bupropion, Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban, Aplenzin, Forfivo XL (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
Carbamazepine (Tegretol) may reduce the effect of bupropion by reducing the blood concentration of bupropion. Monamine oxidase inhibitors (MAOIs) antidepressants should not be combined with bupropion because of the risk of severe reactions. At least 14 days should elapse between discontinuation of an MAOI and initiation of bupropion.
Bupropion may affect the action of warfarin (Coumadin).
Ritonavir (Norvir) may increase the breakdown and elimination of bupropion. In some studies ritonavir reduced the concentration of bupropion in the body by 22% to 66%.
PREGNANCY: There are no adequate studies of bupropion in pregnant women. In one study, there was no difference between bupropion and other antidepressants in the occurrence of birth defects. Bupropion should only be used in pregnancy if the benefit outweighs the potential risk.
NURSING MOTHERS: Bupropion is secreted in breast milk.
SIDE EFFECTS: The most common side effects associated with bupropion are agitation, dry mouth, insomnia, headache, nausea, constipation, and tremor. In some people, the agitation or insomnia is most marked shortly after starting therapy. Some patients may experience weight loss. Uncommonly, patients may experience manic episodes or hallucinations. Four of every 1000 persons who receive bupropion in doses less than 450 mg/day experience seizures. When doses exceed 450 mg/day, the risk increases ten-fold. Other risk factors for seizures include past injury to the head and medications which can lower the threshold for seizures. (See drug interactions.)
Antidepressants increased the risk of suicidal thinking and behavior (suicidality in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of bupropion or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.
Reference: FDA Prescribing Information
Last Editorial Review: 1/22/2014
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