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Bupropion Hydrochloride XL
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What is Bupropion?

Bupropion is a prescription medicine used to treat adults with major depressive disorder (MDD). It is also indicated for the treatment of seasonal affective disorder and is used to help people quit smoking.

The effectiveness of Bupropion in treating MDD has been demonstrated in both short-term and long-term clinical trials. The maximum recommended dose is 450 mg per day, with individual doses not exceeding 150 mg to reduce the risk of seizures.

Bupropion tablets should be taken whole and can be taken with or without food. Additionally, Bupropion is sometimes used off-label for conditions like ADHD and depression associated with bipolar disorder.

How Does Bupropion Work?

Bupropion is an aminoketone antidepressant that helps balance brain chemicals, specifically norepinephrine and dopamine.

Norepinephrine affects attention and responses, while dopamine is crucial for pleasure and motivation.

Bupropion weakly inhibits the reuptake of these neurotransmitters, raising their levels in the brain to improve mood and well-being. It also acts on nicotinic and serotonin receptors, influencing mood and cognitive functions. These combined effects contribute to its unique antidepressant benefits.

Dosage Information and Usage

Bupropion comes in different strengths and forms. The tablets are round, biconvex, and coated with a film.

These tablets are extended-release (SR) and are used to treat major depressive disorder (MDD) in adults, among other conditions. It’s essential to follow your healthcare provider’s instructions regarding the dosage and frequency of taking these tablets.

Dosage form and strengths of Bupropion

Here are the dosage forms and strengths of Bupropion HCl:

  • 75 mg tablets: Pale lavender, round, biconvex, film-coated, debossed with “L1” on one side and plain on the other side.
  • 100 mg tablets: Pale lavender, round, biconvex, film-coated, debossed with “L7” on one side and plain on the other side.

Here are the dosage forms and strengths of Bupropion XL:

  • 100 mg: These are blue, round, biconvex tablets with a film coating. They are extended-release (SR) and are debossed with “S” on one side and “522” on the other.
  • 150 mg: These are purple, round, biconvex tablets with a film coating. They are extended-release (SR) and are debossed with “S” on one side and “525” on the other.
  • 200 mg: These are pink, round, biconvex tablets with a film coating. They are extended-release (SR) and are debossed with “S” on one side and “527” on the other.

Usage

To use Bupropion tablets safely and effectively, follow these instructions:

  • Swallow Bupropion tablets whole; don’t break, crush, or chew them.
  • You can take these tablets with or without food.

Recommended Dosage

  • For adults, the usual dose is 300 mg/day, taken as 150 mg twice daily.
  • Start with 150 mg/day for the first three days, then increase to 300 mg/day, taken as 150 mg twice daily.
  • Wait at least 8 hours between doses.
  • If needed, the dose can be increased to 400 mg/day, taken as 200 mg twice daily.
  • Don’t take more than 200 mg at once.

Special Cases

  • If your liver or kidney isn’t working well, your doctor may adjust your dose.
  • For patients with liver issues, the highest dose should be 100 mg/day or 150 mg every other day.
  • If you have mild liver problems, your doctor might reduce your dose.
  • Patients with kidney problems may need a lower dose or less often.

Switching Medications

  • If you’re switching to or from MAOIs (Monoamine Oxidase Inhibitors), wait at least 14 days.

Using with Reversible MAOIs

  • Don’t start Bupropion hydrochloride extended-release (SR) tablets if you’re taking drugs like linezolid or intravenous methylene blue.
  • If urgent treatment is needed, consider non-drug options or hospitalization.
  • If you have to take linezolid or intravenous methylene blue, stop taking Bupropion hydrochloride extended-release (SR) tablets right away.

Always listen to your doctor and talk to them regularly about your treatment.

Storage Information

Store Bupropion tablets in a cool place between 20°C and 25°C (68°F to 77°F). A slight temperature range from 15°C to 30°C (59°F to 86°F) is acceptable, but avoid drastic changes. Protect the tablets from light and moisture by keeping them in their original bottle.

Side Effects of Bupropion

Side effects of Bupropion hydrochloride tablets can range from mild to severe. If you experience one or any of these side effects, consult your healthcare provider or pharmacist for more information.

Common Side Effects

  • Headache
  • Nausea or vomiting
  • Dizziness
  • Heavy sweating
  • Shakiness (tremor)
  • Fast heartbeat
  • Nervousness
  • Dry mouth
  • Constipation
  • Trouble sleeping
  • Blurred vision

Serious but Rare Side Effects

  • Suicidal thoughts and behaviors in adolescents and young adults
  • Neuropsychiatric symptoms and suicide risk in smoking cessation treatment
  • Seizure
  • Hypertension
  • Activation of mania or hypomania
  • Psychosis and other neuropsychiatric reactions
  • Angle-closure glaucoma
  • Hypersensitivity reactions

Warnings and Precautions

Before starting Bupropion, be aware of several important warnings and precautions for safe and effective use.

Always consult your healthcare provider to understand the implications of taking Bupropion and to customize your treatment plan to your needs.

Boxed Warnings for Bupropion

Bupropion comes with a warning about the risk of suicidal thoughts and behaviors. In short-term trials, antidepressants like Bupropion increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults.

These trials did not show an increased risk for people over 24 years old and in those aged 65 and older.

It’s important to closely monitor patients of all ages who start taking Bupropion for any worsening of symptoms or new suicidal thoughts and behaviors.

Families and caregivers should be advised to keep in close contact with the prescriber to report any concerns.

General Precautions for Bupropion Medication

When using Bupropion, it is important to be aware of certain precautions. This helps ensure the medication is used safely and effectively.

Here are some precautions to know when using Bupropion:

  • Suicidal Thoughts and Behaviors: Bupropion can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Monitor patients closely for worsening depression or unusual changes in behavior.
  • Neuropsychiatric Symptoms: Some people may experience serious mood changes, hallucinations, or other psychiatric symptoms. These may include aggression, anxiety, or panic attacks.
  • Seizures: The risk of seizures increases with higher doses of Bupropion. Do not exceed the recommended dose, and gradually increase the dose as prescribed by a healthcare provider.
  • Hypertension: Bupropion can cause high blood pressure. Regularly check your blood pressure during treatment, especially if you have a history of hypertension.
  • Activation of Mania/Hypomania: Bupropion may trigger manic or hypomanic episodes, particularly in people with bipolar disorder. Monitor for signs of mania, such as extreme energy or irritability.
  • Angle-Closure Glaucoma: Bupropion can cause pupil dilation, which may trigger an attack in individuals with narrow angles in the eye. Seek immediate medical attention if you experience eye pain or vision changes.
  • Hypersensitivity Reactions: Allergic reactions like rash, itching, or breathing difficulties may occur. Stop taking Bupropion and seek medical help if you experience these symptoms.

It is essential to talk to your healthcare provider about any concerns or side effects you may experience while taking Bupropion.

Overdosage of Bupropion

Overdosing on Bupropion is very dangerous and requires immediate medical attention. Taking too much, even up to 30 grams, can cause serious health issues.

Symptoms include seizures, hallucinations, loss of consciousness, rapid heartbeat, and mental changes.

Severe reactions may involve muscle stiffness, fever, low blood pressure, coma, or respiratory failure.

Deaths have occurred from large overdoses. If an overdose is suspected, contact a Poison Control Center immediately.

There is no specific antidote for Bupropion; treatment focuses on supportive care and monitoring vital signs.

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Drug Interactions With Other Medications

Bupropion can interact with various other medications, which can affect how well it works or increase the risk of side effects. It is important to be aware of these potential interactions to manage your treatment effectively.

Here are the following drug interactions to note:

  • CYP2B6 Inhibitors (e.g., Ticlopidine and Clopidogrel): These drugs can increase the levels of Bupropion in your body. Higher Bupropion levels may increase the risk of side effects because more of the drug stays in your system.
  • CYP2B6 Inducers (e.g., Ritonavir, Lopinavir, Efavirenz): These drugs can decrease the levels of Bupropion in your body. Lower Bupropion levels might make it less effective because there is not enough of the drug in your system.
  • Drugs Metabolized by CYP2D6 (e.g., certain antidepressants, antipsychotics, beta-blockers): Bupropion can increase the levels of these drugs in your body. This happens because Bupropion inhibits the enzyme that breaks them down.
  • Digoxin: Bupropion can decrease the levels of digoxin in your body. Lower digoxin levels might make it less effective because it reduces the drug’s presence in your bloodstream.
  • Drugs that Lower Seizure Threshold (e.g., other Bupropion products, antipsychotics, theophylline): Using these drugs with Bupropion can increase the risk of seizures. This is because Bupropion also lowers the seizure threshold.
  • Dopaminergic Drugs (e.g., Levodopa and Amantadine): Combining these drugs with Bupropion can cause side effects like restlessness and dizziness. This is because both types of drugs increase dopamine levels in the brain.
  • Alcohol: Drinking alcohol while taking Bupropion can lead to adverse neuropsychiatric events or reduced alcohol tolerance. This is because alcohol and Bupropion can both affect the brain.
  • Monoamine Oxidase Inhibitors (MAOIs): Using MAOIs with Bupropion is not recommended because it can increase the risk of hypertensive reactions. MAOIs and Bupropion both affect brain chemicals. You should wait at least 14 days after stopping an MAOI before starting Bupropion, and vice versa.

Alternative Medications

If Wellbutrin isn’t suitable for you, there are other options available. These include prescription medications like escitalopram, sertraline, fluoxetine, duloxetine, aripiprazole, and quetiapine. Your doctor can help you explore these alternatives to find the best option for your needs.

FREQUENTLY ASKED QUESTIONS

Bupropion is used to treat depression and prevent seasonal affective disorder (SAD), also known as winter depression. It’s also part of a support program to help people quit smoking. Bupropion is available under various brand names.

Bupropion can cause weight changes, but weight loss is more common than weight gain. Some people might experience weight gain due to emotional eating if their anxiety or depression symptoms worsen. However, not everyone taking Bupropion will notice a change in their weight.

Bupropion can make you feel sleepy because it may cause drowsiness, dizziness, or a false sense of well-being. It’s important to know how you react to this medicine before doing activities that require alertness, like driving or using machines.

Yes, Bupropion can cause insomnia. Clinical research shows that 11% to 20% of people taking Bupropion experience insomnia, compared to about 4% to 7% of those given a placebo. This means Bupropion can disrupt sleep and increase the number of times you wake up during the night.

You can get Bupropion only with a doctor’s prescription. It’s important to ensure you receive just one prescription at a time for this medication. Always consult with your healthcare provider for the appropriate prescription and guidance on how to take Bupropion.

Bupropion is typically prescribed for individuals diagnosed with depression or seasonal affective disorder. It may also be recommended for those trying to quit smoking.

Bupropion should be taken exactly as prescribed by your doctor. Typically, it is taken orally, usually once or twice daily, with or without food. Your doctor will determine the appropriate dosage based on your medical condition and response to treatment.

Bupropion is primarily classified as an antidepressant medication. It is commonly prescribed to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). Additionally, Bupropion is used in smoking cessation therapy to help individuals quit smoking by reducing cravings and withdrawal symptoms.

The maximum recommended dose of Bupropion varies depending on the formulation and individual factors. For most adults, the typical maximum daily dose of Bupropion is 450 mg.

Yes, Bupropion has the potential to cause serotonin syndrome, although it’s not classified as a selective serotonin reuptake inhibitor (SSRI). As a norepinephrine-dopamine reuptake inhibitor, it can still lead to serotonin syndrome, a serious condition resulting from an excess of serotonin in the body.

It’s important to be aware of the symptoms of serotonin syndrome, such as agitation, confusion, rapid heart rate, high blood pressure, dilated pupils, muscle rigidity, and sweating, and seek medical attention immediately if you experience any of them while taking Bupropion.

Bupropion can be prescribed by various healthcare professionals, including psychiatrists, primary care providers, licensed nurse practitioners, and licensed physician assistants. These healthcare providers are qualified to assess your medical condition, determine if Bupropion is appropriate for you, and prescribe the medication accordingly.

Bupropion side effects can include dizziness, trouble sleeping, nausea, headaches, dry mouth, anxiety, tremors, and changes in appetite or weight. If you experience any of these side effects, it’s essential to talk to your doctor.

Individuals who are at higher risk of seizures, such as those with epilepsy, a current or prior eating disorder, or those who suddenly stop drinking alcohol or certain medications like benzodiazepines, should avoid taking bupropion.

While taking bupropion, avoid activities that could increase side effects or interactions. These include consuming alcohol, which can worsen dizziness or drowsiness. Also, avoid other medications that increase seizure risk, like certain antidepressants or antipsychotics, unless directed by your doctor. Do not abruptly stop drinking alcohol or certain medications, as this can raise seizure risk.

Yes, you can take bupropion on an empty stomach. It is generally recommended to take bupropion with or without food, as directed by your healthcare provider.