Medication Information:
Divalproex sodium, valproic acid (generic) ~ Depakote, Depakote ER, Depakene (brand) ~ Valproate (common name for both forms)

Classification: Dopamine and norepinephrine reuptake inhibitor antidepressant.
Common Usage: Bupropion is indicated for the treatment of major depressive disorder and for tobacco smoking cessation in adults.

Important Side Effects: Most people that take bupropion do not have any adverse effects.  Among those that are commonly reported are loss of appetite, dry mouth, skin rash, sweating, ringing in ears, agitation and shakiness.  Some patients have reported feeling nausea and other have reported having difficulty sleeping.  These side effects are generally mild and disappear after a few weeks.  If you have nausea, you may want to take your medicine with food.  If you have trouble sleeping, avoid taking your medication too close to bedtime.

Seizures: Bupropion is associated with a dose-related risk of seizure.  At doses of up to 300 mg/day, the incidence of seizure is approximately 1 out of every 1,000 people (0.1%).  At doses of 300 to 450 mg/day, the incidence of seizure is approximately 4 out of every 1,000 people (0.4%).  At doses between 450 and 600 mg/day, the estimated seizure incidence increases almost tenfold.  It is important that you take your medication as directed and do not take more than one dose at a time.  If you experience a seizure while on this treatment, discontinue taking the medication and contact your physician immediately.

This is not a complete list of all known or potential adverse effects.  Notify your prescriber or pharmacist of any symptoms that have started since you began taking this medication, changing its dose, or adding or changing other medication or diet.  Take care when performing any task (for example, driving or operating machinery) that requires your attention until you have experience with this drug and are confident you can perform the task safely.  If you are planning to become pregnant, are pregnant or are a nursing mother, the potential benefits of bupropion must be weighed against the possible hazards.  Discuss these issues in advance with all of your health care providers.

Interactions with Other Medications: Bupropion should not be taken with other antidepressants unless specifically recommended by your prescriber.  Your risk of adverse effects could be increased if you combine bupropion with carbamazepine (Tegretol), clozapine (Clozaril), fluoextine (Prozac, Sarafem), haloperidol (Haldol), lithium (Eskalith, Lithobid), loxapine (Loxitane), molindone (Moban), the phenothiazines, phenytoin (Dilantin), the thioxanthenes, or trazodone (Desyrel).  Bupropion should not be taken with cimetidine (Tagamet) or with any of the monomine oxidase inhibitors (MAOIs), such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), orphenadrine (Norflex) or cyclophosphamide (Cytoxan), as these drugs could increase bupropion's effects.

Patients should be made aware that Zyban, used as an aid to stop smoking, contains the same active ingredient found in Wellbutrin SR and Wellbutrin XL and should not be used in conjunction with these or any other medication that contain bupropion.

This is not a complete list of all known or potential drug interactions.  To help prevent problems, make sure that your pharmacist and all prescribers know all medications you are taking, including over-the-counter drugs; dietary herbal supplements; folk or home remedies; or unusual foods, drinks or dietary habits.

Common Dosages: Bupropion (immediate release):  The recommended initial dose is 200 mg/day, given as 100 mg in the morning and 100 mg in the evening.  Based on response, the dose may be increased to 300 mg/day in 100 mg doses three times a day.

Wellbutrin sustained release (SR):  The recommended initial dose is a single 150 mg daily dose given in the morning.  If that is adequately tolerated, an increase to the 300 mg dose, given as Wellbutrin SR 150 mgs twice daily, may be made as early as day four of dosing.  There should be an interval of at least eight hours between successive doses.

Wellbutrin extended release (XR):  The recommended initial dose is a single 150 mg daily dose given in the morning.  If that is adequately tolerated, an increase to the 300 mg dose, given once daily, may be made as early as day four of dosing.  There should be an interval of at least 24 hours between successive doses.

Sustained-release (SR) and extended-release tablets (XL) always should be swallowed whole - not chewed, crushed or dissolved - so that the time-release mechanism will not be altered.  The full antidepressant effect of bupropion may not be felt until four weeks or longer.  If you forget to take a dose, take it as soon as you remember, but if it is within eight hours of your next dose, then skip the missed dose.  Do not take double doses.

Identification: Wellbutrin immediate release formulation is available in 75-mg and 100-mg tablets.  The 75-mg tablets are yellow-gold, round and printed with "Wellbutrin 75".  The 100-mg tablets are red, round and printed with "Wellbutrin 100".

Wellbutrin SR is available in 100, 150, and 200-mg strength tablets.  The 100-mg tablets are blue and round, printed with "WELLBUTRIN SR 100".  The 150-mg tablets are purple and round, printed with "WELLBUTRIN SR 150".  The 200-mg tablets are light-pink and round, printed with "WELLBUTRIN SR 200".

Wellbutrin XL is available in 150 mg and 300 mg tablets.  Both the 150-mg and 300-mg tablets are creamy-white to pale yellow, round tablets printed with either "WELLBUTRIN XL 150" or "WELLBUTRIN XL 300".

Zyban is available in 150-mg tablets that are purple and round, printed with "ZYBAN 150".

Storage: Bupropion should be stored at controlled room temperature (68° F to 77° F) in a tightly closed, light- and moisture-resistant container.  If you have difficulty opening child-resistant containers, your pharmacist can provide a container that is easier to open.  Keep the medication out of direct sunlight and avoid storing it in a warm or humid area - such as the bathroom or kitchen - to prevent deterioration.  To prevent accidental poisoning, keep all medications out of the reach of children.  Do not take an expired medication.  Do not transfer medication from one container to another.  Carefully discard discontinued medication where children cannot find it.

A SERVICE OF…. Manisses Communications Group, Inc.

Note: These guidelines are for general information only. For more specific information, consult your physician or pharmacist.