Bupropion: MedlinePlus Drug Information

Depressed patients treated with WELLBUTRIN have had a variety of neuropsychiatric signs and symptoms, including delusions, hallucinations, psychosis, concentration disturbance, paranoia, and confusion. Monitoring of blood pressure is recommended in patients who receive the combination of bupropion and nicotine replacement. The estimated seizure incidence for WELLBUTRIN increases almost 10-fold between 450 and 600 mg/day. Additional predisposing conditions include diabetes mellitus treated with oral hypoglycemic drugs or insulin; use of anorectic drugs; and excessive use of alcohol, benzodiazepines, sedative/hypnotics, or opiates. Consider these risks before initiating treatment with WELLBUTRIN.

These data suggest there is no prominent effect of age on bupropion concentration; however, another single- and multiple-dose pharmacokinetics trial suggested that the elderly are at increased risk for accumulation of bupropion and its metabolites see Use In Specific Populations. However, higher doses (which could not be tested because of the risk of seizure) might be modestly attractive to those who abuse CNS stimulant drugs. Findings in clinical trials, however, are not known to reliably predict the abuse potential of drugs. Consider the risks to the mother of untreated depression and potential effects on the fetus when discontinuing or changing treatment with antidepressant medications during pregnancy and postpartum. Instruct patients to take WELLBUTRIN in equally divided doses 3 or 4 times a day, with doses separated by at least 6 hours to minimize the risk of seizure. Counsel patients to notify their healthcare provider if they are taking or plan to take any prescription or over-the-counter drugs because WELLBUTRIN and other drugs may affect each other’s metabolisms.

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When bupropion is used to treat seasonal affective disorder, take it once a day in the morning beginning in the early fall, continuing through the winter, and stopping in the early spring. Many medicines increase your chances of having seizures or other serious side effects if you take them while you are taking WELLBUTRIN. Tell your healthcare provider about all the medicines you take, including prescription, over-the-counter medicines, vitamins, and herbal supplements.

Dosing above 300 mg/day may be accomplished using the 75- ­or 100-mg tablets. WELLBUTRIN (bupropion hydrochloride), an antidepressant of the aminoketone class, is chemically unrelated to tricyclic, tetracyclic, selective serotonin re-uptake inhibitor, or other known antidepressant agents. In one study, there was no difference between Wellbutrin and other antidepressants in the occurrence of birth defects. Get medical help right away, if you have any of the symptoms listed above. By Nancy SchimelpfeningNancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary.

Switching A Patient To Or From A Monoamine Oxidase Inhibitor (MAOI) Antidepressant

The FDA has also approved a medication called Contrave, which is a combination of bupropion and naltrexone, for weight loss. Another brand of bupropion (the active ingredient in Wellbutrin), called Zyban, is used to help people quit smoking. We also share what you should know before you take this medication, including the potential side effects of Wellbutrin and drug interactions.

Wellbutrin Side Effects: What to Expect

Neuropsychiatric adverse events occurred in patients without and with pre-existing psychiatric disease; some patients experienced worsening of their psychiatric illnesses. Confirmatory tests, such as gas chromatography/mass spectrometry, will distinguish bupropion from amphetamines. False-positive test results may result even following discontinuation of bupropion therapy.

What are the most common side effects of bupropion?

There were suicides in the adult trials, but the number was not sufficient to reach any conclusion about drug effect on suicide. The risk differences (drug vs. placebo), however, were relatively stable within age strata and across indications. There were differences in absolute risk of suicidality across the different indications, with the highest incidence in MDD. False-positive urine immunoassay screening tests for amphetamines have been reported in patients taking bupropion.

If you feel the anxiety is too severe, your healthcare provider may change your dose or recommend specific anti-anxiety measures. If symptoms are too severe, speak with your doctor about medication to help with sleep. Check with your healthcare provider if the dizziness is severe to identify the cause; they may change your dose strength or time as well. Your healthcare provider may also decide to change your dose to a lower strength more frequently throughout the day. Managing side effects may involve taking additional medications when needed, changing the strength or dose of Wellbutrin, or changing the time of day Wellbutrin is taken. The risk of experiencing these severe side effects can be dependent upon your specific health history.

  • Limit your caffeine intake to help prevent tremors; and your provider may prescribe or recommend treatments to help reduce anxiety as well.
  • In a trial in healthy volunteers, efavirenz 600 mg once daily for 2 weeks reduced the AUC and Cmax of bupropion by approximately 55% and 34%, respectively.
  • Depressed patients treated with WELLBUTRIN have had a variety of neuropsychiatric signs and symptoms, including delusions, hallucinations, psychosis, concentration disturbance, paranoia, and confusion.
  • Advise patients that until they are reasonably certain that WELLBUTRIN does not adversely affect their performance, they should refrain from driving an automobile or operating complex, hazardous machinery.
  • But if you have nausea, take the medicine with food.

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The threohydrobupropion metabolite of bupropion does not appear to be produced by cytochrome P450 enzymes. This effect is thought to be due to the inhibition of the CYP2B6-catalyzed bupropion hydroxylation. The exposures (Cmax and AUC) of hydroxybupropion were decreased 50% and 52%, respectively, by clopidogrel, and 78% and 84%, respectively, by ticlopidine. In addition, in vitro studies suggest that paroxetine, sertraline, norfluoxetine, fluvoxamine, and nelfinavir inhibit the hydroxylation of bupropion. In vitro studies indicate that bupropion is primarily metabolized to Wellbutrin side effects hydroxybupropion by CYP2B6. The differences in half-life for bupropion and the other metabolites in the 2 groups were minimal.

Lifestyle Quizzes

If you have thoughts of suicide during Wellbutrin treatment, call 911 or your local emergency number. They can discuss ways to manage side effects or suggest other available treatment options. This article uses the term “Wellbutrin” to describe both forms of the drug unless noted otherwise. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional.

Bupropion may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

This will help monitor how high your blood pressure increases if at all. This can cause issues in patients who already have hypertension, especially if uncontrolled. Be sure to attend all appointments set for you, as you will have your eye health checked routinely. If you have a therapist, be sure to tell them you are starting treatment with Wellbutrin so they can counsel you accordingly.

Tell your healthcare provider if you have any of these side effects that bother you. These side effects may vary depending on the condition being treated and what form of bupropion you are taking. The most common side effects of bupropion are listed below. Bupropion may also be used for other conditions as determined by your healthcare provider. Some of the most common side effects of bupropion are dry mouth, nausea, trouble sleeping, and dizziness.

Be sure to alert your healthcare provider if any of the following warnings apply to you. Understanding each warning and taking precautions is necessary to avoid risk of harm or even death. Tell your healthcare provider if you have a history of seizures; Wellbutrin will most likely not be a good option for you. Be sure to alert your cardiologist that you will be taking Wellbutrin as this could change your hypertension treatment as well.

  • When bupropion was administered to pregnant rats during organogenesis, there was no evidence of fetal malformations at doses up to approximately 10 times the maximum recommended human dose (MRHD) of 450 mg/day.
  • However, it appears likely that only a small proportion of any orally administered dose reaches the systemic circulation intact.
  • This includes prescription or nonprescription (over-the-counter OTC) medicines and herbal or vitamin supplements.
  • There were suicides in the adult trials, but the number was not sufficient to reach any conclusion about drug effect on suicide.
  • Taking too much bupropion may increase your risk of a seizure.

A single-dose pharmacokinetic trial demonstrated that the disposition of bupropion and its metabolites in elderly subjects was similar to that of younger subjects. During a chronic dosing trial with bupropion in 14 depressed subjects with left ventricular dysfunction (history of CHF or an enlarged heart on x-ray), there was no apparent effect on the pharmacokinetics of bupropion or its metabolites, compared with healthy volunteers. In subjects with severe hepatic cirrhosis, significant alterations in the pharmacokinetics of bupropion and its metabolites were seen (Table 3). The second trial demonstrated no statistically significant differences in the pharmacokinetics of bupropion and its active metabolites in 9 subjects with mild-to-moderate hepatic cirrhosis compared with 8 healthy volunteers. The first trial demonstrated that the half-life of hydroxybupropion was significantly longer in 8 subjects with alcoholic liver disease than in 8 healthy volunteers (32 ± 14 hours versus 21 ± 5 hours, respectively). Following a single dose in humans, peak plasma concentrations of hydroxybupropion occur approximately 3 hours after administration of WELLBUTRIN and are approximately 10 times the peak level of the parent drug at steady state.

A contraindication is a factor or condition that could prevent your doctor from prescribing a drug due to the risk of harm. Wellbutrin is contraindicated in people who have a history of seizure disorder. No, hair loss was not reported in clinical trials of Wellbutrin SR and Wellbutrin XL.

At least 14 days should elapse between discontinuation of an MAOI intended to treat depression and initiation of therapy with WELLBUTRIN. Consider reducing the dose and/or frequency of WELLBUTRIN in patients with renal impairment (Glomerular Filtration Rate GFR less than 90 mL/min) see Use In Specific Populations, CLINICAL PHARMACOLOGY. Periodically reassess the need for maintenance treatment and the appropriate dose for such treatment. It is unknown whether the dose of WELLBUTRIN needed for maintenance treatment is identical to the dose that provided an initial response. The recommended starting dose is 200 mg/day, given as 100 mg twice daily. Increases in dose should not exceed 100 mg/day in a 3-day period.