Brand Name: Zyban
Generic Name: bupropion

Bupropion

(byoo-PROE-pee-on)

NEWLY DISCOVERED USES (OFF-LABEL)
Attention deficit/hyperactivity disorder (ADHD), bipolar disorder, chronic neuropathic pain, diabetic neuropathy, female orgasmic disorder, hypoactive sexual desire disorder

ORIGINAL USES (ON-LABEL)
Treatment of depression (Wellbutrin) and used in combination therapy in smoking cessation (Zyban)

BRAND NAME
Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban

DRUG CLASS
Antidepressant, smoking deterrent (dopamine-reuptake inhibitor)

DESCRIPTION
Bupropion works by inhibiting the activity of certain chemicals in the brain.

POTENTIAL SIDE EFFECTS
Dizziness, headache, insomnia, nausea, dry mouth, sore throat, chest pain, agitation, anxiety, memory decreased, nervousness, itching, rash, sweating increased, anorexia, constipation, diarrhea, taste perversion, urinary frequency, joint aches, arthritis, muscle aches, tremor, double vision, ringing in ears, cough increased, abdominal pain, increased heart rate, sedation.

CAUTIONS

• Inform your doctor if you have a history of seizures, anorexia, bulimia, liver or kidney dysfunction, high blood pressure, or heart disease.
• Do not use if you have used MAO inhibitors within 14 days or if you have suddenly stopped sedatives or chronic alcohol use.
• Elderly patients may need to be monitored while using this drug.
• Notify your doctor if you experience any changes in concentration or mental status.
• Wear protective clothing and sunscreen, as this drug has been associated with photosensitivity reactions (skin reactions related to sun exposure).

DRUG INTERACTIONS
Desipramine, paroxetine, sertraline, orphenadrine, thiotepa, cyclophosphamide, carbamazepine, nevirapine, phenobarbital, phenytoin, rifampin, amantadine, levodopa, tonavir, warfarin.

This drug is metabolized by a specific set of liver enzyme. Several other drugs interfere with these liver enzymes, and thus, may increase or decrease the clearance of bupropion from the body, potentially increasing the risk of side effects or decreasing effectiveness. When these drugs are given in combination with bupropion, dosage adjustments may be needed. As these are too numerous to list, you should always check with your doctor or pharmacist prior to starting a new medication, herbal, or nonprescription product.

FOOD INTERACTIONS
Alcohol

HERBAL INTERACTIONS
Valerian, St. John’s wort, SAMe, gotu kola, kava kava

PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category B. This drug is excreted in breast milk. Breast-feeding is not recommended during therapy with this drug.

SPECIAL INFORMATION
Do not use Zyban and Wellbutrin concurrently, as they contain the same active ingredient.

Take immediate release formulations in equally divided doses (three or four times daily) to avoid risk of seizures. Do not chew or crush the XL or SR formulations. The bupropion XL formulation may be excreted in the stool. This is an empty shell which is not absorbed. The drug has been absorbed. This drug may cause significant sedation and drowsiness, which may impair your ability to perform tasks requiring judgment or motor or cognitive skills. If you experience a seizure while on this medication, stop immediately and report it to your doctor.

In January 2005, the FDA announced new labeling for antidepressants regarding the need to closely monitor for worsening of depression and for the potential of increased suicidal thinking or suicide behavior during therapy. Although this recommendation applies to all patients (adults, children, and adolescents) treated with antidepressants for any indication, this is of particular importance if you are being treated for depression.