Medications such as bupropion may increase the risk of suicidal thoughts and actions. This increase was found in children, teenagers, and young adults (less than 24 years of age). The risk may be more likely with the first few months of treatment and when the dose is increased.
Call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to do so.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with bupropion and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You also can visit the Food and Drug Administration (FDA) website: https://www.fda.gov/Drugs/DrugSafety/ucm085729.htm or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks and benefits of taking bupropion.
Why is this medicine prescribed?
Bupropion is used to treat depression. and seasonal affective disorder (SAD; episodes of depression that occur at the same time each year [usually in the fall and winter but rarely may occur in the spring or summer months]). Bupropion is also used to help people stop smoking. Bupropion is in a class of medications called antidepressants. It works by increasing certain types of activity in the brain.
Are there other uses for this medicine?
Bupropion is also sometimes used to treat episodes of depression in patients with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods) and to treat attention deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age). Talk to your doctor about the possible risks of using this medication for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medicine be used?
Bupropion comes as a tablet and a sustained-release or extended-release (long-acting) tablet to take by mouth. It is taken 1 to 4 times a day depending on the formulation being used. Follow the directions on your label carefully. Take bupropion at around the same time(s) every day.
Take bupropion with food if the medication upsets your stomach. If you have trouble falling asleep or staying asleep, do not take bupropion too close to bedtime.
When bupropion is used to treat seasonal affective disorder, take it once a day in the morning beginning in the early fall, continuing through the winter, and stopping in the early spring.
Take bupropion exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the sustained-release and extended-release tablets whole; do not split, chew, or crush them.
Your doctor will probably start you on a low dose of bupropion and gradually increase your dose.
It may take 4 weeks or longer before you feel the full benefit of bupropion. Continue to take bupropion even if you feel well. Do not stop taking bupropion without talking to your doctor. Your doctor may decrease your dose gradually.
What special precautions should I follow?
Before taking bupropion,
- tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
- tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two weeks: monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan®), linezolid, methylene blue, phenelzine, selegiline, and tranylcypromine.
- some medications should not be taken with bupropion. Other medications may cause dosing changes or extra monitoring when taken with bupropion. Make sure you have discussed any medications you are currently taking or plan to take before starting bupropion with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking bupropion, please get the advice of your doctor or pharmacist.
- tell your doctor if you have or have ever had seizures, anorexia nervosa (an eating disorder) or bulimia (an eating disorder). Also tell your doctor if you drink large amounts of alcohol but expect to suddenly stop drinking or you take sedatives or medications for seizures but expect to suddenly stop taking them. Your doctor will probably tell you not to take bupropion.
- tell your doctor if you drink large amounts of alcohol, use street drugs, or overuse prescription medications and if you have ever had a heart attack; a head injury; a tumor in your brain or spine; high blood pressure; diabetes; or liver, kidney, or heart disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking bupropion, call your doctor.
- you should know that bupropion may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- you should know that bupropion may cause an increase in your blood pressure. Your doctor may check your blood pressure before starting treatment. Check or have your blood pressure checked regularly while you are taking this medication, especially if you also are using nicotine replacement therapy.
- you should know that bupropion may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.
- talk to your doctor about the safe use of alcoholic beverages while you are taking bupropion. Alcohol can make the side effects from bupropion worse.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget to take a dose?
Skip the missed dose and continue your regular dosing schedule. Always allow the full scheduled amount of time to pass between doses of bupropion. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
- seizure
- hallucinating (seeing things or hearing voices that do not exist)
- loss of consciousness
- rapid or pounding heartbeat
What side effects can this medicine cause?
Bupropion may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- drowsiness
- anxiety, agitation
- difficulty falling asleep or staying asleep
- dry mouth, nausea, abdominal pain, constipation
- dizziness
- headache
- uncontrollable shaking of a part of the body
- loss of appetite
- excessive sweating
- ringing in the ears
- sore throat
Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections, call your doctor immediately or get emergency medical treatment:
- seizures
- confusion, hallucinating (seeing things or hearing voices that do not exist).irrational fears
- rapid, pounding, or irregular heartbeat
- greatly increased energy, severe trouble sleeping, racing thoughts, reckless behavior, unusually grand ideas, excessive happiness or irritability, talking more or faster than usual
If you experience any of the following symptoms, stop taking bupropion and call your doctor immediately or get emergency medical treatment:
- fever; rash or blisters; itching; hives; swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs; hoarseness; difficulty breathing or swallowing;
Bupropion may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( https://www.fda.gov/Safety/MedWatch ) or by phone ( 1-800-332-1088).What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom).
Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.What other information should I know?
Keep all appointments with your doctor.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking bupropion.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
If you are taking the extended-release tablet, you may notice something that looks like a tablet in your stool. This is just the empty tablet shell and does not mean that you did not get your complete dose of medication.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.