Bupropion (Oral)

Bupropion is used to treat seasonal affective disorder (SAD) in patients who suffer depression in the winter months.

Overview

Bupropion is used for the treatment of depression in those who suffer from seasonal affective disorder (SAD), which is also commonly known as winter depression. Bupropion can also be used as an element of a support program for people struggling to stop smoking.

Bupropion is sold under a wide range of different brand names including:

  • Aplenzin
  • Budeprion SR
  • Budeprion XL
  • Buproban
  • Forfivo XL
  • Wellbutrin
  • Wellbutrin SR
  • Wellbutrin XL
  • Zyban

This medication is available only with a doctor's prescription and can be taken in the following forms:

  • 24-hour release tablet
  • 12-hour release tablet
  • Tablet
  • Extended-release tablet

Only one prescription for Bupropion should be taken at any one time and you should not take this medication alongside any other treatments for depression. This medication is not recommended for use by children, teenagers or young adults. There is a potential risk of them experiencing thoughts of suicide when taking it.

Use of Bupropion should be consistent and to a schedule. You should not stop using suddenly. If you wish to stop taking the treatment then you should discuss this with your doctor before doing so.

Condition treated:

  • Seasonal affective disorder (SAD)

Type of medicine:

  • Antidepressant

Side Effects:

Alongside the required effects of this medication, it is possible that this treatment will cause you to experience other unwanted side effects. In cases where other side effects occur, you may need to seek medical attention.

If you experience any of the following side effects then you should consult your doctor immediately:

Occurring more commonly:

  • Anxiousness
  • Dry mouth or feeling of dehydration
  • Hyperventilation or rapid breathing
  • Irregular heart rate
  • Irritability or unusual quickness to annoyance
  • Restlessness
  • Shaking or trembling
  • Shortness of breath
  • Trouble sleeping

Occurring less commonly:

  • Buzzing or ringing in the ears not heard by others
  • Headaches of significant pain
  • Skin rash, hives, or itching

Occurring only rarely:

  • Confusion or disorientation
  • Faintness or fainting
  • False beliefs that cannot be changed by facts even when clearly presented
  • Having extreme distrust of people and situations
  • Seeing, hearing, or feeling things that are not present
  • Seizures or convulsions
  • Trouble concentrating on anything

Frequency of occurrence unknown:

  • Actions that are out of control or unusual
  • Anger
  • Assaulting others
  • Attacking others
  • Being aggressive towards others
  • Being impulsive or making sudden decisions
  • Chest pain or discomfort
  • Fast or pounding heart rate
  • Feeling of being forced to take certain actions
  • Inability to sit still
  • Need to keep moving around or pace
  • Sweating when cold
  • Talking, feeling, or acting with excitement

Other side effects may occur that do not require you to seek medical attention. These side effects may subside over time as your body gets used to the treatment and will not usually necessitate medical attention. If, however, these side effects are ongoing or become bothersome to you, then you can consult your healthcare professional to seek help to alleviate the side effects and relieve the discomfort.

Occurring more commonly:

  • Abdominal pain or stomach discomfort
  • Constipation or inability to pass stools
  • Decrease in hunger
  • Dizziness or lack of coordination
  • Increased sweating
  • Trembling
  • Weight loss (unusual)

Occurring less commonly:

  • Blurring of vision
  • Change in sense of taste
  • Drowsiness
  • Frequent need to urinate in volume
  • Sore throat
  • Unusual feeling of wellbein

Side effects not listed here may also occur. If they do occur then seek medical advice on what to do. If you are concerned that you are at risk of a side effect then seek emergency medical attention.

Dosage:

This medication should be used only as prescribed by your doctor. Do not take more of it or use it more frequently than you have been prescribed. Use beyond the recommended dosage can cause greater and more serious side effects to occur.

This medication should come with an accompanying medication guide. Read this and ask your doctor if you do not understand any of it.

Use only the brand of medication that your doctor has prescribed. Other brands of the treatment may not have the same effect on you and may not work in the same way. Swallow the tablet whole. Do not break, crush, dissolve, chew or in any way divide the medication. These tablets will release the medication slowly into your body. Do not take a crushed or broken tablet.

This medication can be taken either with or without food. However, if you feel nauseous when you take it then you should take the medication with food.

Parts of the tablets may appear in your stools. This is normal and you should not be concerned by it.

If you are using the following medication to quit smoking then you should follow these instructions along with the advice given to you by your doctor:

  • You may continue to smoke for seven days after starting treatment.
  • Set a target date to quit smoking during the second week.
  • If you struggle to quit over a period of seven weeks then you should talk to your doctor.
  • If you are using a nicotine patch in addition to treatment then you should not smoke at all. This will increase the chance of serious side effects.

The following is a guideline dose only. Follow instructions from your doctor:

o 150 mg taken once daily for the first three days. Results to be assessed and dose may be adjusted up to a maximum of 300 mg taken once daily.

If you are using this medication for the treatment of seasonal affective disorder (SAD) then you should take this medication during autumn before symptoms start. You should then continue use into early spring.

If you suffer from insomnia then you should avoid the use of this treatment close to the time that you go to bed.

The following dosage information is a guideline only and you should follow the instructions given by your doctor:

  • Extended-release tablets

o For depression in adults

  • Aplenzin® - 174 mg taken once daily in the morning. Your doctor can amend this dose but it should not normally be more than 522 mg per day.
  • Forfivo XL® - 450 mg taken once daily.
  • Wellbutrin XL® - 150 mg taken once daily in the morning. Your doctor can amend this dose but it should not normally be more than 450 mg per day.

o For depression in children

  • Use to be determined by the doctor.

o For seasonal defective disorder (SAD) in adults

  • Aplenzin® - 174 mg taken once daily in the morning. Your doctor can amend this dose but it should not normally be more than 522 mg per day.
  • Wellbutrin XL® - 150 mg taken once daily in the morning. Your doctor can amend this dose but it should not normally be more than 300 mg per day.

o For seasonal affective disorder (SAD) in children

  • Use to be determined by the doctor.
  • Sustained release tablets

o For depression in adults

  • 150 mg taken once daily in the morning. Your doctor can amend this dose but it should not normally be more than 200 mg twice daily taken eight hours apart.

o For depression in children

  • Use to be determined by the doctor.
  • Tablets

o For depression in adults

  • 100 mg taken twice daily. Your doctor can amend this dose but it should not normally be more than 150 mg thrice daily taken at least six hours apart.

o For depression in children

  • Use to be determined by the doctor.

If you miss a dose of this medication then you should skip the dose and return to your usual dosing schedule. Never take a double dose of this medication.

Interactions:

This medication can interact with a wide range of other medications. In some cases medications can interact violently with one another, causing serious side effects. It is vital that you inform your doctor of all medication that you are taking before you receive a prescription to take this medication. This includes any herbal remedies, over the counter medications and prescribed medications that you might be taking. This is particularly important if you are taking any of the following medications.

The use of the following medications alongside Bupropion is not recommended. Your doctor may need to change one or more prescription you receive:

  • Tranylcypromine
  • Selegiline
  • Rasagiline
  • Procarbazine
  • Phenelzine
  • Nialamide
  • Moclobemide
  • Metoclopramide
  • Methylene Blue
  • Linezolid
  • Isocarboxazid
  • Iproniazid
  • Furazolidone
  • Bromopride

The use of Bupropion is not usually recommended with the following. In some cases, both treatments may be prescribed, but your doctor may wish to change the dose or frequency of use of one or more prescription:

  • Vortioxetine
  • Venlafaxine
  • Varenicline
  • Valethamate
  • Umeclidinium
  • Trospium
  • Tropicamide
  • Triprolidine
  • Tripelennamine
  • Trimipramine
  • Trimeprazine
  • Tramadol
  • Tolterodine
  • Tiotropium
  • Timiperone
  • Ticlopidine
  • Ticarcillin
  • Tibolone
  • Thonzylamine
  • Thiotepa
  • Thioridazine
  • Theophylline
  • Testosterone
  • Terfenadine
  • Tacrine
  • Sultamicillin
  • Stanozolol
  • Sorafenib
  • Solifenacin
  • Sibutramine
  • Sertraline
  • Scopolamine
  • Rivastigmine
  • Ritonavir
  • Risperidone
  • Rimexolone
  • Regorafenib
  • Ranitidine
  • Quinestrol
  • Pyrilamine
  • Protriptyline
  • Propranolol
  • Propizepine
  • Propiverine
  • Propicillin
  • Propantheline
  • Propafenone
  • Promethazine
  • Promestriene
  • Procaine
  • Procainamide
  • Prednisone
  • Prednisolone
  • Prasugrel
  • Polyestradiol Phosphate
  • Pizotyline
  • Pivampicillin
  • Pirenzepine
  • Piperacillin
  • Pindolol
  • Pinaverium
  • Pimozide
  • Physostigmine
  • Phenytoin
  • Phenyltoloxamine
  • Phenobarbital
  • Pheniramine
  • Phenindamine
  • Penicillin V
  • Penicillin G
  • Paroxetine
  • Paramethasone
  • Oxymetholone
  • Oxybutynin
  • Oxatomide
  • Oxandrolone
  • Oxaliplatin
  • Oxacillin
  • Ospemifene
  • Opipramol
  • Ondansetron
  • Olopatadine
  • Nortriptyline
  • Niaprazine
  • Neostigmine
  • Nefazodone
  • Nebivolol
  • Nandrolone
  • Nalidixic Acid
  • Nafcillin
  • Mizolastine
  • Milnacipran
  • Mezlocillin
  • Mexiletine
  • Metronidazole
  • Methyltestosterone
  • Methylprednisolone
  • Methylphenidate
  • Methixene
  • Methimazole
  • Methicillin
  • Methenolone
  • Methdilazine
  • Methantheline
  • Metformin
  • Mestranol
  • Mepenzolate
  • Memantine
  • Meclizine
  • Mebhydrolin
  • Mebeverine
  • Loxapine
  • Lopinavir
  • Lofepramine
  • Lindane
  • Lidocaine
  • Levomilnacipran
  • Levodopa
  • Levocabastine
  • Ketotifen
  • Ketamine
  • Isopropamide
  • Isoniazid
  • Isoflurophate
  • Iobenguane I 123
  • Indalpine
  • Imipramine
  • Hyoscyamine
  • Hydroxyzine
  • Hydrocortisone
  • Homatropine
  • Hetacillin
  • Haloperidol
  • Guanidine
  • Glycopyrrolate
  • Galantamine
  • Fosphenytoin
  • Fluvoxamine
  • Fluticasone
  • Fluoxetine
  • Flunisolide
  • Flunarizine
  • Fludrocortisone
  • Floxacillin
  • Flecainide
  • Flavoxate
  • Fesoterodine
  • Famotidine
  • Ethinyl Estradiol
  • Estropipate
  • Estrone
  • Estriol
  • Estramustine
  • Estradiol
  • Esterified Estrogens
  • Escitalopram
  • Epinastine
  • Enflurane
  • Emedastine
  • Eliglustat
  • Efavirenz
  • Edrophonium
  • Echothiophate
  • Ebastine
  • Duloxetine
  • Droperidol
  • Doxylamine
  • Doxorubicin Hydrochloride Liposome
  • Doxorubicin
  • Doxepin
  • Dothiepin
  • Dopamine
  • Donepezil
  • Distigmine
  • Diphenylpyraline
  • Diphenhydramine
  • Dimenhydrinate
  • Diethylstilbestrol
  • Dienestrol
  • Dicyclomine
  • Dicloxacillin
  • Dibenzepin
  • Dextromethorphan
  • Dexchlorpheniramine
  • Dexbrompheniramine
  • Dexamethasone
  • Desvenlafaxine
  • Desonide
  • Desipramine
  • Demecarium
  • Delavirdine
  • Deflazacort
  • Darifenacin
  • Danazol
  • Cyproheptadine
  • Cyclosporine
  • Cyclizine
  • Cyclacillin
  • Cosyntropin
  • Cortisone
  • Corticotropin
  • Conjugated Estrogens
  • Codeine
  • Clozapine
  • Cloxacillin
  • Clopidogrel
  • Clomipramine
  • Clobetasone
  • Clidinium
  • Clemizole
  • Clemastine
  • Citalopram
  • Cinnarizine
  • Cimetropium
  • Cimetidine
  • Chlorphenoxamine
  • Chlorpheniramine
  • Chlorotrianisene
  • Chlorambucil
  • Carvedilol
  • Carbinoxamine
  • Carbimazole
  • Carbenicillin
  • Carbamazepine
  • Butylscopolamine
  • Butriptyline
  • Bupivacaine
  • Budesonide
  • Buclizine
  • Brompheniramine
  • Bromperidol
  • Bromodiphenhydramine
  • Brexpiprazole
  • Betamethasone
  • Bepotastine
  • Benperidol
  • Belladonna Alkaloids
  • Bacampicillin
  • Azlocillin
  • Azelastine
  • Azatadine
  • Atropine
  • Atomoxetine
  • Astemizole
  • Aripiprazole
  • Antazoline
  • Anisotropine
  • Ampicillin
  • Amoxapine
  • Amitriptylinoxide
  • Amitriptyline
  • Aminophylline
  • Amineptine
  • Amiloride
  • Amdinocillin Pivoxil
  • Amdinocillin
  • Ambenonium
  • Amantadine
  • Alcaftadine
  • Acrivastine
  • Aclidinium
  • Acetophenazine

Use of the following medications alongside Bupropion can increase the side effects experienced and increase the risk of side effects. Both treatments may still be administered but doses and frequencies may be changed:

  • Zolpidem
  • Tipranavir
  • St John's Wort
  • Isavuconazonium Sulfate

Other medications not listed herein may also interact with Bupropion. Ensure that you inform your doctor of all medications that you are taking before beginning treatment. Once you are being treated you should also consult your doctor before starting any other treatments.

Other medical problems can also interact with the use of this medication. You should inform your doctor of all medical conditions from which you suffer. This is particularly important if any of the following conditions apply to you:

Bupropion should not be used in patients with the following conditions:

  • Recent changes to alcohol consumption
  • Arteriovenous malformation
  • Brain tumor
  • Brain infection
  • Eating disorders
  • Severe head injury
  • History of seizures
  • Use of seizure medication
  • Use of sleeping medication
  • Use of anxiety medication
  • Stroke

The following conditions can be worsened by Bupropion use:

  • Bipolar disorder
  • Angle-closure glaucoma
  • Hypertension
  • Mania
  • Hypomania
  • Psychosis
  • Schizophrenia

The side effects of the following conditions can be worsened by Bupropion use:

  • Diabetes
  • Drug or alcohol abuse
  • Hypoglycemia
  • Hyponatremia
  • Hypoxia
  • Liver disease

The effects of the drug can be increased in patients with the following conditions:

  • Kidney disease
  • Liver disease

Other medical conditions not listed herein may also interact with the use of Bupropion. Ensure that your doctor is informed of all medical conditions from which you suffer or have suffered in the past.

Warnings:

The use of this medication should be carried out only after a due consideration of the risks in relation to the benefits of use. You and your doctor should make this decision and the following should be considered in order to reach the conclusion:

Allergies: Your doctor should be informed of any allergies you have suffered from in the past. This is especially important where you have reacted badly to any medications in the past.

Pediatric: Use in children is not recommended. While appropriate studies have not been carried out for Bupropion it is known that other depression medications can trigger children, teenagers and young adults to think about suicide. There is potential that this unwanted side effect may occur.

Geriatric: No age-related limitations of use are known in relation to use in elderly patients. Caution needs to be taken due to the likelihood of elderly patients having age-related kidney and liver problems that could impact use.

Pregnancy: Use during pregnancy is not recommended but can be used in cases where it is required. Bupropion would usually only be considered if a pregnant woman has not responded to other antidepressant treatments in the past. Discuss pregnancy with your doctor and inform them if you think you may become pregnant during treatment.

Breastfeeding: Minimal information about the effect that doses of Bupropion can have on breastfeeding is available. It is not generally expected to have any negative effects. There are, however, reports of possible seizures in breastfed six-month olds. You should discuss the risks with your doctor to decide whether the benefits are worth the risks. Alternative drug options exist for the treatment of depression in mothers who are breastfeeding at the time of treatment and these would be recommended unless circumstances dictated a need for this use of Bupropion.

You will need to attend regular appointments with your doctor when taking this medication. This is especially important during the first few months of treatment with this medication.

Use of this medication alongside monoamine oxidase inhibitor medications is dangerous and can cause significant side effects. You should not take this medication within two weeks of receipt of an (MAO) treatment. If you need an (MAO) treatment then you will need to cease use of Bupropion and wait a further two weeks before treatment. Failing to do so could result in the following side effects being experienced:

  • Confusion and disorientation
  • Agitation
  • Restlessness
  • Stomach problems
  • Intestinal problems
  • High body temperature
  • Excessive blood pressure
  • Sever convulsions or seizures

Your blood pressure may increase during use of this medication. This can put your heart and cardiovascular system under a lot of strain. If you believe your blood pressure is increased then you should contact your doctor straight away.

Bupropion can cause agitation, irritability, anger and behavioural abnormalities in patients. It can also lead to come individuals having suicidal thoughts or a desire to act recklessly. You should inform your doctor immediately if you have any strong emotional urges or changes in mood.

Anaphylaxis can occur when taking this medication. It can occur at any time and will require emergency medical attention. You should seek emergency assistance if you experiencing more than one of the following symptoms of anaphylaxis:

  • Rash
  • Itching
  • Swelling of the face
  • Swelling of the tongue
  • Selling of the throat
  • Finding it difficult to breathe
  • Pain experienced across the chest

This medication can cause serious skin conditions. If you experience any changes to your skin condition then you should talk to your doctor immediately. This includes skin loosening, blistering, rashes, itchiness, irritation and acne.

This medication can cause a false sense of wellbeing. At the same time, it may make you drowsy and less alert than usual. You should beware of this and only operate machinery or drive if you are completely confident that you are safe to do so.

Do not cease this treatment without talking to your doctor first. You should be gradually weaned off the medication because an abrupt stop can cause severe side effects. A gradual reduction should help to prevent the following side effects:

  • Agitation
  • Anxiousness
  • Feeling that the surroundings are constantly moving
  • Shaking
  • Difficulty walking
  • Difficulty sleeping
  • Sweating when cold
  • Feeling nauseous

Patients should be made aware of the potential signs of serious liver problems that may occur. They should also be made aware of what to do if they notice these symptoms of liver problems. Medical advice should be sought immediately.

This medication can lead to changes in weight and appetite. Your doctor will need to check your weight regularly during treatment.

This medication will affect the results of medical tests. Before you have any test carried out you should inform your doctor that you have taken this medication to prevent results being misinterpreted.

Do not take any other medications for the treatment of any conditions without first discussing this with your doctor. This includes the use of over the counter medications and herbal remedies or vitamin supplements.

Storage:

This medication should always be kept out of the reach of children. Store the medication in a closed container away from direct light, moisture and heat. Prevent medication from freezing. Dispose of outdated medicine appropriately and as soon as possible. Discuss disposal of medication with your healthcare professional.

Summary:

Bupropion is used in the treatment of depression, seasonal affective disorder (SAD) and as an assistive medication to quit smoking. Patients using this treatment to quit smoking should take the medication for seven days before attempting to quit smoking. They should then quit during the second week. If the patient is still struggling to quit smoking after seven weeks then they should seek further medical advice.

Patients using the Bupropion medication for the treatment of seasonal affective disorder should begin treatment in the autumn before the symptoms begin to appear. Use should be carried on until early spring before the dose is gradually reduced and ended.

Bupropion is not suitable for use in children, teenagers or young adults. There is a potential risk that individuals in these categories may experience suicidal thoughts as an unwanted side effect of the use of this medication.

The use of Bupropion can have serious and far-reaching side effects on the body. This includes changes to personality, liver problems, kidney problems, cardiovascular problems and the development of serious skin conditions. Patients should consider all of these risks in relation to the benefits of the use of this medication with their doctor before beginning treatment.

This medication interacts with a wide range of medications including some over the counter treatments and herbal remedies. You should discuss all medication use with your doctor before taking this treatment. Once treatment has started you should inform your doctor before beginning any other medications.

This medication can interact with ethanol in the body. You should discuss your drinking habits with your doctor before beginning treatment and should consider changes to your alcohol intake during treatment. If your use of alcohol changes during your use of this medication then you should inform your doctor as soon as possible.

A wide range of brands of this medication is available. You should only take a prescription for one brand of treatment at any one time. You should not try replacing one brand of treatment with another as they do not all work in the same manner. Take only the medicine prescribed to you in the dose that it was prescribed. You should not exceed the frequency of dosing as recommended by your doctor.