Buproban: Black Box Warnings

Buproban: Adult Dosing

Dosage forms: 150 ER

smoking cessation

150 mg PO bid x7-12wk

Start: 150 mg PO qd x3 days; Max: 300 mg/day; Info: separate doses by at least 8h; last dose no later than 6pm; stop smoking after 5-7 days of tx; avoid/minimize alcohol use; do not cut/crush/chew

renal dosing

not defined

renal impairment: caution advised, consider decr. dose freq and/or amt

hepatic dosing

adjust dose amount, frequency

mild-mod cirrhosis: consider decr. dose freq and/or amt; severe cirrhosis: max 150 mg q48h

Buproban: Peds Dosing

This information is currently unavailable or not applicable for this drug.

Buproban: Contraindications/Cautions

• hypersens. to drug/class/compon.
• MAO inhibitor use w/in 14 days
• seizure disorder
• bulimia
• anorexia
• abrupt alcohol, BZD or sedative D/C
• caution if seizure threshold lowered
• caution if head injury/intracranial lesion
• caution if alcohol/drug abuse
• caution if diabetes mellitus
• caution if cirrhosis, severe
• caution if impaired liver fxn
• caution if impaired renal fxn
• caution if recent MI
• caution if HTN
• caution if bipolar disorder
• caution if suicidality hx
• caution if suicidal ideation
• caution if <25 yo
• caution in elderly pts

Buproban: Drug Interactions

Contraindicated

• MAOIs, all

Avoid/Use Alternative

• ethanol

Monitor/Modify Tx

• acetaminophen/tramadol

• amantadine

• aripiprazole

• atomoxetine

• beta blockers, 2D6 substrates

• clozapine

• corticosteroids, systemic

• loxapine

• meperidine/promethazine

• mexiletine

• molindone

• nicotine

• olanzapine

• olanzapine/fluoxetine

• phenothiazines

• quetiapine

• SSRIs 3 (2D6 substrates)

• theophyllines

• thiothixene

• tramadol

• warfarin

• ziprasidone

Caution Advised

• acetaminophen/propoxyphene

• antidepressants, other

• baclofen

• baclofen intrathecal

• barbiturates

• beta blockers, ophthalmic 2D6 substrates

• bismuth subcitrate potassium/metronidazole/tetracycline

• bismuth subsalicylate/metronidazole/tetracycline

• carbamazepine

• cevimeline

• chloroquine phosphate

• cimetidine

• codeines

• cyclobenzaprine

• cyclosporine

• desvenlafaxine

• donepezil

• duloxetine

• edrophonium

• flecainide

• galantamine

• haloperidol

• hydrocodones

• imipenem/cilastatin

• isoniazid

• isoniazid/pyrazinamide/rifampin

• isoniazid/rifampin

• lindane topical

• linezolid

• meperidine

• methocarbamol

• metronidazole

• neostigmine

• paliperidone

• penicillins

• phenytoins

• physostigmine

• propafenone

• propoxyphene

• protease inhibitors

• pyridostigmine

• pyrimethamine

• pyrimethamine/sulfadoxine

• quinolones, all

• rifampin

• risperidone

• rivastigmine

• sodium phosphate

• sorafenib

• stimulants/anorexiants

• tacrine

• tacrolimus

• tamoxifen

• tricyclic antidepressants

• venlafaxine

Buproban: Adverse Reactions

Serious Reactions

• seizures
• arrhythmias
• tachycardia
• Stevens-Johnson syndrome
• erythema multiforme
• anaphylactic/anaphylactoid rxns
• hallucinations
• paranoia
• mania
• psychosis
• suicidality
• depression, worsening
• hepatotoxicity
• HTN, severe
• elevated IOP
• migraine

Common Reactions

• dry mouth
• headache
• agitation
• nausea
• dizziness
• constipation
• tremor
• sweating
• abnormal dreams
• insomnia
• tinnitus
• pharyngitis
• anorexia
• weight loss
• infection
• abdominal pain
• diarrhea
• anxiety
• flatulence
• rash
• palpitations
• myalgia/arthralgia
• chest pain
• blurred vision
• urinary frequency

Buproban: Safety Monitoring

Pregnancy: C

Lactation: Possibly Unsafe

Monitoring Parameters: Cr at baseline, then in elderly pts cont. periodically; BP if combo w/ nicotine tx; sx suicidality, clinical worsening, and/or unusual behavior changes, especially during initial tx or after dose changes

Buproban: Pharmacology

Metabolism: liver; CYP450: 2B6 substrate; 2D6 inhibitor; Info: active metabolites

Excretion: urine 87% (0.5% unchanged), feces 10%; Half-life: 21h

Class: Smoking Cessation

Mechanism Of Action
mechanism for smoking cessation unknown; exact mechanism of action for depression unknown, inhibits neuronal uptake of norepinephrine and dopamine (aminoketone)

Buproban: Manufacturer/Pricing

Manufacturer: generic DEA/FDA: Rx

Buproban: Patient Education

• Generic Name: bupropion (oral)

• Pronounced: byoo PRO pee on

• Brand Names: Budeprion, Budeprion XL, Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban, Zyban Advantage Pack

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

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

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.

Call your doctor at once if you have any new or worsening symptoms 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.

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.

Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.

Avoid drinking alcohol while taking bupropion. Alcohol may increase your risk of a seizure while you are taking bupropion. 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.

What is bupropion?

Bupropion is an antidepressant medication.

Bupropion is used to treat major depressive disorder and seasonal affective disorder. At least one brand of bupropion (Zyban) is used to help people stop smoking by reducing cravings and other withdrawal effects.

Bupropion may also be used for purposes other than those 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 isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl), 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 or when using certain drugs. Tell your doctor about all of your medical conditions and the drugs you use.

Before taking bupropion, tell your doctor if you have:

• heart disease or high blood pressure;
• head injury, brain or spinal cord tumor;
• kidney disease;
• liver disease (especially cirrhosis);
• bipolar disorder (manic depression);
• diabetes for which you use insulin or take oral medication;
• if you currently use steroids, theophylline (Theo-Dur, Slo-Bid, Bronkodyl Theolair, Respbid), or medicine to treat depression or mental illness; or
• if you recently used alcohol, sedatives (such as Valium), narcotic pain medicines, diet pills, or street drugs such as "speed" or cocaine.

If you have any of these conditions, you may not be able to use bupropion, or you may need a dosage adjustment or special tests during treatment.

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. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Bupropion passes into breast milk and could be harmful to a nursing baby. Do not take bupropion without telling your doctor if you are breast-feeding a baby.

Do not give this medication to anyone younger than 18 years old without the advice of a doctor.

How should I take bupropion?

Take bupropion exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Follow the directions on your prescription label.

Bupropion can be taken with or without food.

Do not crush, chew, or break the extended-release tablet (Wellbutrin SR, Wellbutrin XL, Zyban SR). Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

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 Zyban treatment. By that time you will have enough of the medicine in your blood stream to help you quit smoking. 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.

If you use the bupropion extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.

Store bupropion at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include seizures, muscle stiffness, hallucinations, fainting, fast or uneven heartbeat, shallow breathing, heart failure, or coma.

What should I avoid while taking bupropion?

Avoid drinking alcohol while taking bupropion. Alcohol may increase your risk of a seizure while you are taking bupropion. 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 can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and 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.

Call your doctor at once if you have any new or worsening symptoms 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 seizure (convulsions) or fast, uneven heartbeats.

Less serious side effects may be more likely to occur, such as:

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

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect bupropion?

There are many other drugs that can interact with bupropion. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about bupropion.

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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.

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The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Buproban: Pill Pictures

This information is currently unavailable or not applicable for this drug.