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
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Treatment of major depressive disorder
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Aid to smoking cessation treatment (Zyban)
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Prevention of major depressive episodes in patients with seasonal affective disorder (Wellbutrin XL)
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Treatment of seasonal affective disorder (Aplenzin)
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Unlabeled uses: Treatment of neuropathic pain, ADHD, weight loss, aphthous ulcers, migraine prevention, PMDD
Contraindications and Cautions
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Contraindicated with hypersensitivity to bupropion; history of seizure disorder, bulimia or anorexia, head trauma, CNS tumor (increased risk of seizures); treatment with MAOIs; lactation.
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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
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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.
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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.
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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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