Information on Bupropion HCl

Pronounced:byoo-PRO-pee-on
Generic name:Bupropion hydrochloride
Other brand name:Bupropion SR, Wellbutrin

Why is Bupropion prescribed?

Bupropion, a relatively new antidepressant medication, is given to help relieve certain kinds of major depression.

Major depression involves a severely depressed mood (for 2 weeks or more) and loss of interest or pleasure in usual activities accompanied by sleep and appetite disturbances, agitation or lack of energy, feelings of guilt or worthlessness, decreased sex drive, inability to concentrate, and perhaps thoughts of suicide.

Unlike the more familiar tricyclic antidepressants, such as Elavil, Tofranil, and others, Bupropion tends to have a somewhat stimulating effect.

The drug is available in regular and sustained-release formulations (Bupropion SR).

Most important fact about Bupropion

Although Bupropion occasionally causes weight gain, a more common effect is weight loss: Some 28 percent of people who take this medication lose 5 pounds or more. If depression has already caused you to lose weight, and if further weight loss would be detrimental to your health, Bupropion may not be the best antidepressant for you.

How should you take Bupropion?

Take Bupropion exactly as prescribed by your doctor. The usual dosing regimen is 3 equal doses spaced evenly throughout the day. Allow at least 6 hours between doses. Your doctor will probably start you at a low dosage and gradually increase it; this helps minimize side effects.

You should take Bupropion SR, the sustained-release form, in 2 doses, at least 8 hours apart. Swallow Bupropion SR tablets whole; do not chew, divide, or crush them.

If Bupropion works for you, your doctor will probably have you continue taking it for at least several months.

Why is Bupropion prescribed?

Bupropion, a relatively new antidepressant medication, is given to help relieve certain kinds of major depression.

Major depression involves a severely depressed mood (for 2 weeks or more) and loss of interest or pleasure in usual activities accompanied by sleep and appetite disturbances, agitation or lack of energy, feelings of guilt or worthlessness, decreased sex drive, inability to concentrate, and perhaps thoughts of suicide.

Unlike the more familiar tricyclic antidepressants, such as Elavil, Tofranil, and others, Bupropion tends to have a somewhat stimulating effect.

The drug is available in regular and sustained-release formulations (Bupropion SR).

Most important fact about Bupropion

Although Bupropion occasionally causes weight gain, a more common effect is weight loss: Some 28 percent of people who take this medication lose 5 pounds or more. If depression has already caused you to lose weight, and if further weight loss would be detrimental to your health, Bupropion may not be the best antidepressant for you.

How should you take Bupropion?

Take Bupropion exactly as prescribed by your doctor. The usual dosing regimen is 3 equal doses spaced evenly throughout the day. Allow at least 6 hours between doses. Your doctor will probably start you at a low dosage and gradually increase it; this helps minimize side effects.

You should take Bupropion SR, the sustained-release form, in 2 doses, at least 8 hours apart. Swallow Bupropion SR tablets whole; do not chew, divide, or crush them.

If Bupropion works for you, your doctor will probably have you continue taking it for at least several months.

Take it as soon as you remember. If it is within 4 hours of your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature. Protect from light and moisture.

What side effects may occur with Bupropion?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Bupropion.

Seizures are perhaps the most worrisome side effect.

More common side effects may include:

• abdominal pain (Bupropion SR)
• agitation
• anxiety (Bupropion SR)
• constipation
• dizziness
• dry mouth
• excessive sweating
• headache
• loss of appetite (Bupropion SR)
• nausea palpitations (Bupropion SR)
• vomiting
• skin rash
• sleep disturbances
• sore throat (Bupropion SR)
• tremor

Other side effects may include:

• acne
• allergic reactions (severe)
• bed-wetting
• blisters in the mouth and eyes (Stevens-Johnson syndrome)
• blurred vision
• breathing difficulty
• chest pain
• chills
• complete or almost complete loss of movement
• confusion
• dry skin
• episodes of over-activity
• elation
• irritability
• extreme calmness
• fatigue
• fever
• fluid retention
• flu-like symptoms
• gum irritation and inflammation
• hair color changes
• hair loss
• hives
• impotence
• incoordination and clumsiness
• indigestion
• itching
• increased libido
• menstrual complaints
• mood instability
• muscle rigidity
• painful ejaculation
• painful erection
• retarded ejaculation
• ringing in the ears
• sexual dysfunction
• suicidal ideation
• thirst disturbances
• toothache
• urinary disturbances
• weight gain or loss

Why should Bupropion NOT be prescribed?

Do not take Bupropion if you are sensitive to or have ever had an allergic reaction to it.

Since Bupropion causes seizures in some people, do not take it if you have any type of seizure disorder or if you are taking another medication containing bupropion, such as Zyban, the quit smoking aid. If you have a seizure while taking Bupropion, stop taking the drug and never take it again.

Do not take Bupropion while abruptly giving up alcohol or sedatives, including tranquilizers such as Librium, Valium, and Xanax. Rapid withdrawal increases the risk of seizures.

If you have had any kind of heart trouble or liver or kidney disease, be sure your doctor knows about it before you start taking this drug. It must be used with extreme caution if you have severe cirrhosis of the liver. A reduced dosage may be needed if you have any sort of liver or kidney problem.

You should not take Bupropion if you currently have, or formerly had, an eating disorder. For some reason, people with a history of anorexia nervosa or bulimia seem to be more likely to experience Bupropion-related seizures.

Do not take Bupropion if, within the past 14 days, you have taken a monoamine oxidase inhibitor (MAO inhibitor) drug, such as the antidepressants Marplan, Nardil or Parnate. This particular drug combination could cause you to experience a sudden, dangerous rise in blood pressure.

Special warnings about Bupropion

If you take Bupropion, you may be vulnerable to seizures if your dosage is too high or if you ever suffered brain damage or experienced seizures in the past.

Stop taking Bupropion and call your doctor immediately if you have difficulty breathing or swallowing; notice swelling in your face, lips, tongue, or throat; develop swollen arms and legs; or break out with itchy eruptions. These are warning signs of a potential severe allergic reaction.

The danger of seizures is greater in people addicted to narcotics, cocaine, or stimulants, and in those using over-the-counter stimulants or diet pills. Alcohol abuse or withdrawal also increases the risk, as does the use of other antidepressants or major tranquilizers. The risk is higher, too, if you are taking insulin or oral diabetes medication.

Since Bupropion may impair your coordination or judgment, do not drive or operate dangerous machinery until you find out how the medication affects you.

Possible food and drug interactions when taking Bupropion

Do not drink alcohol while you are taking Bupropion; an interaction between alcohol and Bupropion could increase the possibility of a seizure.

If Bupropion is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Bupropion with the following:

• beta blockers (used for high blood pressure and heart conditions) such as Inderal, Lopressor, and Tenormin
• Carbamazepine (Tegretol)
• Cimetidine (Tagamet)
• Cyclophosphamide (Cytoxan)
• Heart-stabilizing drugs such as Rythmol and Tambocor
• Levodopa (Larodopa)
• Major tranquilizers such as Haldol, Risperdal, Thorazine, and Mellaril
• MAO inhibitors (such as the antidepressants Parnate and Nardil)
• Nicotine patches such as Habitrol, NicoDerm CQ, and Nicotrol patch
• Orphenadrine (Norgesic)
• Other antidepressants such as Elavil, Norpramin, Pamelor, Paxil, Prozac, Tofranil, and Zoloft
• Phenobarbital
• Phenytoin (Dilantin)
• Steroid medications such as Prednisone
• Theophylline (Theo-Dur)

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, notify your doctor immediately. Bupropion should be taken during pregnancy only if clearly needed.

Bupropion does pass into breast milk and may cause serious reactions in a nursing baby; therefore, if you are a new mother, you may need to discontinue breastfeeding while you are taking this medication.

Recommended dosage

No single dose of Bupropion should exceed 150 milligrams.

ADULTS
Bupropion

At the beginning, your dose will probably be 200 milligrams per day, taken as 100 milligrams 2 times a day. After at least 3 days at this dose, your doctor may increase the dosage to 300 milligrams per day, taken as 100 milligrams 3 times a day, with at least 6 hours between doses. This is the usual adult dose. The maximum recommended dosage is 450 milligrams per day taken in doses of no more than 150 milligrams each.

Bupropion SR

The usual starting dose is 150 milligrams in the morning. After 3 days, if you do well, your doctor will have you take another 150 milligrams at least 8 hours after the first dose. It may be 4 weeks before you feel the benefit and you will take the drug for several months. The maximum recommended dose is 400 milligrams a day, taken in doses of 200 milligrams each.

If you have severe cirrhosis of the liver, your dosage should be no more than 75 milligrams once a day. With less serious liver and kidney problems, the dosage will be somewhat reduced.

CHILDREN
The safety and effectiveness in children under 18 years old have not been established.

OLDER ADULTS

Although they are more sensitive to antidepressant drugs, older people have responded no differently to Bupropion than younger people.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of Bupropion, seek medical attention immediately.

Symptoms of Bupropion overdose may include:

• Hallucinations
• heart failure
• loss of consciousness
• rapid heartbeat
• seizures

Symptoms of Bupropion SR overdose may include:

• blurred vision
• confusion
• jitteriness
• lethargy
• light-headedness
• nausea
• seizures
• vomiting

An overdose that involves other drugs in combination with Bupropion may also cause these symptoms:

• breathing difficulties
• coma
• fever
• rigid muscles
• stupor