Bupropion Treatment Report

Precautions

Instructions

Side Effects

Interactions

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.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take this medication:

• heart disease, high blood pressure, history of heart attack;
• a history of head injury, seizures, or brain or spinal cord tumor;
• kidney disease;
• liver disease (especially cirrhosis);
• bipolar disorder (manic depression);

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. It is not known whether this medication is harmful to an unborn baby. Before taking bupropion, 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.

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.

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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.

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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 serious side effect such as:

• seizure (convulsions);
• severe blistering, peeling, and red skin rash;
• fever, swollen glands, rash or itching, joint pain, or general ill feeling;
• confusion, trouble concentrating; or
• hallucinations, unusual thoughts or behavior.

Less serious side effects may include:

• headache or migraine;
• sleep problems (insomnia);
• nausea, vomiting, constipation, dry mouth;
• 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. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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Many drugs can interact with bupropion. Below is just a partial list. Tell your doctor if you are using:

• cancer medicine such as cyclophosphamide (Cytoxan, Neosar) or thiotepa (Thioplex);
• heart rhythm medication such as flecainide (Tambocor), propafenone (Rythmol), and others; or
• heart or blood pressure medication such as atenolol (Tenormin), metoprolol (Lopressor, Toprol), propranolol (Inderal), and others.

This list is not complete and there are many other medicines 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. Keep a list of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

You may have a higher risk of seizures if you use certain medications together with bupropion. Tell your doctor about all other medications you use, especially:

• any other antidepressant, or a medicine to treat a psychiatric disorder;
• antihistamines that make you sleepy;
• asthma medications or bronchodilators;
• birth control pills or hormone replacement estrogens;
• bladder or urinary medications such as oxybutynin (Ditropan, Urotrol);
• certain antibiotics such as cefdinir (Omnicef), cephalexin (Keflex), ciprofloxacin (Cipro), amoxicillin (Amoxil, Augmentin), penicillin, and others;
• diet pills, a stimulant, or ADHD medication such as Adderall or Ritalin;
• insulin or diabetes medications you take by mouth;
• medication for nausea, vomiting, or motion sickness;
• medications to treat or prevent malaria;
• medicines to treat Parkinson's disease, restless leg syndrome, or pituitary gland tumor (prolactinoma);
• medicines used to prevent organ transplant rejection;
• narcotic pain medication;
• a sedative such as diazepam (Valium), and others;
• a steroid such as prednisone, and others;
• street drugs such as "speed" or cocaine;
• theophylline (Theo-Dur, Slo-Bid, Bronkodyl Theolair, Respbid); or
• ulcer or irritable bowel medications.

Budeprion, Budeprion XL, Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban, Zyban Advantage Pack, buPROPion, Aplenzin, and Budeprion SR

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