| | Medication Information:
Bupropion (generic) ~ Wellbutrin, Wellbutrin SR and Zyban (brand) Classification: Antidepressant
Common Usage: Major depressive disorder; attention-deficit/hyperactivity
disorder (ADHD); tobacco smoking cessation CommonMajor Side Effects: Restlessness or nervousness, confusion, agitation,
dizziness, rapid heartbeat, hearing disturbances, dry mouth, headache, sweating,
tremor, menstrual disturbance and constipation. This drug is not
associated with the incidence of weight gain as seen with other classes of
antidepressants, and has a lower incidence of sexual dysfunction. The
seizure risks with this drug are of lower incidence than originally reported.
However, extreme caution is still advised when using this drug in a patient with
a history of head trauma or seizure disorder (see also "Common Dosages").
This is not a complete list of all known or potential adverse effects.
Notify your prescriber or pharmacist of any symptoms that concern you that have
started since you began taking this medication, or if you have changed the dose,
or added or changed other medication. Interactions with Other Medications: As with all other antidepressants,
avoid alcohol. Not to be mixed with other antidepressants, especially
monoamine oxidase inhibitors (MAOIs) such as Parnate and Nardil. A
two-week waiting period is recommended between stopping an MAOI and starting
Wellbutrin. Patients taking medications containing levodopa - Larodopa,
Dopar, Sinemet and Sinemet CR - should be aware that some of the above mentioned
side effects (especially dizziness and agitation) may increase in severity and
may require lower doses and slower increase in Wellbutrin doses. Regarding
the use of Hismanal (astemizole), it is probably best to be cautious and not
used the nonsedating antihistamines with Wellbutrin, even though there is no
specific contraindication. While on Wellbutrin, abrupt stopping of some
medications such as benzodiazepines (Valium, Xanax, Ativan, Klonopin, etc.) or
other meds used to control seizure disorder, is not recommended. This is
not a complete list of all known or potential drug interactions. To help
prevent avoidable problems, always make sure your pharmacist and all prescribers
know all of the medications you are taking. This includes over-the-counter
drugs and any dietary or herbal supplements or medications. CommonDosages: As mentioned earlier, even though the incidence of seizure is
extremely low, caution is advised regarding dosing and dosing increases.
The following guidelines are recommended, not only for decreasing the risk of
seizure, but also for decreasing the risk of increased side effects:
- Total daily doses
should not exceed 450 mg/day.
- Daily doses (except for
starting doses ) are to be divided into 3 or 4 dosing intervals (i.e., every 6
or every 8 hours) with no single doses to exceed 150 mg.
- Dose increases should
not occur any more frequently than every 3 days, and for no more than 100 mg.
Beginning doses for adults
are at 200 mg/day, given twice daily for 3 days. Doses may be increased
along with dosing frequency as long as the above criteria is met. For
smoking cessation, starting dose is 150 mg once daily and increased to 150 mg
twice daily on the fourth day as tolerated. Do not exceed 300 mg daily.
Children with ADHD treated with a bupropion dose that averaged 3.3 (range 1.4 to
5.7) mg/kg daily showed similar benefits to methylphenidate (Ritalin) doses that
averaged 31 (range 20 to 60) mg daily. Notify your prescriber or
pharmacist if you change your dose or discontinue this medication for any
reason. Identification: Both dosage forms come in tablets, unscored, absent of
markings. Wellbutrin - 75 mg (gold) and 100 mg (red) rapid release
tablets; Wellbutrin SR - 100 mg and 150 mg sustained release tablets; and Zyban
(available as 60-tablet Advantage Pack or refill) - film coated 75 and 100 mg
tablets. Storage: Store this medication at normal room temperature (59° F to 86°
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. Edited by Stephen R.
Saklad, Pharm.D. ASERVICE OF…. Psychopharmacology Update
Note: These guidelines are for general information only.For more specific information, consult your physician orpharmacist. |
