bupropion

What is the most important information I should know about bupropion?

Do not take bupropion if you have taken a monoamine oxidase inhibitor (MAOI) such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.

You should not take bupropion if you have seizures, an eating disorder, if you are using a second form of bupropion, or if you have suddenly stopped using alcohol or sedatives.

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.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

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.

What is bupropion?

Bupropion is an antidepressant medication.

Bupropion is 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.

What should I discuss with my healthcare provider before taking bupropion?

Do not take bupropion if you have taken a monoamine oxidase inhibitor (MAOI) such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.

You should not take bupropion if you have:

• epilepsy or a seizure disorder;
• an eating disorder such as anorexia or bulimia;
• if you are using a second form of bupropion; or
• if you have suddenly stopped using alcohol or sedatives (such as Valium).

Bupropion may cause seizures, especially in people with certain medical conditions. Tell your doctor about all of your medical conditions.

To make sure you can safely take bupropion, tell your doctor if you have any of these other conditions:

• a history of head injury, seizures, or brain or spinal cord tumor;
• heart disease, high blood pressure, history of heart attack;
• kidney or liver disease (especially cirrhosis); or
• bipolar disorder (manic depression).

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. It is not known whether bupropion will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Bupropion passes into breast milk and could be harmful to a nursing baby. You should not breast-feed while you are taking bupropion.

How should I take bupropion?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Bupropion can be taken with or without food.

Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time, which could increase side effects including seizures.

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 weeks.

Your doctor may prescribe nicotine patches or gum to help support your smoking cessation treatment. Be sure you read all directions and safety information for the nicotine product. Using nicotine with Zyban may raise your blood pressure and your doctor may want to check your blood pressure regularly. Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.

Do not stop taking bupropion without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.

This medication 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.

What happens if I miss a dose?

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.

What happens if I overdose?

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.

What should I avoid while taking bupropion?

Drinking alcohol may increase your risk of seizures. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Bupropion can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking. when they start using the medication.

Avoid using bupropion to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking. Too much of this medicine can increase your risk of a seizure.

Bupropion may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What are the possible side effects of bupropion?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

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.

Call your doctor at once if you have a serious side effect such as:

• seizure (convulsions);
• severe blistering, peeling, and red skin rash;
• fever, swollen glands, rash or itching, joint pain, or general ill feeling;
• confusion, trouble concentrating; or
• hallucinations, unusual thoughts or behavior.

Less serious side effects may include:

• headache or migraine, dizziness, tremors (shaking);
• sleep problems (insomnia), loss of interest in sex;
• nausea, vomiting, constipation, dry mouth;
• appetite changes, weight loss or gain; or
• mild itching or skin rash, increased sweating.

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.

What other drugs will affect bupropion?

Many drugs can interact with bupropion. Below is just a partial list. Tell your doctor if you are using:

• medication used to prevent blood clots, such as clopidogrel (Plavix) or ticlopidine (Ticlid), tirofiban (Aggrastat);
• cancer medicine such as cyclophosphamide (Cytoxan, Neosar), doxorubicin (Adriamycin, Doxil), irinotecan (Camptosar), or thiotepa (Thioplex);
• heart or blood pressure medication such as atenolol (Tenormin), flecainide (Tambocor), metoprolol (Lopressor, Toprol), propafenone (Rythmol), propranolol (Inderal), and others; or
• HIV or AIDS medications such as efavirenz (Atripla, Sustiva) or ritonavir (Norvir, Kaletra).

This list is not complete and there are many other drugs that can interact with bupropion. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

You may have a higher risk of seizures if you use certain medications together with bupropion. Tell your doctor about all other medications you use, especially:

• any other antidepressant, or a medicine to treat a psychiatric disorder;
• antihistamines that make you sleepy;
• asthma medications or bronchodilators;
• birth control pills or hormone replacement estrogens;
• bladder or urinary medications such as oxybutynin (Ditropan, Urotrol);
• antibiotics such as cefdinir (Omnicef), cephalexin (Keflex), ciprofloxacin (Cipro), amoxicillin (Amoxil, Augmentin), penicillin, and others;
• diet pills, a stimulant, or ADHD medication such as Adderall or Ritalin;
• insulin or diabetes medications you take by mouth;
• medication for nausea, vomiting, or motion sickness;
• medications to treat or prevent malaria;
• medicines to treat Parkinson's disease, restless leg syndrome, or pituitary gland tumor (prolactinoma);
• medicines used to prevent organ transplant rejection;
• narcotic pain medication;
• a sedative such as diazepam (Valium), and others;
• a steroid such as prednisone, and others;
• street drugs such as "speed" or cocaine;
• theophylline (Theo-Dur, Slo-Bid, Bronkodyl Theolair, Respbid); or
• ulcer or irritable bowel medications.

Where can I get more information?

Your pharmacist can provide more information about bupropion.