Bupropion

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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

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