Bupropion

Administration

• Type: Antidepressant
• Dosage Forms: tablet, sustained-release tablet, extended-release tablet
• Dosage Strengths: tablet: 75, 100mg; sustained-release tablet (Wellbutrin SR): 100, 150, 200mg; extended-release tablet (Wellbutrin XL): 150, 300mg; extended-release tablet (Aplenzin): 174, 348, 522mg; extended-release tablet (Forfivo XL): 450mg; extended-release tablet (Zyban): 150mg
• Routes of Administration: PO
• Common Trade Names: Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban, Forfivo XL, Budeprion SR, Aplenzin, Buproban

Adult Dosing

• Immediate release: 100-150mg PO 2-4 times daily
• Sustained release: 150mg PO 1-2 times daily

Pediatric Dosing

Safety/efficacy not established

Special Populations

• Pregnancy Rating: C
• Lactation risk: infant risk cannot be ruled out
• Renal dosing: dose reduction or avoidance recommended
• Hepatic dosing: dose reduction or avoidance recommended

Contraindications

• Allergy to class/drug
• Use of MAOI, linezolid, or methylene blue concomitantly or within past 2 weeks
• Seizure disorder
• Condition which lowers seizure threshold (e.g. abrupt cessation of ETOH, benzos, or AEDs, anorexia/bulimia, electrolyte derangement)

Adverse Reactions

Serious

• Seizure
• Cardiac dysrhythmia
• Angle-closure glaucoma
• Suicidal ideation, worsening depression, mania, psychosis

Common

• Insomnia
• Dizziness, tremor
• Headache
• Nausea, constipation
• Tachyarrhythmia (10.8% )
• Pruritus, rash, urticaria
• Arthralgia, myalgia
• Tinnitus
• Xerostomia, pharyngitis

Pharmacology

• Half-life: 14-33h
• Metabolism: Hepatic, CYP2B6
• Excretion: Mostly renal

Mechanism of Action

• Exact therapeutic mechanism unknown. Weakly inhibits neuronal uptake of dopamine and norepinephrine
• Structurally belongs to the class of synthetic cathinones
  • Due to structure, can cause false positive screen for amphetamine on UDS

See Also

• Bupropion toxicity