BUPROPION
Generic Name: bupropion (oral) (byoo PROE pee on)
Brand Names: Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban SR

What is the most important information I should know about bupropion?
• While you are taking bupropion you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking bupropion. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with bupropion. Do not stop taking bupropion.
• Do not stop taking bupropion without first talking to your doctor. It may be several weeks before you begin to feel better, and you may require continuous treatment for quite some time.
• Avoid alcohol or drink it only in moderation while taking bupropion. Alcohol may increase the risk of having a seizure while taking bupropion. However, if you usually drink a lot of alcohol, talk with your doctor before stopping. Suddenly stopping may increase the risk of having a seizure. Talk to your doctor about alcohol use before starting treatment with bupropion.
• Do not crush, chew, or break the sustained- or extended-release tablets (Wellbutrin SR, Wellbutrin XL, Zyban SR). Swallow them whole. They are specially formulated to release slowly in the body. If you are unsure of the formulation of your medication, ask your healthcare provider.
• Bupropion may be used to treat different medical conditions. You should not be taking more than one product containing bupropion at a time (e.g., Wellbutrin and Zyban SR). Talk to your doctor if a second product containing bupropion is prescribed for you. Too much of this medicine can increase the risk of a seizure.
• Never take more bupropion in one dose or in one day than is directed by your doctor. Higher doses of bupropion may increase the risk of a seizure.

What is bupropion?
• Bupropion is an antidepressant medication. The exact way that bupropion works is unknown.
• Bupropion is used to relieve symptoms of depression such as feelings of sadness, worthlessness or guilt, loss of interest in daily activities, changes in appetite, tiredness, sleeping too much, insomnia, and thoughts of death or suicide. Bupropion is also used to help people stop smoking by reducing 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?
• While you are taking bupropion you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking bupropion. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with bupropion. Do not stop taking bupropion.
• Do not take bupropion if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days.
• Do not take bupropion without first talk to your doctor if you
· have liver problems;
· have kidney problems;
· have heart problems, high blood pressure, or history of heart attack;
· have anorexia or bulimia;
· have epilepsy or a seizure disorder;
· have a head injury or brain or spinal column tumor;
· have diabetes; or
· drink alcohol, use street drugs, or take a prescription benzodiazepine such as alprazolam (Xanax), diazepam (Valium), temazepam (Restoril), and others.
• You may not be able to take bupropion or you may require a dosage adjustment or special monitoring during treatment.
• Bupropion may be used to treat different medical conditions. You should not be taking more than one product containing bupropion at a time (e.g., Wellbutrin and Zyban). Talk to your doctor if a second product containing bupropion is prescribed for you. Too much of this medicine can increase the risk of a seizure.
• Bupropion is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not take bupropion without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• It is not known whether bupropion will be harmful to a nursing baby. Do not take bupropion without first talking to your doctor if you are breast-feeding a baby.

How should I take bupropion?
• Take bupropion exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Bupropion can be taken with or without food.
• Do not crush, chew, or break the sustained- or extended-release tablets (Wellbutrin SR, Wellbutrin XL and Zyban SR). Swallow them whole. They are specially formulated to release slowly in the body. If you are unsure of the formulation of your medication, ask your healthcare provider.
• Never take more bupropion in one dose or in one day than is directed by your doctor. Higher doses of bupropion may increase the risk of a seizure. Maximum doses of bupropion are as follows:
· No single dose of the regular-release product Wellbutrin should be more than 150 mg, and doses should be taken at least 6 hours apart with a maximum daily dose of 450 mg.
· Single doses of the sustained-release product Wellbutrin SR should not exceed 200 mg and should be taken at least 8 hours apart with a maximum daily dose of 400 mg.
· Single doses of the extended-release product Wellbutrin XL should not exceed 450 mg, and doses should be taken 24 hours apart.
· Single doses of Zyban SR should not exceed 150 mg and doses should be taken at least 8 hours apart with a maximum daily dose of 300 mg.
• Take bupropion exactly as directed by your doctor.
• If you are taking Zyban SR to help you stop smoking, a target "quit date" is usually set for the second week of treatment with Zyban SR. Although it is not physically harmful to smoke while taking Zyban SR, continuing to smoke after the date you set to stop smoking will seriously reduce your chance of breaking the smoking habit.
• Nicotine replacement products (patches or gum) can be used during treatment with Zyban SR under the supervision of a doctor. Zyban SR and a nicotine replacement product together may raise 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 SR as this can cause serious side effects from too much nicotine.
• The WELLBUTRIN XL tablet is covered by a shell that slowly releases the medicine inside the body. You may notice something in the stool that looks like a tablet. This is normal. This is the empty shell passing from the body.
• It is important to take bupropion regularly to get the most benefit.
• Do not stop taking bupropion without first talking to your doctor. It may be several weeks before you begin to feel better, and you may require continuous treatment for quite some time.
• Your doctor may want you to have blood tests or other medical evaluations during treatment with bupropion to monitor progress and side effects.
• Bupropion tablets may have an odor. If present, this odor is normal.
• Store bupropion at room temperature away from moisture and heat.

What happens if I miss a dose?
• Skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose.

What happens if I overdose?
• Seek emergency medical attention if an overdose is suspected.
• Symptoms of a bupropion overdose include seizures, hallucinations, loss of consciousness, weakness, a fast heartbeat, and heart attack.

What should I avoid while taking bupropion?
• Avoid alcohol or drink it only in moderation while taking bupropion. Alcohol may increase the risk of having a seizure while taking bupropion. However, if you usually drink a lot of alcohol, talk with your doctor before stopping. Suddenly stopping may increase the risk of having a seizure. Talk to your doctor about alcohol use before starting treatment with bupropion.
• Use caution when driving, operating machinery, or performing other hazardous activities. Bupropion may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
• Bupropion may be used to treat different medical conditions. You should not be taking more than one product containing bupropion at a time (e.g., Wellbutrin and Zyban SR). Talk to your doctor if a second product containing bupropion is prescribed for you. Too much of this medicine can increase the risk of a seizure.

What are the possible side effects of bupropion?
• If you experience any of the following uncommon but serious side effects, stop taking bupropion and seek emergency medical attention or contact your doctor immediately:
· an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
· seizures; or
· fast or irregular heartbeats.
• Other, less serious side effects may be more likely to occur. Continue to take bupropion and talk to your doctor if you experience
· headache;
· insomnia;
· dry mouth;
· tremors, restlessness, agitation, or anxiety;
· dizziness or drowsiness;
· sweating;
· skin rash;
· ringing in the ears;
· flulike symptoms such as aching muscles, fatigue, and discomfort;
· frequent urination; or
· weight loss or gain.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect bupropion?
• Do not take bupropion if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days.
• Many drugs can interact with bupropion, resulting in side effects and/ or decreased effectiveness of the medication. Do not take any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, without first talking to your doctor during treatment with bupropion.

Where can I get more information?
• Your pharmacist has more information about bupropion written for health professionals that you may read.

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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. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/ or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. 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.