum of 522 mg once a day in the morning (equivalent to 450 mg bupropion HCl).

Usual Adult Dose for Smoking Cessation:

Initial Dose: 150 mg orally once a day.
Maintenance: Based on clinical response, this dosage may be increased to 300 mg/day, given as 150 mg twice a day, no sooner than 3 days after beginning therapy.

Usual Adult Dose for Seasonal Affective Disorder:

Initiate treatment for seasonal affective disorder in the autumn prior to onset of symptoms.

Wellbutrin XL (R):
Initial: 150 mg orally once a day in the morning
Titration: If tolerated, after 7 days dose may be increased to maximum dose of 300 mg once a day administered in the morning. Patients who are unable to tolerate this increase in dose should be reduced back to 150 mg orally once a day.

Aplenzin (R):
Initial: 174 mg once daily (equivalent to 150 mg bupropion) in the morning
Titration: If tolerated, after 7 days dose may be increased to 348 mg once daily (equivalent to 300 mg bupropion) in the morning through the winter season.

What other drugs will affect bupropion?

Many drugs can interact with bupropion. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with bupropion, especially:

  • medication used to prevent blood clots, such as clopidogrel, ticlopidine, tirofiban;

  • heart or blood pressure medication such as atenolol, flecainide, metoprolol, propafenone, propranolol, and others;

  • HIV or AIDS medications such as efavirenz or ritonavir; or

  • seizure medication such as carbamazepine, phenobarbital, phenytoin.

This list is not complete and many other drugs can interact with bupropion. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

You may have a higher risk of seizures if you use certain medications together with bupropion. Tell your doctor about all other medications you use, especially:

  • any other antidepressant, or a medicine to treat a psychiatric disorder;

  • an antibiotic (amoxicillin, cefdinir, cephalexin, ciprofloxacin, penicillin, and others);

  • antihistamines that make you sleepy;

  • asthma medications or bronchodilators;

  • birth control pills or hormone replacement estrogens;

  • bladder or urinary medications (oxybutynin, tolterodine, and others);

  • diet pills, a stimulant, or ADHD medication;

  • insulin or oral diabetes medication;

  • medicine for nausea, vomiting, or motion sickness;

  • medications to treat or prevent malaria;

  • medicines to treat Parkinson's disease, restless leg syndrome, or pituitary gland tumor (prolactinoma);

  • medicines used to prevent organ transplant rejection;

  • narcotic pain medication;

  • numbing medicine such as lidocaine or Novocain;

  • a steroid such as prednisone, and others;

  • street drugs such as "speed" or cocaine;

  • theophylline; or

  • ulcer or irritable bowel medications.

Where can I get more information?

  • Your pharmacist can provide more information about bupropion.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 18.02. Revision Date: 2013-01-05, 4:20:33 PM.

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