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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.
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.
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.
Tell your doctor if you are pregnant or breastfeeding.
If you are pregnant, your name may be listed on a pregnancy registry to track the effects of bupropion on the baby.
Bupropion is not approved for use by anyone younger than 18 years old.
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.
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.
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.
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.
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, stuffy nose;
problems with vision or hearing;
nausea, vomiting, constipation;
sleep problems (insomnia);
tremors, sweating, feeling anxious or nervous;
fast heartbeats;
confusion, agitation, hostility;
rash;
headache, dizziness; 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.
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.
Further informationRemember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use bupropion only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Bupropion Hydrochloride (www.drugs.com/bupropion.html).
Commonly reported side effects of bupropion include: insomnia, nausea, pharyngitis, weight loss, constipation, dizziness, headache, and xerostomia. Other side effects include: abdominal pain, agitation, arthralgia, chest pain, migraine, skin rash, urinary frequency, anxiety, asthenia, confusion, diarrhea, hostility, hypertension, lack of concentration, myalgia, nervousness, palpitations, pruritus, tinnitus, tremor, vomiting, anorexia, diaphoresis, dysgeusia, flushing, and abnormal dreams. See below for a comprehensive list of adverse effects.
For the ConsumerApplies to bupropion: oral tablet, oral tablet extended release, oral tablet extended release 12 hr, oral tablet extended release 24 hr
Oral route (Tablet; Tablet, Extended Release)
Suicidality and Antidepressant DrugsAlthough Zyban® is not indicated for treatment of depression, it contains the same active ingredient as the antidepressant medications Wellbutrin®, Wellbutrin® SR, and Wellbutrin XL®. Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term trials. These trials did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in subjects over age 24; there was a reduction in risk with antidepressant use in subjects aged 65 and older. In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber BuPROPion hydrochloride extended-release tablet is not approved for use in pediatric patients.
Oral route (Tablet, Extended Release)
Suicidality and Antidepressant DrugsAntidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term trials. These trials did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in subjects aged 65 and older.In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber.
Along with its needed effects, bupropion may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking bupropion:
More common
Less common
Rare
Incidence not known
Get emergency help immediately if any of the following symptoms of overdose occur while taking bupropion:
Symptoms of overdose
Some side effects of bupropion may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
For Healthcare Professionals
Applies to bupropion: oral tablet, oral tablet extended release
GeneralIn placebo-controlled clinical studies, the specific adverse events that led to discontinuation in at least 1% of patients treated with either 300 mg or 400 mg per day of Wellbutrin SR (R)included rash, nausea, agitation, and migraine. Additional events leading to discontinuation in the immediate-release formulation included mental state abnormalities, vomiting, seizures, headaches, and sleep disturbances, many of which occurred at doses greater than the recommended daily dose.
Adverse events leading to treatment discontinuation with Zyban (R) included tremors, and rashes. The most commonly observed adverse reactions were dry mouth and insomnia. Smoking cessation is often associated with nicotine withdrawal symptoms, some of which are also recognized as adverse events associated with bupropion.
PsychiatricVery common (10% or more): Insomnia (up to 45%), agitation (up to 31.9%), abnormal dreams (up to 13%)
Common (1% to 10%): Anxiety, confusion, decreased/increased libido, decreased memory/memory impairment, delusions, depression, disturbed concentration, dysphoria, euphoria, hallucinations, hostility, impaired sleep quality, irritability, mania/hypomania, nervousness, thinking abnormality
Uncommon (0.1% to 1%): Aggression, bruxism, depersonalization, emotional lability, formal thought disorder, frigidity, mood instability, nightmares, paranoia, paranoid ideation, psychosis, suicidal ideation
Rare (0.01% to 0.1%): Derealization, impaired attention
Frequency not reported: Abnormalities in mental status, post-ictal confusion, sleep disturbances
Postmarketing reports: Completed suicide, delirium, manic reaction, restlessness, suicidal behavior, suicide attempt
The Australian Adverse Drug Reaction Advisory Committee reported that 285 of the 780 reports it received in association with bupropion through mid-May 2001 involved psychological disturbances.
Two cases of tactile hallucinations ("bugs crawling over skin") have been reported in association with bupropion extended-release (200 mg twice daily) therapy. In both cases the symptoms abated following a reduction in the total daily dose of bupropion (300 mg daily).
Insomnia may also be dose-dependent. In a dose response clinical study for smoking cessation, 29% of patients receiving bupropion 150 mg/day versus 35% of those receiving 300 mg/day reported insomnia. Insomnia may be minimized by reducing the dosage or avoiding administration at bedtime.
Nervous systemThe Australian Adverse Drug Reaction Advisory Committee reported that 268 of the 780 reports it received in association with bupropion through mid-May 2001 involved nervous system disorders.
Grand mal seizures have been reported in 0.4% of patients undergoing bupropion therapy at dosages up to 450 mg daily. The incidence of seizures increases dramatically at higher dosages. The seizure rate in patients taking sustained-release bupropion up to a dosage of 300 mg/day (e.g. for smoking cessation) has been approximated at 0.1%.
The risk of seizure appears to be dose-related. Other risk factors are related to patient factors e.g., severe head injury, arteriovenous malformation, CNS tumor or CNS infection, or severe stroke, concomitant medications that lower the seizure threshold (e.g., other bupropion products, antipsychotics, tricyclic antidepressants, theophylline, and systemic corticosteroids), metabolic disorders, illicit drug use, abuse or misuse of prescription drugs such as CNS stimulants, diabetes mellitus treated with oral hypoglycemics or insulin, treatment with anorectic drugs, and excessive use of alcohol, benzodiazepines, sedative/hypnotics, or opiates.
Two cases of elderly patients falling backwards have been attributed to the effects of bupropion on the basal ganglia.
Very common (10% or more): Headache (up to 34%), migraine (up to 25.7%), dizziness (up to 22.3%), tremor (up to 21.1%), sedation (up to 19.8%)
Common (1% to 10%): Akathisia, ataxia/incoordination, central nervous system stimulation, dyskinesia, dystonia, feeling jittery, myoclonus, paresthesia, seizure, sensory disturbance, somnolence, syncope, taste disturbance, taste perversion
Uncommon (0.1% to 1%): Abnormal coordination, dysarthria, hypesthesia, hyperkinesia, hypertonia, vertigo
Rare (0.01% to 0.1%): Abnormal electroencephalogram, amnesia, parkinsonism
Frequency not reported: Generalized tonic-clonic seizures
Postmarketing reports: Akinesia, aphasia, coma, extrapyramidal syndrome, hypokinesia, neuropathy, neuralgia, unmasking tardive dyskinesia
MetabolicVery common (10% or more): Weight loss greater than 2.3 kg (up to 28%), weight gain greater than 2.3 kg (up to 11%)
Common (1% to 10%): Anorexia, decreased appetite, increased appetite, thirst/thirst disturbance
Rare (0.01% to 0.1%): Blood glucose disturbances
Very rare (less than 0.01%): Hyponatremia
Postmarketing reports: Hyperglycemia, hypoglycemia
GastrointestinalVery common (10% or more): Dry mouth (up to 27.6%), constipation (up to 26%), nausea (up to 22.9%), vomiting (up to 22.9%)
Common (1% to 10%): Abdominal pain, diarrhea, dyspepsia, dysphagia, flatulence, gastrointestinal disturbance, gustatory disturbance, mouth ulcer, stomatitis
Uncommon (0.1% to 1%): Gastric reflux, gingivitis, gum irritation, increased salivation, inguinal hernia, oral edema, toothache
Rare (0.01% to 0.1%): Edema of the tongue, intestinal perforation
Frequency not reported: Esophagitis
Postmarketing reports: Colitis, gastrointestinal hemorrhage, glossitis, gum hemorrhage, pancreatitis, stomach ulcer, stool abnormality
DermatologicVery Common (10% or more): Excessive sweating (up to 22.3%)
Common (1% to 10%): Dry skin, facial edema, pruritus, rash, sweating, urticaria
Uncommon (0.1% to 1%): Alopecia, ecchymosis, photosensitivity
Rare (0.01% to 0.1%): Erythema multiforme, exacerbation of psoriasis, Stevens-Johnson syndrome
Frequency not reported: Skin reactions
Postmarketing reports: Exfoliative dermatitis, hirsutism, maculopapular rash
The Australian Adverse Drug Reaction Advisory Committee reported that 307 of the 780 reports it received in association with bupropion through mid- May 2001 involved skin reactions. Urticaria was the most commonly reported event (167 cases). Other rashes (86 cases) were also reported.
LocalVery common (10% or more): Application site reaction (up to 15%)
OcularVery common (10% or more): Blurred vision (up to 14.6%)
Common (1% to 10%): Diplopia, visual disturbance
Uncommon (0.1% to 1%): Accommodation abnormality, dry eye, mydriasis
Postmarketing reports: Angle-closure glaucoma, increased intraocular pressure
RespiratoryVery common (10% or more): Nasopharyngitis (up to 13%), rhinitis (up to 12%), pharyngitis (up to 11%)
Common (1% to 10%): Bronchitis, cough, dyspnea/shortness of breath, epistaxis, increased cough, sinusitis, upper respiratory tract infection
Rare (0.01% to 0.1%): Bronchospasm, pulmonary embolism
Postmarketing reports: Pneumonia
CardiovascularIn clinical practice, hypertension, in some cases severe, requiring acute treatment, has been reported in patients receiving bupropion alone and in combination with nicotine replacement therapy. These events have been observed in both patients with and without evidence of preexisting hypertension.
Some investigators have suggested that bupropion therapy may be 10 to 100 times less likely to induce conduction problems than tricyclic antidepressants.
Very Common (10% or more): Tachycardia (up to 11%)
Common (1% to 10%): Cardiac arrhythmias, chest pain, edema, flushing, hot flashes, hypertension, hypotension, palpitations
Uncommon (0.1% to 1%): Electrocardiogram abnormalities, nonspecific ST-T changes, peripheral edema, postural hypotension, premature beats, stroke, vasodilation
Rare (0.01% to 0.1%): Myocardial infarction
Postmarketing reports: Cardiovascular disorder, complete atrioventricular block, extrasystoles, orthostatic hypotension, phlebitis, severe hypertension, third degree heart block
OtherCommon (1% to 10%): Accidental injury, asthenia, auditory disturbance, chills, cutaneous temperature disturbance, fever, nonspecific fever, pain, temperature disturbance, tinnitus
Uncommon (0.1% to 1%): Inguinal hernia, nonspecific pain
Rare (0.01% to 0.1%): Malaise, overdose
Postmarketing reports: Deafness
GenitourinaryCommon (1% to 10%): Decrease in sexual function, dysmenorrhea, impotence, menstrual complaints, nocturia, urinary frequency, urinary tract infection, urinary urgency, vaginal hemorrhage
Uncommon (0.1% to 1%): Painful erection, polyuria, prostate disorder, retarded ejaculation, testicular swelling, vaginal irritation
Rare (0.01% to 0.1%): Enuresis, urinary incontinence, urinary retention
Postmarketing reports: Abnormal ejaculation, dyspareunia, dysuria, menopause, prostate disorder, salpingitis, urinary tract disorder, vaginitis
One study in which 150 patients received the sustained released form of bupropion reported the incidence of orgasm dysfunction at 8% in patients receiving a 300 mg daily dose and 10% in patients receiving a 400 mg daily dose.
Among antidepressants, bupropion may be associated with the lowest incidence of sexual dysfunction (i.e., impotence, abnormal ejaculation, changes in libido).
MusculoskeletalCommon (1% to 10%): Arthralgia, arthritis, myalgia, neck pain, pain in extremity, twitch/twitching
Uncommon (0.1% to 1%): Leg cramps
Postmarketing reports: Muscle rigidity, muscle weakness, musculoskeletal chest pain, rhabdomyolysis
HypersensitivityCommon (1% to 10%): Allergic reaction, hypersensitivity reactions
Uncommon (0.1% to 1%): Fever with rash and other symptoms suggestive of delayed hypersensitivity
Rare (0.01% to 0.1%): Angioedema, anaphylactic shock
ImmunologicCommon (1% to 10%): Flu-like symptoms, infection
Uncommon (0.1% to 1%): Serum sickness-like reaction
HepaticUncommon (0.1% to 1%): Abnormal liver function, jaundice, liver damage
Rare (0.01% to 0.1%): Elevated liver enzymes, hepatitis
EndocrineUncommon (0.1% to 1%): Gynecomastia
Frequency not reported: Syndrome of inappropriate antidiuretic hormone
RenalRare (0.01% to 0.1%): Glycosuria
Postmarketing reports: Cystitis
HematologicFrequency not reported: Anemia, leukopenia, thrombocytopenia
Postmarketing reports: Altered prothrombin time/INR with/without hemorrhagic/thrombotic complications, leukocytosis, lymphadenopathy, pancytopenia
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Bupropion Hydrochloride (www.drugs.com/bupropion.html).
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