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Bupropion

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WARNING

For those using the antidepressant bupropion (Wellbutrin):

A tiny number of kids, teenagers, and young adults (up to 24 years old) who took mood-elevating antidepressants like bupropion in clinical research developed suicide thoughts (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental diseases may have a higher risk of committing suicide than those who do not take these medications. When evaluating whether a kid or teenager should take an antidepressant, this risk should be taken into account and weighed against any potential benefits in the treatment of depression. Bupropion is typically not recommended for use in people under the age of 18, although in some circumstances, a doctor may determine that it is the best treatment option for a child’s illness.

No of your age, you, your parent, or your carer should discuss the advantages and disadvantages of treating your disease with an antidepressant or with alternative treatments with your doctor before starting an antidepressant. The dangers and advantages of not treating your ailment should also be discussed. You should be aware that having depression or another mental disease considerably increases your chance of committing suicide, particularly at the start of treatment or whenever your dose is changed. If you or anyone in your family has bipolar disorder, mania, or has ever contemplated or attempted suicide, your risk is increased. Discuss your ailment, symptoms, and personal and family medical history with your doctor. What kind of treatment is best for you will be decided by both you and your doctor.

Even if you are an adult over the age of 24 or if you do not have a mental illness and are taking bupropion to treat a different type of ailment, you should be aware that your mental health may alter in unexpected ways while you take bupropion or other antidepressants. Suicidal thoughts may come to mind, especially at the start of treatment and whenever your dose is changed. If you experience any of the following symptoms, you, your family, or your carer should contact your doctor right away: new or worsening depression; thoughts of self-harm or suicide; plans or attempts to do so; extreme worry; agitation; panic attacks; difficulty falling or staying asleep; aggressive behaviour; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Make sure your family or carer is aware of any symptoms that could be significant so they can contact the doctor on your behalf if you are unable to call for help.

For everyone who uses bupropion:

While you are on bupropion, your doctor will want to see you frequently, especially at the start of your treatment. Remember to show up for all of your doctor’s appointments and office visits.

Whenever you need a prescription refill for bupropion, your doctor or pharmacist will provide you the manufacturer’s patient information leaflet (Medication Guide). If you have any questions, carefully read the material and contact your doctor or pharmacist. To obtain the Medication Guide, you can also go to the Food and Drug Administration (FDA) website at http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm or the manufacturer’s website.

Discuss the advantages and disadvantages of taking bupropion with your doctor.

Why is this medication prescribed?

Depression is treated with bupropion (Aplenzin, Wellbutrin, Wellbutrin SR, and Wellbutrin XL). Another condition that is treated with bupropion is seasonal affective disorder (Aplenzin, Wellbutrin XL) (SAD; episodes of depression that occur at the same time each year [usually in the fall and winter but rarely may occur in the spring or summer months]). Smokers who want to quit can use the medication bupropion (Zyban). The drug bupropion belongs to the group of drugs known as antidepressants. It functions by boosting specific types of brain activity.

How should this medicine be used?

The oral forms of bupropion include tablets and sustained-release or extended-release (long-acting) tablets. Wellbutrin regular tablets are often taken three times daily, at least six hours apart between each dosage, or four times daily, at least four hours apart between each dose. The sustained-release pill (Wellbutrin SR, Zyban) is often taken twice daily, at least eight hours apart from one another. The extended-release tablet (Aplenzin, Wellbutrin XL) should be taken at least 24 hours apart from other doses. It is typically used once daily in the morning. Bupropion is often taken once daily in the morning starting in the early fall, continuing through the winter, and stopping in the early spring when treating SAD. Bupropion may occasionally be used for two weeks at a reduced dosage before being discontinued. If bupropion makes your stomach feel queasy, take it with meals. Avoid taking bupropion too close to bedtime if you have difficulties falling or staying asleep. Take bupropion every day at about the same time(s). Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the bupropion directions exactly. Never take it in larger or less amounts or more frequently than directed by your doctor.

Do not split, chew, or crush the sustained-release or extended-release tablets; instead, swallow them whole.

Most likely, your doctor will start you on a low dose of bupropion and then gradually raise it.

Before you experience the full benefits of bupropion, it could take up to 4 weeks. Bupropion should still be used even if you feel OK. Without consulting your doctor, do not discontinue taking bupropion. Your dose could be gradually reduced by your doctor.

Other uses for this medicine

Bupropion is also occasionally used to treat attention deficit hyperactivity disorder (ADHD) and episodes of depression in people with bipolar disorder (manic depressive disorder; a condition that produces episodes of melancholy, episodes of mania, and other aberrant moods) (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age). Discuss the potential dangers of using this medicine for your illness with your doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before taking bupropion,

  • If you have an allergy to bupropion, any other medications, or any of the ingredients in bupropion tablets, let your doctor and pharmacist know right once. For a list of the ingredients, consult the Medication Guide or speak with your pharmacist.
  • Inform your doctor if you are currently using an MAO inhibitor, such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate), or if you have just discontinued taking one. Most likely, your doctor will advise against using bupropion.
  • Take no more than one bupropion-containing product at a time. If you take too much medication, you can encounter negative side effects.
  • Inform your doctor and pharmacist about any additional prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you are now taking or intend to use. Incorporate any of the following: cimetidine (Tagamet); amantadine (Symmetrel); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), and propranolol (Inderal); efavirenz (Sustiva, in Atripla), cyclophosphamide (Cytoxan, Neosar), clopidogrel (Plavix), insulin or oral diabetes drugs, flecainide (Tambocor), propafenone (Rythmol), and treatments for mental disorders like haloperidol (Haldol), drugs for seizures such as carbamazepine (Tegretol), phenobarbital (Luminal, Solfoton), and phenytoin (Dilantin); risperidone (Risperdal) and thioridazine (Mellaril); levodopa (Sinemet, Larodopa); lopinavir and ritonavir (Kaletra); nelfinavir (Viracept);Other antidepressants include citalopram (Celexa), desipramine (Norpramin), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine (Luvox), and imipramine. Oral steroids include dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone) (Tofranil), theophylline (Theobid, Theo-Dur, other brands), paroxetine (Paxil), nortriptyline (Aventyl, Pamelor), and sertraline (Zoloft); ritonavir (Norvir); sedatives; sleeping aids; tamoxifen (Nolvadex, Soltamox); theophylline (Theobid, Theo-Dur, other brands); (Ticlid). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
  • Inform your physician if you suffer from or have ever suffered from bulimia, anorexia nervosa, or seizures (an eating disorder). Tell your doctor if you consume a lot of alcohol but anticipate quitting abruptly, or if you take sedatives but anticipate quitting abruptly. Most likely, your doctor will advise against using bupropion.
  • Inform your doctor if you abuse prescription drugs, consume excessive amounts of alcohol, or use illegal drugs. Also let them know if you have ever experienced a heart attack, a head injury, a tumour in the brain or spine, high blood pressure, diabetes, liver, renal, or heart problems.
  • Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor if you become pregnant while taking bupropion.
  • You should be aware that bupropion may cause you to feel sleepy. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
  • The safe consumption of alcoholic beverages while taking bupropion should be discussed with your doctor. The negative effects of bupropion can be made worse by alcohol.
  • You should be aware that bupropion might make your blood pressure go up. Before beginning treatment and periodically while you are taking this medicine, especially if you also use nicotine replacement therapy, your doctor may check your blood pressure.
  • Bupropion may result in angle-closure glaucoma, therefore you should be aware of this (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Ask your doctor if you should get your eyes checked before beginning this medicine. Call your doctor or get emergency medical attention right away if you are experiencing nausea, eye pain, changes in your vision, such as seeing coloured rings around lights, or swelling or redness in or around your eyes.
  • You should be aware that some individuals using bupropion to quit smoking have experienced side effects such alterations in behaviour, aggression, agitation, low mood, and suicidal thoughts (thinking about harming or killing oneself or making plans to do so). Since persons who stop smoking with or without medicine may experience changes in their mental health due to nicotine withdrawal, the function of bupropion in triggering these mood changes is unclear. However, some of these symptoms also appeared in patients who continued to smoke while taking bupropion. Some individuals experienced these effects as soon as they started using bupropion, while others did not until several weeks had passed or after discontinuing the medication. These symptoms have appeared in people who have no prior history of mental illness and have gotten worse in those who already did. Inform your physician if you currently experience or have ever experienced depression, bipolar disorder (a mental illness that causes mood swings between depressed and abnormally excited), schizophrenia (a mental illness that results in disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions), or any other mental illnesses.Call your doctor right away and stop taking bupropion (Zyban) if you have any of the following signs: Suicidal ideas or behaviours, fresh or worsening depression, anxiety, or panic attacks, agitation, restlessness, aggressive or dangerous behaviour, mania (frenzied, abnormally excited, or irritable mood), abnormal thoughts or sensations, hallucinations (seeing things or hearing voices that are not there), the impression that others are against you, confusion, or any other abrupt or unusual changes in behaviour. Make sure your family or carer is aware of any symptoms that could be significant so they can contact the doctor on your behalf if you are unable to call for help. Till your symptoms disappear, your doctor will keep a careful eye on you.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise

What should I do if I forget a dose?

Ignore the missed dose and carry on with my normal dosing routine. Always wait the whole prescribed length of time between bupropion dosages. To make up for a missing dose, do not take a second one.

What side effects can this medication cause?

Bupropion could have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Drowsiness
  • Anxiety
  • Excitement
  • Inability to sleep or difficulty maintaining sleep
  • Mouth arid
  • Dizziness
  • Headache
  • Nausea
  • Vomiting
  • Stomach ache
  • Body shaking that is uncontrollable
  • Loss of appetite
  • Losing weight
  • Constipation
  • Sweating excessively
  • The ears are ringing
  • Alterations to your sense of taste
  • Recurring urination
  • Throat pain

Some adverse effects can be very harmful. Call your doctor right away or seek emergency medical attention if you notice any of the following symptoms or those noted in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections:

  • Seizures
  • Confusion
  • Hallucinating (seeing things or hearing sounds and voices that do not exist)
  • Unreasonable fears
  • Joint or muscle ache
  • Irregular, hammering, or quick heartbeat

If you experience any of the following symptoms, stop taking bupropion and call your doctor immediately or get emergency medical treatment:

  • Fever
  • Blisters or rashes
  • Itching
  • Hives
  • Swelling of the lower legs, hands, feet, ankles, or face, neck, tongue, lips, eyes, or mouth
  • Hoarseness
  • Breathing or swallowing challenges
  • Chest discomfort

Other negative effects of bupropion are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Store it away from light, excessive heat, and moisture at room temperature (not in the bathroom).

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for additional information.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose signs could include the following:

  • Seizure
  • Hallucinating (seeing things or hearing voices that do not exist)
  • Consciousness loss
  • Hammering or rapid heartbeat

What other information should I know?

Keep all of your doctor’s appointments.

Inform the lab staff and your doctor that you are taking bupropion prior to any laboratory test.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

If you are taking the extended-release tablet, you might see something in your stool that resembles a tablet. It does not necessarily follow that you did not take your entire prescription dose because this is merely the empty pill shell.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Aplenzin®
  • Budeprion® SR
  • Budeprion® XL
  • Buproban®
  • Forfivo® XL
  • Wellbutrin®
  • Wellbutrin® SR
  • Wellbutrin® XL
  • Zyban®
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