Bupropion

Generic name: bupropion (byoo PRO pee on)
Brand name: Aplenzin, Forfivo XL, Wellbutrin SR, Wellbutrin XL, Zyban, Budeprion XL
Drug class: Miscellaneous antidepressants, Smoking cessation agents

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.

Warnings

You should not take bupropion if you have seizures or 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.

Do not use bupropion within 14 days before or 14 days after you have used a MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

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.

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.

Before taking this medicine

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

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

  • a seizure disorder;
  • an eating disorder such as anorexia or bulimia; or
  • if you have suddenly stopped using alcohol, seizure medication, or a sedative (such as Xanax, Valium, Fiorinal, Klonopin, and others).

Do not use an MAO inhibitor within 14 days before or 14 days after you take bupropion. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

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

Bupropion may cause seizures, especially if you have certain medical conditions or use certain drugs. Tell your doctor about all of your medical conditions and the drugs you use.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

  • a head injury, seizures, or brain or spinal cord tumor;
  • narrow-angle glaucoma;
  • heart disease, high blood pressure, or a heart attack;
  • diabetes;
  • kidney or liver disease (especially cirrhosis);
  • depression, bipolar disorder or other mental illness; or
  • if you drink alcohol.

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 this medicine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Ask your doctor about taking this medicine if you are pregnant. It is not known whether bupropion will harm an unborn baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking bupropion without your doctor's advice.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of bupropion on the baby.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Bupropion is not approved for use by anyone younger than 18 years old.

How should I take bupropion?

Take bupropion exactly as prescribed by your doctor. 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 the tablet whole.

You should not change your dose or stop using bupropion suddenly, unless you have a seizure while taking this medicine. Stopping suddenly can cause unpleasant withdrawal symptoms.

Ask your doctor how to safely stop using bupropion.

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 to 12 weeks.

Your doctor may prescribe a nicotine replacement product (such as patches or gum) to help you stop smoking. Start using the nicotine replacement product on the same day you stop (quit) smoking or using tobacco products.

Some people taking bupropion (Wellbutrin or Zyban) have had high blood pressure that is severe, especially when also using a nicotine replacement product (patch or gum). Your blood pressure may need to be checked before and during treatment with bupropion.

You may have nicotine withdrawal symptoms when you stop smoking, including: increased appetite, weight gain, trouble sleeping, trouble concentrating, slower heart rate, having the urge to smoke, and feeling anxious, restless, depressed, angry, frustrated, or irritated. These symptoms may occur with or without using medication such as Zyban.

Smoking cessation may also cause new or worsening mental health problems, such as depression.

This medicine 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 to avoid

Drinking alcohol with bupropion may increase your risk of seizures. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. This medicine can also 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 to bupropion: (hives, itching, fever, swollen glands, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, 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:

  • a seizure (convulsions);
  • confusion, unusual changes in mood or behavior;
  • blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
  • fast or irregular heartbeats; or
  • a manic episode - racing thoughts, increased energy, reckless behavior, feeling extremely happy or irritable, talking more than usual, severe problems with sleep.

Common bupropion side effects may include:

  • dry mouth, sore throat, stuffy nose;
  • ringing in the ears;
  • blurred vision;
  • nausea, vomiting, stomach pain, loss of appetite, constipation;
  • sleep problems (insomnia);
  • tremors, sweating, feeling anxious or nervous;
  • fast heartbeats;
  • confusion, agitation, hostility;
  • rash;
  • weight loss;
  • increased urination;
  • headache, dizziness; or
  • muscle or joint pain.

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.

What other drugs will affect bupropion?

You may have a higher risk of seizures if you use certain other medicines while taking bupropion.

Many drugs can interact with bupropion. Tell your doctor about all medicines you use, and those you start or stop using during your treatment. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.