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Side Effects
Serious

When treating depression: Hallucinations, heartbeat irregularities, confusion, skin rash, insomnia, severe headache, excitement or agitation, seizures. Call your doctor immediately. Smoking cessation: None reported.
Common

When treating depression: Nausea or vomiting, constipation, unusual weight loss, dry mouth, loss of appetite, dizziness, increased sweating, trembling or shaking. Smoking cessation: Dry mouth, insomnia.
Less Common

When treating depression: Fever or chills, concentration difficulties, drowsiness, fatigue, change in or blurred vision, unusual feeling of euphoria, hostility or anger. Smoking cessation: Mild rash, tremor.
Bupropion Hydrochloride


Drug Class:
Antidepressant/smoking deterrent

Available OTC?: No

Available Generic?: No

Wellbutrin 100 mg
(Glaxo Wellcome)
Available In
Why Prescribed
How It Works
Range and Frequency
Onset of Effect
Duration of Action
Dietary Advice
Storage
Missed Dose
Stopping the Drug
Prolonged Use
Over 60
Driving and Hazardous Work
Alcohol
Pregnancy
Breast Feeding
Infants and Children
Special Concerns
Overdose Symptoms
What to Do
Drug Interactions
Food Interactions
Disease Interactions


Available In
Tablets, extended-release tablets

Why Prescribed
To relieve symptoms of major depression. Bupropion is also used as a non-nicotine aid to smoking cessation. It should be used as a part of a comprehensive smoking cessation program carried out under the supervision of your doctor.

How It Works
While the exact mechanism of action of bupropion is not known, it appears to help balance the levels of brain chemicals that are thought to be linked to mood, emotions, and mental state. Unlike other smoking cessation medications, bupropion does not contain nicotine. It is believed that bupropion's effects on brain chemistry help to curb the desire for nicotine and enhance the patient's ability to abstain from smoking.

Range and Frequency
Depression (Wellbutrin)-- Adults: To start, 100 mg twice a day. Dosage may be increased to 450 mg a day. No more than 150 mg should be taken within 4 hours. Older adults: To start, 75 or 100 mg twice a day. Children: Dosages must be determined by your doctor. Smoking cessation (Zyban)-- Adults: For the first 3 days of treatment, 150 mg a day. Dosage may then be increased to 150 mg, 2 times a day. The doses should be taken at least 8 hours apart. Do not take more than 300 mg per day. You should not stop smoking until you have been taking Zyban for 1 week. Treatment generally lasts 7 to 12 weeks.

Onset of Effect
1 to 3 weeks.

Duration of Action
Unknown.

Dietary Advice
Bupropion can be taken with food to reduce stomach irritation. The tablet should be swallowed whole, because it has a bitter taste and can produce an unpleasant numbing sensation inside of the mouth.

Storage
Store in a tightly sealed container away from heat, moisture, and direct light.

Missed Dose
Take it as soon as you remember, unless your next scheduled dose is within the next 4 hours (8 hours for smoking cessation). If so, do not take the missed dose. Take your next scheduled dose at the proper time and resume your regular dosage schedule. Do not double the next dose.

Stopping the Drug
Depression: Take it as prescribed for the full treatment period, even if you begin to feel better before the scheduled end of therapy. Discontinuing the drug abruptly may produce unpleasant withdrawal symptoms. Dosage should be reduced gradually according to your doctor's instructions. The decision to stop taking the drug should be made in consultation with your doctor. Smoking cessation: If you have not made significant progress toward abstinence by the end of the seventh week of treatment, consult your doctor. Treatment should probably be discontinued. You do not need to gradually decrease the dose before stopping.

Prolonged Use
Depression: The usual course of therapy lasts 6 months to 1 year; some patients benefit from additional therapy. Smoking cessation: Treatment generally lasts 7 to 12 weeks.

Over 60
Dosage may be decreased because of age-related decline in liver or kidney function.

Driving and Hazardous Work
Use caution until you determine how the medication affects you. Drowsiness or lightheadedness can occur.

Alcohol
Alcohol increases the risk of seizures. It is recommended to not drink alcohol at all or to drink very little while taking bupropion. If you regularly drink a lot of alcohol and then suddenly stop, this may also increase your chance of having a seizure; gradual tapering of alcohol is recommended.

Pregnancy
Bupropion has not caused birth defects in animals. Adequate human studies have not been done. Bupropion is not recommended while you are pregnant. Before taking it, tell your doctor if you are pregnant or plan to become pregnant.

Breast Feeding
Bupropion passes into breast milk; avoid or discontinue using it while nursing.

Infants and Children
Adequate studies in children have not been done. Bupropion is not recommended for use by children under age 18.

Special Concerns
This is a potentially dangerous drug, especially if taken in excess. Antidepressants should not be within easy reach of suicidal patients. To prevent insomnia, take the last dose several hours before bedtime. When taking bupropion for smoking cessation, it is advised to continue smoking through the first week of treatment. Set a target date to stop smoking no later than the second week of therapy. Continuing to smoke beyond the designated date reduces your chances of successfully quitting. You may use a nicotine transdermal patch (see Nicotine) while taking Zyban, but consult your doctor before initiating such therapy. The combination of nicotine and bupropion increases the risk of hypertension; blood pressure should be monitored regularly throughout treatment. Zyban should be regarded as but one part of a comprehensive treatment program that includes counseling, social support, and regular contact with your doctor. The goal of therapy with Zyban is complete abstinence from cigarettes. Do not chew, divide, or crush the tablets or extended-release tablets.

Overdose Symptoms
Hallucinations, seizures, rapid heartbeat, chest pain, breathing difficulty, loss of consciousness. Few cases of overdose associated with treatment for smoking cessation have been reported. Some of the symptoms experienced include: vomiting, blurred vision, lightheadedness, confusion, lethargy, nausea, jitteriness, hallucinations, drowsiness, and seizures.

What to Do
Call your doctor, emergency medical services (EMS), or the nearest poison control center immediately.

Drug Interactions
Bupropion should not be taken if you are taking other medicines containing bupropion or within 14 days of taking an MAO inhibitor. Consult your doctor for advice if you are taking loxapine, tricyclic antidepressants, phenothiazines, clozapine, molindone, fluoxetine, thioxanthenes, haloperidol, lithium, trazodone, maprotiline, levodopa, or theophylline.

Food Interactions
No known food interactions.

Disease Interactions
Bupropion should not be taken if you have a history of seizures, anorexia nervosa, or bulimia. Caution is advised when taking bupropion. Consult your doctor if you have any of the following: a tumor of the brain or spinal cord, heart disease, or head injury. Since the liver and kidneys work together to remove bupropion from the body, a lower dose may be prescribed for patients with impaired liver or kidney function.

Date Published: 04/13/2005
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