About Wellbutrin
Wellbutrin is commonly prescribed to treat major depression.
Bupropion increases levels of the neurotransmitters dopamine
and norepinephrine, working differently than other antidepressants.
It may be a more suitable treatment for depression than tricyclic
antidepressants if those medications cause significant weight
gain in a patient.
Wellbutrin has also been found to be effective for the following
conditions:
- Reduce symptoms of chronic fatigue syndrome.
- Alternative to stimulants in treating attention deficit hyperactivity
disorder (ADHD) for children and adults.
- Treats post-traumatic stress disorder.
- Works to help people quit smokeless tobacco.
- May increase sexual desire.
- May be a useful part of treatment for cocaine addiction when
used along with counseling, as it may reduce cravings.
- Can reduce lower back pain that is unresponsive to other therapies.
It is important that this medication be taken only in the
quantities recommended by your doctor, and that it be taken
only as often as suggested. When you stop taking Wellbutrin,
step off your dose slowly, according to the plan offered by
your doctor in order to minimize the possibility of side effects.
Wellbutrin is only available by prescription. Use only as
directed.
Wellbutrin Side Effects
Common Wellbutrin side effects: Anxiety, confusion,
insomnia, nervousness, or weight loss (individuals who are
underweight may want to consider another treatment, as their
weight may drop further on this medication).
Possible Wellbutrin side effects: Agitation, constipation,
dizziness, dry mouth, frequent urination, heart palpitations,
indigestion, nausea or vomiting, ringing in the ears, severe
headaches, sweating, swelling, tremor. Consult your physician
as soon as possible if any of these conditions develop. While
not all of them are serious, your doctor should make that
determination, and may be able to help alleviate temporary
discomfort.
Rare Wellbutrin side effects: Altered white blood
cell or platelet counts, liver poisoning, mania in patients
with manic depression, psychosis in patients with psychotic
tendencies, or drug-related seizures (increased likelihood
with higher doses). Seek medical attention immediately if
any of these effects occur. If you have had a medical history
of any of these conditions, your doctor should monitor your
treatment closely or may decide on a different medication.
In very rare cases, weight gain has been reported with treatment,
though weight loss is far more common. Speak to your doctor
if this occurs.
Cautions: Before taking Wellbutrin, inform your doctor
of any of the following conditions, or a history of them.
Some of these conditions are contraindications for treatment,
and you should try another medication. Some conditions may
require more careful monitoring, or dosage adjustments.
- Alcoholism or drug abuse: Bupropion does not react well
with alcohol or street drugs. You could be at increased
risk for seizure, psychosis, or a fatal drug interaction.
- Allergies: If you have had an allergic reaction
to Wellbutrin or Zyban in the past, this medication is not
right for you. If you experience any swelling of the face
or extremities, or break out in a rash, contact your doctor
immediately. Also be sure to inform your doctor of any other
allergies you may have had, either to prescription medication,
or food and dyes.
- Brain disease, mental illness, or head injury:
A doctor must consider treatment carefully, on a case by
case basis.
- Eating disorder: If you have, or had in the past,
either anorexia nervosa or bulimia, you may be at an increased
risk for seizure. Also, underweight individuals may find
that their weight drops further with bupropion treatment,
and this could be dangerous for some people. Consult with
your doctor about possible risks.
- Heart problems: If you have heart disease or have had
a recent heart attack, your doctor may be very cautious
in prescribing treatment. Also, bupropion may interact with
certain prescription treatments for heart disease or high
blood pressure.
- Kidney or liver problems: Your doctor may adjust your
dosage and monitor you more carefully.
- Other medicines: Inform your doctor of any medications
you are currently taking, especially if they increase the
likelihood of seizure. Discuss any reactions to medication
you have had in the past, especially to other antidepressants.
Do not take bupropion within 14 days of stopping an MAO
inhibitor.
- Pregnancy or an intention to become pregnant may
indicate that you should not take Wellbutrin. Doctors do
not generally recommend taking bupropion while breastfeeding.
- Seizure disorders: Individuals with seizure disorders
of any kind should not take bupropion either as Wellbutrin
or Zyban, for any reason. This medication increases the
risk of seizure.
Wellbutrin Interactions
If you are planning to take Wellbutrin, be sure that the
prescribing physician is aware of all other medications you
are using, especially if you see multiple doctors. Some medications
should not be mixed with bupropion at all, and with others,
your doctor may want to adjust the dosage of one or the other
prescription. Ask your doctor before starting any medication
while you are being treated with bupropion.
Wellbutrin and Zyban should not be taken together, as higher doses
of bupropion increase the risk of serious side effects, such as
seizures.
- Alcohol can increase the risk of seizure in combination with
bupropion. Do not drink while you are being treated with this
medication, it is not safe.
- Ambien (zolpidem) may
increase the risk of hallucination.
- Anticonvulsants such as Dilantin (phenytoin) or Cerebyx (fosphenytoin)
may be less effective when taken with Wellbutrin or Zyban.
- Barbiturates such as Phenobarbitol may lower levels of bupropion
in the body.
- Beta Blockers (blood pressure, heart disease, migraine prevention
medication) such as Inderal
(propranolol), Lopressor
(metoprolol), or Tenormin (atenolol) should be taken with
care during bupropion treatment
- Bronchodilators of the xanthine (thioxanthine) class (Aminophylline, Dyphylline,
Oxtriphylline, Somophyllin, Theo-Dur, etc...) may increase your risk of seizure.
- Clozaril (clozapine) may increase the risk of seizure from Wellbutrinn.
- Cytoxan (cyclophosphamide)
- Desyrel (trazodone)may increase
the risk of seizure.
- Ginseng - Do not take this herb while using bupropion in any
form.
- Haldol (haloperidol) may increase the risk of seizure from Wellbutrin.
- Lithium may increase the risk
of seizure from Wellbutrin.
- Loxitane (loxapine) may increase the risk of seizure from
Wellbutrin.
- Ludiomil (maprotiline) may increase the risk of seizure
from Wellbutrin.
- Ma Huang - Do not take this herb while using bupropion in any
form.
- MAO inhibitors - Wellbutrin should not be mixed with MAO (monoamine
oxidase) inhibitors, a class of antidepressants and antisenility
drugs, such as Eldepryl (selegiline), Furoxone (furazolidone),
Nardil (phenelzine), Marplan (isocarboxazid), or Parnate
(tranylcypromine). Wait 2 weeks after stopping an MAO inhibitor
before taking bupropion, this drug reaction could be very
dangerous.
- Marijuana - There is a risk of psychotic behavior if marijuana
usage is combined with Wellbutrin treatment. Avoid this
combination.
- Moban (molindone) may increase the risk of seizure from
Wellbutrin.
- Nicotine gum or patches - If you plan to use nicotine
replacement in addition to bupropion while you are trying
to quit smoking, consult your doctor about the best plan
of action. Combining these two treatments may not work for
you.
- Norgesic/Norflex (orphenadrine)
- Protease inhibitors such as Norvir (ritonavir) may lead to toxic
levels of bupropion in the body. This drug combination is dangerous,
and these treatments should not be used at the same time.
- Provigil (modafinil) -
May increase CNS stimulation.
- Risperdal (risperdone) may build up to toxic levels in the body
if taken with bupropion.
- Ritalin (methylphenidate)
- Rythmol (propafenone) should be taken in lower doses, as it
may build up to toxic levels in the body if taken with bupropion.
- Selective serotonin reuptake inhibitors (SSRIs) like Celexa
(citalopram), Paxil
(paroxetine), Prozac
(fluoxetine), Luvox
(fluvoxamine), or Zoloft
(sertraline) may increase the risk of seizure from Wellbutrin.
- Sinemet (carbidopa, levodopa) - Increases risk of side effects.
- St. John's Wort - Do not take this herb while using bupropion
in any form.
- Steroids like Prednisone or Hydrocortisone - Consult your doctor
before combining treatment.
- Stimulants and certain prescription diet pills may increase
the risk of seizure with bupropion, this combination is
not advised. Consult your doctor about the safety of any
stimulant medication while you are being treated with Wellbutrin.
- Tagamet (cimetidene) may raise levels of bupropion.
- Tambocor (flecainide) - Bupropion may increase levels of this
medication, and it is recommended that your doctor lower your
Tambocor dosage to avoid toxicity.
- Tegretol (carbamazepine) - Bupropion may lower levels of this
medication.
- Tranquilizers and antipsychotics of the phenothiazine class,
such as Mellaril (thioridazine), Trilafon (perphenazine),
and Thorazine (chlorpromazine) may increase the risk of
seizure from Wellbutrin.
- Tricyclic antidepressants such as Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor
(nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine),
may increase the risk of seizure from Wellbutrin.
- Yohimbe - Do not take this herb while using bupropion in any
form.
Wellbutrin Directions
A common starting dose of Wellbutrin for depression is 100 mg in
the morning and again in the evening. This may be increased after
four days by adding a 100 mg dose at midday, for a total daily dose
of 300 mg. Doses should be no closer than 6 hours, and may be increased
above 300 mg after three or four weeks to a maximum of 450 mg per
day in divided doses of 150 mg each. For attention-deficit hyperactivity
disorder (ADHD) in adults, 100-200 mg of the sustained release form
two times per day is recommended.
Zyban is commonly started with 150 mg once a day, for three days.
After this, it may be increased to 150 mg twice per day for up to
12 weeks. You should have made progress with stopping your smoking
habit by 7 weeks, or your doctor should reevaluate your treatment.
Bupropion dosage should never exceed a total of 450 mg per day,
as this would greatly increase the risk of seizure. Never take double
doses of this medication, or take it more often than your doctor
has suggested. Only a doctor with access to your full medical history
can determine if Wellbutrin or Zyban are safe treatments for you.
Never allow anyone else to use your prescription, as this could
be very dangerous.
Wellbutrin
- Immediate release tablets - 75 mg, 100 mg
- Sustained release tablets - 100 mg, 150 mg
Wellbutrin tablets are best taken whole, as the medication is bitter.
Sustained release Wellbutrin tablets, should never be crushed
or broken as it could result in a dangerously high dosage
of bupropion. The tablets may be taken with food or milk to
reduce stomach upset, there are no restrictions on taking
bupropion with food.
If you miss a dose: For regular Wellbutrin tablets, take
it as soon as you remember, unless it is close to the time
for your next dose. If it is almost time for the next tablet,
skip the missed dose. If you are taking sustained release
Wellbutrin, simply wait until the next day and resume your
regular schedule, ignoring missed doses. Never take double
doses of bupropion, or take doses too close together, as it
increases the risk of seizure. Dosage should never exceed
450 mg per day, or be taken closer together than your doctor
suggests is safe.
Store bupropion away from direct light and heat. Store in a dry
location; avoid storing it in the bathroom, near sinks, or other
areas where it may become damp. Do not use after the expiration
date.
Keep bupropion away from children; both when storing it, and when
discarding any unused medication.
Bupropion may cause drowsiness, disorientation, or seizure. Be
cautious if you plan to drive or operate heavy machinery, avoid
these activities if you find yourself feeling tired or experience
slowed reactions.
Wellbutrin is a trademark of Glaxo Wellcome
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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