BUPROPION (Wellbutrin, Zyban)
Bupropion HCl and Wellbutrin is indicated for the treatment of depression and as a smoking cessation treatment.
Side Effects
Bupropion Hcl has numerous side effects on all the body systems
*Body as a Whole: Headache, Infection, Abdominal pain, Flu-like symptoms
*Dermatologic: Rash, Sweating, Pruritis
*Cardiovascular: Palpitation, Flushing, Edema
*Gastrointestinal: Nausea, Dry Mouth, Decreased Appetite, Vomiting, diarrhea, Abdominal Pain, Constipation
*Nervous System: Insomnia, Agitation, Anxiety, Nervousness, Irritability, Ataxia (lack of muscle coordination), Seizure, Myoclonus (muscle spasm), Dyskinesia (impairment of voluntary movement), Dystonia (disorder of muscle tone) Somnolence (sleepiness), Tremor, Dizziness
*Psychiatric: Mania/hypomania, Increased libido, Hallucinations, decrease in sexual function and depression
*Respiratory: Pharyngitis
*Urogenital: Urinary frequency, Nocturia
*Special Senses: Tinnitus, Taste perversion
Precautions and drug interactions:
Bupropion has adverse interactions with many drugs. Bupropion should not be taken with the following medications:
*Adderall: Combined use of Bupropion and Adderall can lead to convulsions and other health isues. Reference: http://www.buyadderallxronline.com/other-medication.html
*Nicotine: Using bupropion HCl and nicotine patches together may raise your blood pressure.
*MAOI'S
*Other Antidepressants
*Alcohol: Alcohol and bupropion can lead to seizures
*Levodopa
Other precautions
*Suicide: The possibility of a suicide attempt is inherent in depression and may persist until significant remission occurs.
*Allergic Reactions: Allergic reactions characterized by symptoms such as pruritis, urticaria, angioedema, and dyspnea, requiring medical treatment have been reported for bupropion HCl for smoking cessation.
*Be aware that Zyban, used as an aid to smoking cessation, contains the same active ingredient found in Wellbutrin and Wellbutrin SR used to treat depression and that Zyban should not be used in conjunction with Wellbutrin, Wellbutrin SR, or any other medications that contain bupropion HCl.
*DO NOT SMOKE AT ANY TIME: It is possible to get too much nicotine and have serious side effects.IMPORTANT WARNING: At a dose of 300 mg each day, there is a chance that approximately 1 out of every 1000 people taking bupropion HCl, the active ingredient in bupropion sustained release tablets, will have a seizure. The chance of this happening increases if you:
*Have a seizure disorder (for example, epilepsy).
*Have or have had an eating disorder (for example, bulimia or anorexia nervosa).
*Take more than the recommended amount of bupropion sustained release tablets.
*Take other medications with the same active ingredient that is in bupropion HCl (such as taking Wellbutrin (bupropion HCl for depression) and taking Zyban (bupropion HCl for smoking cessation).
You can reduce the chance of experiencing a seizure by following your doctor's directions on how to take bupropion HCl. You should also discuss with your doctor whether bupropion HCl is right for you.
Pregnancy and Nursing Mothers
Bupropion is in pregnancy category B. this drug should be used during pregnancy only if clearly needed. Pregnant smokers should be encouraged to attempt cessation using educational and behavioral interventions before pharmacological approaches are used.
Like many other drugs, bupropion and its metabolites are secreted in human milk. Because of the potential for serious adverse reactions in nursing infants from bupropion, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Pediatric Use
Clinical trials with bupropion HCl for smoking cessation did not include individuals under the age of 18. Therefore, the safety and efficacy in a pediatric smoking population have not been established. The immediate release formulation of bupropion was studied in 104 pediatric patients (age range, 6 to 16) in clinical trials of the drug for other indications. Although generally well tolerated, the limited exposure is insufficient to assess the safety of bupropion in pediatric patients.
Geriatric Use
No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Bupropion HCl and its metabolites are almost completely excreted through the kidney and metabolites are likely to undergo conjugation in the liver prior to urinary excretion. The risk of toxic reaction to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.
Drug Abuse and Dependence
Bupropion is not a controlled substance. Controlled clinical studies of bupropion conducted in normal volunteers, in subjects with a history of multiple drug abuse, and in depressed patients showed some increase in motor activity and agitation/excitement. There have been few reported cases of drug dependence and withdrawal symptoms associated with the immediate release form of bupropion.
Recommended Dosage
Recommended dosage differs depending upon the condition being treated.
*Treatment of Depression: Sustained Release: The usual adult target dose for bupropion sustained release tablets is 300 mg/day, given as 150 mg, twice daily. Dosing with bupropion sustained release tablets should begin at 150 mg/day given as a single daily dose in the morning
* Treatment of Depression: Immediate Release: Increases in dose should not exceed 100 mg/day in a 3-day period. No single dose of bupropion HCl should exceed 150 mg. Bupropion HCl should be administered three times daily, preferably with at least 6 hours between successive doses. The usual adult dose is 300 mg/day, given three times daily.
* Treatment for Smoking Cessation: The recommended and maximum dose of bupropion HCl sustained release tablets for smoking cessation is 300 mg/day, given as 150 mg twice daily. Dosing should begin at 150 mg/day given every day for the first 3 days, followed by a dose increase for most patients to the recommended usual dose of 300 mg/day. There should be an interval of at least 8 hours between successive doses. Doses above 300 mg/day should not be used.
Overdose
Since introduction, overdoses of up to 17,500 mg of the immediate release formulation of bupropion have been reported. Seizure was reported in approximately one third of all cases. Other serious reactions reported with overdoses of the immediate release formulation of bupropion alone included hallucinations, loss of consciousness, and sinus tachycardia (rapid heartbeat). Fever, muscle rigidity, rhabdomyolysis (The destruction of skeletal muscle cells), hypotension (low blood pressure), stupor, coma, and respiratory failure have been reported when the immediate release formulation of bupropion was party of multiple drug overdoses.
*Information for smokers
Insurance companies will not cover Zyban to stop smoking, but will cover Wellbutrin for depression. If you are considering using bupropion to stop smoking, speak with your doctor and see if he will work with you to prescribe bupropion sustained release for depression.