Wellbutrin XL

Bupropion HCl

Treatment of major depressive disorder. Prevention of seasonal major depressive episodes.

Major depressive disorder Initially, 150 mg/day as a single dose in the morning. After 4 days of dosing, the dose may be increased to 300 mg/day. Periodically reassess the need for maintenance treatment & the appropriate dose. Seasonal major depressive episodes Initially, 150 mg/day as a single dose in the morning. May be increased to 300 mg/day once daily in the morning after 1 wk. For patients taking 300 mg/day during the autumn-winter season, dose should be tapered to 150 mg/day prior to discontinuation. Hepatic impairment Max of 150 mg every other day.

May be taken with or without food: Swallow whole, do not chew/crush.

Hypersensitivity. Patients w/ seizure disorder; undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates & antiepileptic drugs; current or prior diagnosis of bulimia or anorexia nervosa. Concomitant use of MAOI or w/in 14 days of discontinuing treatment w/ MAOI.

Risk of worsening of depression &/or emergence of suicidal ideation & behaviour or unusual changes in behaviour. Monitor appropriately & observe closely for clinical worsening, suicidality, & unusual changes in behavior, especially during the initial few mth of a course of drug therapy, or at times of dose changes, either increases or decreases. Not for smoking cessation treatment. Can cause seizure. Can result in elevated BP & HTN; assess BP before treatment initiation & monitor periodically during treatment. Can precipitate a manic, mixed, or hypomanic manic episode especially in patients w/ bipolar disorder or who have risk factors for bipolar disorder. Risk of psychosis & other neuropsychiatric reactions. Pupillary dilation may trigger an angle-closure attack in patient w/ anatomically narrow angles who does not have a patent iridectomy. Discontinue in case of hypersensitivity reactions. Reports of false +ve urine immunoassay screening tests for amphetamines. Patients w/ hepatic/renal impairment. May impair ability to drive or operate machinery. Pregnancy & lactation. Childn & adolescent <18 yr.

Dry mouth, nausea, constipation, flatulence, abdominal pain; headache, dizziness, tremor; nasopharyngitis, upper resp tract infection, sinusitis; insomnia, anxiety, abnormal dreams, agitation, myalgia, pain in extremity, cough, feeling jittery, rash, decreased appetite, dysmenorrhea, tinnitus, HTN.

Increased risk of hypertensive reactions w/ MAOIs. Increased bupropion exposure but decreased hydroxybupropion exposure w/ ticlopidine & clopidogrel (CYP2B6 inhibitors). Decreased exposure of bupropion & hydroxybupropion w/ ritonavir, lopinavir or efavirenz (CYP2B6 inducers). Decreased bupropion exposure w/ carbamazepine, phenobarb, phenytoin (CYP2B6 inducers). Increased exposure of CYP2D6 substrates [including certain antidepressants (eg, venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, sertraline), antipsychotics (eg, haloperidol, risperidone, thioridazine), β-blockers (eg, metoprolol), type 1C antiarrhythmics (eg, propafenone, flecainide)]. Potential reduced efficacy of drugs that require metabolic activation by CYP2D6 to be effective (eg, tamoxifen). Decreased plasma levels of digoxin. Use extreme caution when co-administering w/ other drugs that lower seizure threshold (eg, other bupropion products, antipsychotics, antidepressants, theophylline, systemic corticosteroids). CNS toxicity w/ levodopa or amantadine. Adverse neuropsychiatric events or reduced alcohol tolerance w/ drinking of alcohol.

Antidepressants

N06AX12 - bupropion ; Belongs to the class of other antidepressants.

P₁S₁S₃