BuPROPion(byoo proe’ pee on)
buPROPion hydrobromide
AplenzinDNC
buPROPion hydrochloride
Wellbutrin, Wellbutrin SRDNC, Wellbutrin XLDNC, Zyban
PREGNANCY CATEGORY C
Drug Classes
Antidepressant
Smoking deterrent
Therapeutic Actions
The neurochemical mechanism of the antidepressant effect of bupropion is not understood; it is chemically unrelated to other antidepressant agents; it is a weak blocker of neuronal uptake of serotonin and norepinephrine and inhibits the reuptake of dopamine to some extent.
Indications
Treatment of major depressive disorder
Aid to smoking cessation treatment (Zyban)
Prevention of major depressive episodes in patients with seasonal affective disorder (Wellbutrin XL)
Treatment of seasonal affective disorder (Aplenzin)
Unlabeled uses: Treatment of neuropathic pain, ADHD, weight loss, aphthous ulcers, migraine prevention, PMDD
Contraindications and Cautions
Contraindicated with hypersensitivity to bupropion; history of seizure disorder, bulimia or anorexia, head trauma, CNS tumor (increased risk of seizures); treatment with MAOIs; lactation.
Use cautiously with renal or liver disease; heart disease, history of MI, pregnancy.
Available Forms
Tablets—75, 100 mg; SR tabletsDNC—100, 150, 200 mg; ER tabletsDNC—150, 200, 300 mg; 174, 348, 522 mg (Aplenzin)
Dosages
Adults
Depression: 300 mg PO given as 100 mg tid; begin treatment with 100 mg PO bid; if clinical response warrants, increase to 300 mg/day (given as 100 mg tid) 3 days after beginning treatment. If 4 wk after treatment, no clinical improvement is seen, dose may be increased to 150 mg PO tid (450 mg/day). Do not exceed 150 mg in any one dose. Discontinue drug if no improvement occurs at the 450-mg/day level. SR: 150 mg PO bid; allow at least 8 hr between doses. ER: Initially, 150 mg/day PO as a once-a-day dose. May increase as early as day 4; range 300–450 mg/day. ER (Aplenzin): 174–348 mg/day PO. Maximum dose, 522 mg/day.
Smoking cessation: 150 mg (Zyban) PO daily for 3 days, then increase to 300 mg/day in two divided doses at least 8 hr apart. Treat for 7–12 wk.
Seasonal affective disorder: 150 mg (Wellbutrin XL) PO daily in the morning; may increase after 1 wk to 300 mg/day PO. Begin in autumn and taper off (150 mg/day for 2 wk before discontinuation) in early spring. Or, 174 mg/day PO Aplenzin once daily in the morning; may increase to a maximum 348 mg/day after seven doses if needed.
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