Generic Name: Bupropion (byoo-PRO-pee-on)

Brand Names: Wellbutrin®, Wellbutrin SR®, Wellbutrin XL®, Zyban SR®

Classification: Antidepressant

Issue Date: 1994

Bupropion is an antidepressant medication. Bupropion is used to treat major depressive disorder and seasonal affective disorder. At least one brand of bupropion (Zyban) is used to help people stop smoking by reducing cravings and other withdrawal effects.

You should not take bupropion if you have epilepsy or a seizure disorder, an eating disorder such as anorexia or bulimia, if you are using a second form of bupropion, or if you have suddenly stopped using alcohol or sedatives.

Do not take bupropion if you have taken a monoamine oxidase inhibitor (MAOI) such as:

• isocarboxazid (Marplan®)
• phenelzine (Nardil®)
• rasagiline (Azilect®)
• selegiline (Eldepryl®)
• tranylcypromine (Parnate®)

in the last 14 days.

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are 18 years of age or younger. Talk with your doctor about this risk. While you are taking this medication you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse:

• mood changes
• anxiety
• panic attacks
• trouble sleeping
• irritability
• agitation
• aggressiveness
• severe restlessness
• mania (mental and/ or physical hyperactivity)
• thoughts of suicide or hurting yourself

Do not stop taking bupropion without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.

Avoid using bupropion to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking. Too much of this medicine can increase your risk of a seizure.

Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.

Avoid drinking alcohol while taking bupropion. Alcohol may increase your risk of a seizure while you are taking bupropion. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Bupropion can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.

There are many other drugs that can affect bupropion. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Take bupropion exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.

Bupropion can be taken with or without food. Take each dose with a full glass of water.

Do not crush, chew, or break the extended-release tablet (WellbutrinSR®, WellbutrinXL®, ZybanSR®). Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

If you take Zyban to help you stop smoking, you may continue to smoke for about 1 week after you start the medicine. Set a date to quit smoking during the second week of Zyban treatment. By that time you will have enough of the medicine in your blood stream to help you quit smoking. Talk to your doctor if you are having trouble quitting after you have used Zyban for at least 7 weeks.

Your doctor may prescribe nicotine patches or gum to help support your smoking cessation treatment. Be sure you read all directions and safety information for the nicotine product. Using nicotine with Zyban may raise your blood pressure and your doctor may want to check your blood pressure regularly. Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.

Do not stop taking bupropion without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.

If you use the bupropion extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.

Do not take bupropion if you have taken a monoamine oxidase inhibitor (MAOI) such as:

• isocarboxazid (Marplan®)
• phenelzine (Nardil®)
• rasagiline (Azilect®)
• selegiline (Eldepryl®)
• tranylcypromine (Parnate®)

in the last 14 days.

You should not take bupropion if you have:

• epilepsy or a seizure disorder
• an eating disorder such as anorexia or bulimia
• if you are using a second form of bupropion
• if you have suddenly stopped using alcohol or sedatives (such as Valium)

Before taking bupropion, tell your doctor if you have:

• heart disease or high blood pressure
• head injury, brain or spinal cord tumor
• kidney disease
• liver disease (especially cirrhosis)
• bipolar disorder (manic depression)
• diabetes for which you use insulin or take oral medication

Before taking bupropion, tell your doctor if you currently use:

• steroids
• theophylline (Theo-Dur®, Slo-Bid®, Bronkodyl®, Theolair®, Respbid®)
• medicine to treat depression or mental illness
• alcohol
• sedatives (such as Valium®)
• narcotic pain medicines
• diet pills
• street drugs such as "speed" or cocaine

If you have any of these conditions, you may not be able to use bupropion, or you may need a dosage adjustment or special tests during treatment.

Bupropion may cause seizures, especially in people with certain medical conditions or when using certain drugs. Tell your doctor about all of your medical conditions and the drugs you use.

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. While you are taking bupropion, you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse:

• mood changes
• anxiety
• panic attacks
• trouble sleeping
• irritability
• agitation
• aggressiveness
• severe restlessness
• mania (mental and/ or physical hyperactivity)
• thoughts of suicide or hurting yourself

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Bupropion passes into breast milk and could be harmful to a nursing baby. Do not take bupropion without telling your doctor if you are breast-feeding a baby.

Since Bupropion is sometimes used as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

Do not take bupropion if you have taken a monoamine oxidase inhibitor (MAOI) such as:

• isocarboxazid (Marplan®)
• phenelzine (Nardil®)
• rasagiline (Azilect®)
• selegiline (Eldepryl®)
• tranylcypromine (Parnate®)

in the last 14 days.

There are many other drugs that can affect bupropion. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.