Bupropion

Bupropion Brand Names

Aplenzin | Budeprion SR | Budeprion XL | Buproban | Forfivo XL | Wellbutrin | Wellbutrin SR | Wellbutrin XL | Zyban

What is Bupropion

Bupropion is an oral antidepressant drug of the aminoketone class. It is not a tricyclic antidepressant and is unrelated to other known antidepressants.

Bupropion has been well tolerated in patients experiencing orthostatic hypotension with tricyclic antidepressant drugs, however, it shows a greater potential for causing seizures than other antidepressants.

Bupropion is also indicated for use as an aide to smoking cessation, and is used off-label for addiction to smokeless tobacco. The drug has been shown to help people with COPD quit smoking when combined with behavior modification.

Bupropion is also used off-label for multiple neurological/psychological uses, including ADHD and neuropathic pain.

Bupropion hydrochloride was originally approved by the FDA in December 1985 but was removed from marketing for several years due to concern over drug-induced seizures.

It was reintroduced in July 1989 as an antidepressant (i.e., Wellbutrin), and later in a sustained-release formulation (i.e., Wellbutrin SR). Another sustained-release oral dosage form, Zyban, was approved for the management of smoking cessation in May 1997.

Zyban received an additional indication for use in combination with nicotine transdermal systems (NTS) for treating the symptoms of smoking cessation in 1999. A controlled-release formulation (Wellbutrin XL) was approved in August 2003 as a once-daily formulation for major depression in adults.

In June 2006, Wellbutrin XL was FDA-approved for prevention of major depressive episodes in patients with a history of seasonal affective disorder (SAD). Wellbutrin XL is the first prescription product approved for patients with a history of SAD.

In April 2008, a once-daily formulation of bupropion hydrobromide (Aplenzin) was approved by the FDA for depression, and in August 2012 Aplenzin was approved for the prevention of seasonal major depressive episodes in patients with SAD.

Aplenzin differs from all previously marketed formulations which are the hydrochloride salt of bupropion.

Indications

1. attention-deficit hyperactivity disorder (ADHD)
2. depression
3. diabetic neuropathy
4. neuropathic pain
5. postherpetic neuralgia
6. seasonal affective disorder (SAD)
7. tobacco cessation

Side Effects

1. abdominal pain
2. abnormal dreams
3. acne vulgaris
4. agitation
5. akathisia
6. akinesia
7. alopecia
8. amnesia
9. anaphylactic shock
10. anaphylactoid reactions
11. anemia
12. angioedema
13. anorexia
14. anxiety
15. aphasia
16. appetite stimulation
17. arthralgia
18. asthenia
19. ataxia
20. AV block
21. back pain
22. blurred vision
23. bronchospasm
24. chest pain (unspecified)
25. chills
26. colitis
27. coma
28. confusion
29. constipation
30. cough
31. cystitis
32. delirium
33. dental pain
34. depression
35. diarrhea
36. diplopia
37. dizziness
38. drowsiness
39. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
40. drug-induced body odor
41. dysarthria
42. dysgeusia
43. dyskinesia
44. dysmenorrhea
45. dyspareunia
46. dyspepsia
47. dysphagia
48. dysphoria
49. dyspnea
50. dystonic reaction
51. dysuria
52. ecchymosis
53. edema
54. EEG changes
55. ejaculation dysfunction
56. elevated hepatic enzymes
57. emotional lability
58. epistaxis
59. erythema multiforme
60. esophagitis
61. euphoria
62. exfoliative dermatitis
63. fatigue
64. fever
65. flatulence
66. flushing
67. gastroesophageal reflux
68. GI bleeding
69. GI perforation
70. gingivitis
71. glossitis
72. glycosuria
73. gynecomastia
74. hair discoloration
75. hallucinations
76. headache
77. hearing loss
78. hepatitis
79. hirsutism
80. hostility
81. hot flashes
82. hyperglycemia
83. hyperhidrosis
84. hyperkinesis
85. hypersalivation
86. hypertension
87. hypertonia
88. hypoglycemia
89. hyponatremia
90. hypotension
91. impotence (erectile dysfunction)
92. increased urinary frequency
93. infection
94. influenza
95. insomnia
96. irritability
97. jaundice
98. lethargy
99. leukocytosis
100. leukopenia
101. libido decrease
102. libido increase
103. lymphadenopathy
104. maculopapular rash
105. malaise
106. mania
107. memory impairment
108. menstrual irregularity
109. migraine
110. muscle cramps
111. myalgia
112. myasthenia
113. mydriasis
114. myocardial infarction
115. myoclonia
116. nasal congestion
117. nausea
118. neonatal abstinence syndrome
119. neuropathic pain
120. nocturia
121. ocular hypertension
122. oral ulceration
123. orthostatic hypotension
124. pallor
125. palpitations
126. pancreatitis
127. pancytopenia
128. paranoia
129. paresthesias
130. peripheral edema
131. peripheral vasodilation
132. pharyngitis
133. phlebitis
134. photosensitivity
135. polydipsia
136. polyuria
137. pruritus
138. pseudoparkinsonism
139. psychosis
140. pulmonary embolism
141. rash
142. restlessness
143. rhabdomyolysis
144. rhinitis
145. seizures
146. serotonin syndrome
147. serum sickness
148. SIADH
149. sinus tachycardia
150. sinusitis
151. Stevens-Johnson syndrome
152. stomatitis
153. stroke
154. suicidal ideation
155. syncope
156. tardive dyskinesia
157. teeth grinding (bruxism)
158. testicular swelling
159. thrombocytopenia
160. tinnitus
161. Tourette’s syndrome
162. tremor
163. urinary incontinence
164. urinary retention
165. urinary urgency
166. urticaria
167. vaginal bleeding
168. vaginal irritation
169. vertigo
170. vomiting
171. weight gain
172. weight loss
173. xerophthalmia
174. xerosis
175. xerostomia

Monitoring Parameters

• blood pressure
• heart rate
• weight

Contraindications

• abrupt discontinuation
• acute myocardial infarction
• alcoholism
• anorexia nervosa
• behavioral changes
• benzodiazepine withdrawal
• bipolar disorder
• brain tumor
• breast-feeding
• bulimia nervosa
• cardiac disease
• children
• closed-angle glaucoma
• depression
• diabetes mellitus
• driving or operating machinery
• ethanol intoxication
• geriatric
• head trauma
• heart failure
• hepatic disease
• hypertension
• hypoglycemia
• hyponatremia
• hypoxemia
• increased intraocular pressure
• intracranial mass
• laboratory test interference
• mania
• MAOI therapy
• obesity treatment
• pregnancy
• psychiatric event
• renal disease
• renal failure
• renal impairment
• schizophrenia
• seizure disorder
• seizures
• stroke
• substance abuse
• suicidal ideation
• tics
• tobacco smoking
• Tourette’s syndrome

Interactions

• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetazolamide
• Acrivastine; Pseudoephedrine
• Alosetron
• Amantadine
• Amifampridine
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amobarbital
• Amoxapine
• Amphetamine
• Amphetamine; Dextroamphetamine
• Amphetamine; Dextroamphetamine Salts
• Anticonvulsants
• Aripiprazole
• Armodafinil
• Asenapine
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Oxycodone
• Atazanavir; Cobicistat
• Atropine
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Atropine; Edrophonium
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azelastine; Fluticasone
• Barbiturates
• Beclomethasone
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Benzphetamine
• Benztropine
• Betamethasone
• Bethanechol
• Brexpiprazole
• Brimonidine; Timolol
• Brompheniramine; Guaifenesin; Hydrocodone
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Brompheniramine; Pseudoephedrine
• Budesonide
• Budesonide; Formoterol
• Butabarbital
• Caffeine
• Caffeine; Ergotamine
• Cannabidiol
• Carbamazepine
• Carbetapentane; Pseudoephedrine
• Carbidopa; Levodopa
• Carbidopa; Levodopa; Entacapone
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carbinoxamine; Pseudoephedrine
• Cariprazine
• Carvedilol
• Cenobamate
• Cetirizine; Pseudoephedrine
• Cevimeline
• Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
• Chlordiazepoxide; Clidinium
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Pseudoephedrine
• Chlorpromazine
• Ciclesonide
• Cimetidine
• Citalopram
• Clomipramine
• Clopidogrel
• Clozapine
• Cobicistat
• Cocaine
• Codeine
• Codeine; Guaifenesin
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• Corticosteroids
• Corticotropin, ACTH
• Cortisone
• Cyclobenzaprine
• Dabrafenib
• Dalfampridine
• Darifenacin
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Deflazacort
• Desipramine
• Desloratadine; Pseudoephedrine
• Deutetrabenazine
• Dexamethasone
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dexmethylphenidate
• Dextroamphetamine
• Dextromethorphan; Guaifenesin; Pseudoephedrine
• Dextromethorphan; Promethazine
• Dicyclomine
• Diethylpropion
• Digoxin
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Dorzolamide; Timolol
• Doxepin
• Doxercalciferol
• Doxorubicin
• Duloxetine
• Dutasteride; Tamsulosin
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Encainide
• Ethanol
• Ethotoin
• Felbamate
• Fexofenadine; Pseudoephedrine
• Flavoxate
• Flecainide
• Fludrocortisone
• Flunisolide
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluphenazine
• Fluticasone
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Fluvoxamine
• Formoterol; Mometasone
• Fosphenytoin
• Gabapentin
• Gefitinib
• Glycopyrrolate
• Glycopyrrolate; Formoterol
• Guaifenesin; Hydrocodone
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guaifenesin; Pseudoephedrine
• Guanfacine
• Haloperidol
• Homatropine; Hydrocodone
• Hydantoins
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrocodone
• Hydrocodone; Ibuprofen
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydrocortisone
• Hydromorphone
• Hydroxyprogesterone
• Hyoscyamine
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibuprofen; Oxycodone
• Ibuprofen; Pseudoephedrine
• Iloperidone
• Imipramine
• Indacaterol; Glycopyrrolate
• Iobenguane I 131
• Isavuconazonium
• Isocarboxazid
• Isoniazid, INH
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Ivosidenib
• Lacosamide
• Lamotrigine
• Lasmiditan
• Levetiracetam
• Levodopa
• Linezolid
• Lisdexamfetamine
• Lofexidine
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Loratadine; Pseudoephedrine
• Lorcaserin
• Loxapine
• Lumacaftor; Ivacaftor
• Lumacaftor; Ivacaftor
• Lurasidone
• Maprotiline
• Mepenzolate
• Meperidine
• Meperidine; Promethazine
• Mephobarbital
• Mesoridazine
• Methadone
• Methamphetamine
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methohexital
• Methscopolamine
• Methylene Blue
• Methylphenidate
• Methylprednisolone
• Metoclopramide
• Metoprolol
• Mexiletine
• Midazolam
• Mifepristone
• Modafinil
• Molindone
• Mometasone
• Monoamine oxidase inhibitors
• Morphine
• Morphine; Naltrexone
• Naproxen; Pseudoephedrine
• Nebivolol
• Nebivolol; Valsartan
• Nelfinavir
• Nicotine
• Nitroglycerin
• Non-Ionic Contrast Media
• Nortriptyline
• Olanzapine
• Ombitasvir; Paritaprevir; Ritonavir
• Oxcarbazepine
• Oxybutynin
• Oxycodone
• Oxymorphone
• Paliperidone
• Paroxetine
• Pemoline
• Pentazocine
• Pentazocine; Naloxone
• Pentobarbital
• Perphenazine
• Perphenazine; Amitriptyline
• Phendimetrazine
• Phenelzine
• Phenobarbital
• Phenothiazines
• Phentermine
• Phentermine; Topiramate
• Phenylephrine; Promethazine
• Phenytoin
• Pimozide
• Pitolisant
• Prednisolone
• Prednisone
• Primidone
• Procarbazine
• Prochlorperazine
• Promethazine
• Propafenone
• Propantheline
• Propoxyphene
• Propranolol
• Protriptyline
• Pseudoephedrine
• Ranolazine
• Rasagiline
• Rifampin
• Risperidone
• Ritonavir
• Scopolamine
• Secobarbital
• Selegiline
• Sertraline
• Sodium Oxybate
• Solriamfetol
• Tamoxifen
• Tamsulosin
• Theophylline, Aminophylline
• Thiethylperazine
• Thiopental
• Thioridazine
• Thiotepa
• Thiothixene
• Tiagabine
• Ticlopidine
• Timolol
• tobacco
• Tolterodine
• Topiramate
• Tramadol
• Tranylcypromine
• Triamcinolone
• Triazolam
• Tricyclic antidepressants
• Trifluoperazine
• Trihexyphenidyl
• Trimipramine
• Trospium
• Valproic Acid, Divalproex Sodium
• Vigabatrin
• Vortioxetine
• Warfarin
• Ziprasidone
• Zolpidem
• Zonisamide