WARNING

Combining dextromethorphan (DXM) and bupropion can lead to several risks due to potential interactions between these medications:

• Serotonin Syndrome: Both dextromethorphan and bupropion can increase serotonin levels in the brain. Combining them may lead to a dangerous condition called serotonin syndrome, which can cause symptoms like confusion, agitation, rapid heartbeat, high blood pressure, fever, sweating, muscle stiffness, and even seizures.
• Central Nervous System Effects: Both drugs can affect the central nervous system, leading to symptoms such as dizziness, drowsiness, impaired coordination, and confusion. Combining them can intensify these effects, increasing the risk of accidents or injuries.
• Cardiovascular Effects: Bupropion can increase heart rate and blood pressure. Combining it with dextromethorphan, which can also affect heart rate and blood pressure, may lead to cardiovascular complications such as palpitations, arrhythmias, or hypertensive crisis.
• Psychiatric Effects: Bupropion is used to treat depression and may exacerbate psychiatric symptoms in some individuals. Combining it with dextromethorphan, particularly at high doses, could increase the risk of mood changes, hallucinations, or psychosis.
• Respiratory Depression: Both drugs can depress the respiratory system, leading to slowed breathing or even respiratory failure. Combining them may increase the risk of respiratory depression, especially in individuals with respiratory conditions or at high doses.

It’s crucial to consult a healthcare professional before combining these medications or any other drugs, as they can provide personalized advice based on your medical history and current medications.

Why is this medication prescribed?

Depression is treated with dextromethorphan and bupropion. Within the group of drugs known as NMDA receptor antagonists is dextromethorphan. Its mechanism of action in the brain to cure depression is unknown. Bupropion is a member of the antidepressant drug class. It functions by causing specific brain activity patterns to increase.

How should this medicine be used?

Bupramine and dextromethorphan are available as oral tablets that can be taken with or without food. It is typically given once daily for the first three days. It is often given twice a day (at least eight hours apart) after three days. Take bupropion and dextromethorphan daily at around the same time(s). Pay close attention to the instructions on the label of your prescription and ask your pharmacist or doctor to explain anything you do not understand. Adhere to the recommended dosage for bupropion and dextromethorphan. Never take more or less of it, or take it more frequently than your doctor has instructed.

Do not split, chew, or crush the tablets; instead, swallow them whole.

Bupropion and dextromethorphan manage depression but do not treat it. Don’t stop taking bupropion with dextromethorphan without first consulting your doctor. Serious side effects, including mood swings, agitation, irritability, dizziness, ringing in the ears, shock-like sensations, anxiety, confusion, fatigue, trouble falling or staying asleep, numbness or tingling in the arms, legs, hands, or feet, headache, increased sweating, seizures, or nausea, may occur if you abruptly stop taking dextromethorphan and bupropion.

Other uses for this medicine

Ask your doctor or pharmacist for more information if you think this medicine could be recommended for something else.

What special precautions should I follow?

Regarding precautions for using dextromethorphan and bupropion:

• Consultation with a Healthcare Provider: Before considering any alternative use of these medications, it’s crucial to consult with a healthcare provider. They can provide guidance based on individual health factors, potential interactions, and the latest research findings.
• Dosage and Administration: Follow the prescribed dosage and administration instructions strictly. Altering the dosage or frequency without medical advice can lead to adverse effects or reduced effectiveness.
• Potential Interactions: Both dextromethorphan and bupropion can interact with other medications, supplements, or substances. Inform your healthcare provider about all medications and supplements you’re currently taking to avoid potential interactions.
• Side Effects: Be aware of potential side effects associated with dextromethorphan and bupropion. Common side effects may include nausea, dizziness, dry mouth, and insomnia. Report any unusual symptoms or reactions to your healthcare provider promptly.
• Monitoring: Regular monitoring by a healthcare provider is essential, especially when using medications for off-label purposes. This helps ensure effectiveness and safety while minimizing potential risks.
• Contraindications: Certain medical conditions may contraindicate the use of dextromethorphan or bupropion. Inform your healthcare provider about any pre-existing medical conditions, such as seizure disorders or liver problems, before using these medications.

By following these precautions and working closely with a healthcare provider, individuals can explore alternative uses of dextromethorphan and bupropion while minimizing potential risks.

What special dietary instructions should I follow?

Special Dietary Instructions:

• There are no specific dietary restrictions associated with dextromethorphan use.
• Bupropion can be taken with or without food. However, if it causes stomach upset, taking it with food may help alleviate this side effect.
• Avoid excessive consumption of alcohol while taking either medication, as it can exacerbate side effects and interactions.

What should I do if I forget a dose?

• If you forget to take a dose of dextromethorphan or bupropion, take it as soon as you remember, unless it is almost time for your next scheduled dose.
• If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule.
• Do not double the dose to make up for the missed one, as this can increase the risk of side effects.
• If you are unsure about what to do, consult your healthcare provider or pharmacist for advice.

What side effects can this medication cause?

Dextromethorphan (DXM) and bupropion are both medications with distinct uses and potential side effects.

• Drowsiness
• Tiredness
• Dizziness
• Nervousness
• Restlessness
• Headache
• Nausea
• Diarrhea
• Constipation
• Dry mouth
• Excessive sweating
• Loss of appetite
• Stomach pain
• Joint pain
• Numbness or tingling in the arms, legs, hands, or feet
• Difficulty falling asleep or staying asleep
• Sexual problems in males; decreased sex drive, inability to get or keep an erection, or delayed or absent ejaculation
• Sexual problems in females; decreased sex drive, or delayed orgasm or unable to have an orgasm

There may be dangerous negative effects. Get emergency medical attention or contact your doctor right away if you encounter any of the following symptoms, as well as those mentioned in the IMPORTANT WARNING or SPECIAL PRECAUTIONS section:

• Seizures
• Agitation, fever, sweating, shivering, confusion, fast or irregular heartbeat, and severe muscle stiffness or twitching, loss of coordination, nausea,
• Vomiting, or diarrhea
• Coma (loss of consciousness for a period of time)
• Awelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• Rash, itching, hives, fever, chest pain, shortness of breath, or muscle or joint pain

When taken together, dextromethorphan and bupropion can interact and increase the risk of certain side effects. Specifically, combining these two substances may increase the risk of seizures due to the lowering of seizure threshold by both medications. This interaction can be potentially dangerous and should be avoided unless specifically directed by a healthcare professional.

It’s essential to consult a healthcare provider before combining these medications or if you experience any concerning side effects while taking them individually. They can provide guidance tailored to your specific situation and medical history.

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

Storage and Disposal:

• Store dextromethorphan and bupropion at room temperature away from moisture, heat, and light. Follow specific storage instructions provided on the medication packaging.
• Keep both medications out of reach of children and pets.
• Do not store dextromethorphan or bupropion in the bathroom or near the kitchen sink, where moisture and heat can affect their stability.
• Follow local guidelines or regulations for the proper disposal of unused or expired medications. Do not flush them down the toilet or pour them into drains unless instructed to do so.
• Many communities offer medication take-back programs or special disposal instructions. Contact your local pharmacy, healthcare provider, or waste management facility for guidance on safe disposal methods.

In case of emergency/overdose

• In case of an overdose or emergency involving dextromethorphan or bupropion, contact your local emergency services or go to the nearest emergency room immediately.
• If possible, provide emergency responders with information about the type and amount of medication ingested, as well as any symptoms experienced.
• Do not induce vomiting unless instructed to do so by a healthcare professional or poison control center.
• Be prepared to provide additional information about your medical history, current medications, and any underlying health conditions.

What other information should I know?

• Inform all healthcare providers involved in your care, including doctors, dentists, and pharmacists, about all medications you are taking, including prescription drugs, over-the-counter medications, supplements, and herbal products.
• Attend all scheduled appointments with your healthcare provider for monitoring and follow-up while taking dextromethorphan or bupropion.
• Do not share dextromethorphan or bupropion with others, even if they have similar symptoms or conditions.
• If you have any questions or concerns about dextromethorphan or bupropion, including their use, side effects, or interactions, consult your healthcare provider or pharmacist for guidance.
• Keep a list of all medications you are currently taking, including dosages and frequency, and carry it with you in case of emergencies.

By following these guidelines and being informed about the proper storage, disposal, and emergency procedures for dextromethorphan and bupropion, you can help ensure their safe and effective use.