Bupropion Hydrochloride (Antidepressant), Oral

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KEY POINTS

• This medicine is taken by mouth to treat depression. Take it exactly as directed.
• This medicine may increase suicidal thoughts or actions in some people.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antidepressant

Generic and brand names: bupropion hydrochloride (antidepressant), oral; Aplenzin; Forfivo XL; Wellbutrin; Wellbutrin SR; Wellbutrin XL

What is this medicine used for?

This medicine is taken by mouth to treat depression, including seasonal affective disorder.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Do not take this medicine if you:

• Have ever had a seizure disorder, head injury, stroke, or brain tumor
• Are taking any other medicine that also contains bupropion
• Have or have had an eating disorder such as bulimia or anorexia nervosa
• Are taking an MAO inhibitor medicine (Do not take this medicine and an MAO inhibitor within 14 days of each other.)

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Diabetes
• Glaucoma
• Heart disease, angina, or a heart attack
• High blood pressure
• Kidney or liver disease
• Mental health problems such as bipolar disorder or schizophrenia
• Problems with alcohol or drug abuse
• Problems with low levels of sodium in your blood

Tell your healthcare provider if you drink alcohol or take any other medicines regularly, such as sedatives, stimulants, or weight-loss medicines.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as directed by your healthcare provider in the proper amounts and at the proper times of the day. Do not take more of it or take it longer than prescribed. Taking too much of this medicine may increase the risk of side effects. Do not stop taking this medicine without your healthcare provider's approval. It may take several weeks until you see the full effects of this medicine.

Check with your healthcare provider before using this medicine in children under age 18.

This medicine comes in regular tablets and extended-release tablets. Do not cut, crush, or chew the tablets. Swallow them whole. Ask your pharmacist if you have the extended-release tablets.

You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach. If you have trouble sleeping, do not take your medicine too close to bedtime. Talk with your healthcare provider about this.

What if I miss a dose?

If you miss a dose, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: seizures, muscle stiffness, hallucinations, fainting, fast or irregular heartbeat, trouble breathing, coma.

What should I watch out for?

Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment or at times of dose changes. Talk with your provider about this.

Behavior changes may be caused by the medicine or by depression or another mental health problem. Contact your healthcare provider right away if you or your family notice any disturbing changes in your thoughts or behavior, such as:

• More outgoing or aggressive behavior than normal
• Confusion
• Hallucinations
• Worsening of depression
• Suicidal thoughts

Many other medicines contain bupropion. Do not take this medicine if you are also taking Zyban or Buproban to help you stop smoking, or other medicines that contain bupropion. Taking too much of this medicine may increase the risk of an overdose or seizures. Talk with your healthcare provider or pharmacist about this.

This medicine may trigger angle-closure glaucoma. Contact your provider right away if you have eye pain, vision changes, or redness and swelling in or around your eye.

Your healthcare provider will want to see you regularly to determine whether you should continue taking this medicine. Keep your appointments.

This medicine may affect your ability to do tasks requiring coordination. Do not drive or operate machinery unless you are fully alert.

This medicine increases the effects of alcohol and other medicines that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves. If you drink alcohol regularly, talk with your healthcare provider before changing the amount you drink. If you suddenly quit drinking while taking this medicine, it may increase your risk for seizures.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

You may see pieces of the extended-release tablet in your bowel movement. This is normal. This is the empty tablet shell leaving your body.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine. This medicine may affect the results of certain drug tests.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Seizures, thoughts of suicide, extreme nervousness, chest pain, trouble breathing, severe dizziness or fainting, yellowing of your skin or eyes, extreme weakness, muscle or joint pain, severe skin rash, dark urine, light colored bowel movements, confusion, hallucinations, fast or irregular heartbeat; new or worsening depression; unusual changes in thoughts, mood, or behavior; tremors; severe headache.

Other: Mild headache, nausea, vomiting, dry itchy skin, trouble sleeping, mild dizziness, drowsiness, loss of appetite, constipation, weight gain or loss, dry mouth, sweating, ringing in the ears, urinating more often, mild nervousness, abnormal dreams, change in sexual desire or ability, change in sense of taste.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Amantadine (Symmetrel)
• Antianxiety medicines such as alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), and others
• Antidepressants such as citalopram (Celexa), fluoxetine (Prozac), nortriptyline (Pamelor), sertraline (Zoloft), and others
• Antihistamines such as azelastine (Astelin, Astepro), chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), hydroxyzine (Vistaril), and others
• Antipsychotic medicines such as haloperidol (Haldol), olanzapine (Zyprexa), risperidone (Risperdal), thioridazine, and others
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenytoin (Dilantin, Phenytek), primidone (Mysoline), valproic acid (Depacon, Depakene, Depakote), and others
• Antiviral medicines such as ombitasvir/paritaprevir/ritonavir (Technivie) and ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira)
• Atomoxetine (Strattera)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Beta blockers such as atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), and others
• Cancer medicines such as crizotinib (Xalkori), cyclophosphamide (Cytoxan), doxorubicin (Doxil), tamoxifen, and others
• Cimetidine (Tagamet)
• Corticosteroids such as dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), and others
• Dextromethorphan, an ingredient in many allergy, cold, or cough medicines such as Robitussin-DM
• Dextromethorphan/quinidine (Nuedexta)
• Doxepin (Silenor)
• Guanfacine (Intuniv, Tenex)
• Heart medicines such as flecainide, mexiletine, procainamide, and propafenone (Rythmol)
• HIV medicines such efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), lopinavir/ritonavir (Kaletra), ritonavir (Norvir), and others
• Linezolid (Zyvox)
• Malaria medicines such as chloroquine, mefloquine, primaquine, quinine, and others
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Medicines to treat or prevent blood clots such as clopidogrel (Plavix), and warfarin (Coumadin)
• Muscle relaxants such as carisoprodol (Soma), cyclobenzaprine (Amrix), methocarbamol (Robaxin), orphenadrine (Norflex), and others
• Narcotic allergy, cold, or cough medicines such as guaifenesin/codeine (Robitussin AC, Tussi-Organidin), hydrocodone/chlorpheniramine (Tussionex), hydrocodone/homatropine, promethazine, promethazine with codeine (Phenergan with codeine), and others
• Natural remedies such as kava, SAMe, St. John's wort, valerian, and others
• Nausea medicines such as prochlorperazine (Compro) and promethazine
• Nicotine replacement products such as Habitrol, NicoDerm, Nicorette, Nicotrol, and others
• Other medicines that contain bupropion such as Buproban, Contrave, or Zyban
• Pain medicines such as buprenorphine (Buprenex, Butrans), fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone (Hysingla, Zohydro), oxycodone (OxyContin, Roxicodone), and others
• Parkinson’s disease medicines such as entacapone (Comtan), levodopa/carbidopa (Duopa, Rytary, Sinemet), pramipexole (Mirapex), ropinirole (Requip), and others
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Procarbazine (Matulane)
• Products that contain methylene blue (Hyophen, Prosed DS, Urophen, Uta)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Sleeping pills such as temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), zolpidem (Ambien, Edluar, Intermezzo), and others
• Stimulants and diet pills such as amphetamine/dextroamphetamine (Adderall), dextroamphetamine (Dexedrine), and methamphetamine (Desoxyn)
• Tetrabenazine (Xenazine)
• Theophylline

Drinking alcohol while you are taking this medicine may increase its side effects. Ask your healthcare provider about this.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.