For the treatment of major depression. For the prevention of seasonal major depressive disorder episodes associated with seasonal affective disorder (SAD). For use as an adjunct to psychosocial interventions in the management of tobacco cessation (smoking cessation).
Bupropion is a selective inhibitor of the neuronal re-uptake of catecholamines (noradrenaline and dopamine) with minimal effect on the re-uptake of indolamines (serotonin) and does not inhibit monoamine oxidase. While the mechanism of action of bupropion, as with other antidepressants is unknown, it is presumed that this action is mediated by noradrenergic and/or dopaminergic mechanisms.
ORAL Smoking cessation: Adult: Modifiedrelease preparation: Initially, 150 mg once daily for 6 days then increased to 150 mg bid. Period of treatment: 7-12 wk. To discontinue treatment if abstinence is not achieved by 7thwk. Max: 300 mg/day. Elderly: 150 mg/day.
Bupropion should not be given concurrently with or within 14 days of stopping an MAOI. The use of alcohol should be minimised or avoided completely because it may alter the seizure threshold. Similarly, other drugs that lower the seizure threshold, such as other antidepressants, antimalarials, antipsychotics, sedating antihistamines, Quinolones, Tramadol, Theophylline, or systemic corticosteroids, should be used with extreme caution together with Bupropion. Carbamazepine, Phenobarbital, or Phenytoin may induce the metabolism of Bupropion while other drugs such as Cimetidine or Ritonavir may inhibit its metabolism. Interaction may occur between Bupropion and Orphenadrine, Cyclophosphamide, and Ifosfamide. Caution should be exercised when it is given with drugs such as some antidepressants, antipsychotics, β blockers, and type 1C antiarrhythmics.
Epilepsy; eating diso’oers (e.g. bulimia or anorexia nervosa); hypersensitivity. History of seizure disorders, bipolar disorders; Ml or unstable heart disease; pregnancy; renal or hepatic impairment. Monitor BP before & after treatment; monitor wkly if used w/ nicotine products. May impair ability to drive & operate machinery. Avoid use wlin 2 wk of MAO inhibitor withdrawal.
Facial oedema; nausea, dry mouth, constipation, diarrhoea, anorexia; mouth ulcer; thirst; myalgia, arthralgia; insomnia, dream, abnormality, anxiety, disturbed concentration, dizziness, nervousness, tremor, dysphoria; rhinitis. increased cough, pharyngitis, sinusitis; dyspnoea, epistaxis, agitation, insomnia, tremor, headache, wt loss, vomiting, skin rash. Stevens-Johnson syndrome.
Bupropion hydrochloride is one of the most frequently prescribed antidepressant in the US, and is used to treat depression in pregnant women. Despite the known risks of adverse effects of prenatal smoking on the fetus, 10.7% of pregnant women continue smoking throughout pregnancy. Limited information indicates that maternal bupropion doses of up to 300 mg daily produce low levels in breastmilk and would not be expected to cause any adverse effects in breastfed infants.
Overdoses of up to 30 grams or more of bupropion have been reported. Seizure was reported in approximately one-third of all cases. Other serious reactions reported with overdoses of bupropion alone included hallucinations, loss of consciousness, sinus tachycardia, and ECG changes such as conduction disturbances (including QRS prolongation) or arrhythmias. Fever, muscle rigidity, rhabdomyolysis, hypotension, stupor, coma, and respiratory failure have been reported mainly when bupropion was part of multiple drug overdoses.
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
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