Who Should Not Take Buproprion?

Bupropion is contraindicated in patients with a history of hypersensitivity to bupropion or any inactive ingredients in the formulations. Reactions can be severe, even delayed long after the medicine is started, so report any side effects you might experience.

Anorexia nervosa, bulimia, benzodiazepine (e.g., Valium) withdrawal, alcoholism or sudden alcohol withdrawal, brain tumor, diabetes mellitus, low blood sugar, low sodium blood levels (electrolytes), head trauma, low oxygen levels, mass inside the head, obesity treatment, seizure disorders, seizures, stroke, substance abuse, are all contraindications to the use of bupropion.

Bupropion is contraindicated in patients with a pre-existing seizure disorder or any conditions that can increase the risk of seizures (e.g., severe head trauma, brain blood malformations, brain tumor or any mass in the head, infections in or around the brain, severe stroke, anorexia nervosa, bulimia). It is also contraindicated in cases of abrupt benzodiazepine (e.g., Valium) withdrawal—as well as abrupt withdrawal from alcohol, barbiturates, or anti-epileptic drugs.  All of these are contraindicated because bupropion can cause seizures and those conditions can make it more likely to happen.

Other things that may increase the risk of seizures include alcoholism, substance abuse (e.g., cocaine or prescription abuse of stimulants such as amphetamines), disorders of the metabolism (e.g., low blood sugar, low sodium in the blood, severe liver impairment, low oxygen levels), diabetes mellitus treated with insulin or with oral medicine used to control sugar levels, excessive use of benzodiazepines (like Valium or Librium), sedative/hypnotics, or opiates (e.g., oxycodone), use of drugs for obesity treatment, or use of medications at the same time that lower the seizure threshold—that’s why you have to tell every doctor about all your medications.

Bupropion should be stopped and never used again in patients who experience a seizure during treatment. The incidence of seizures with bupropion is related to how much you take. In studies using bupropion hydrochloride sustained-release up to 300 mg/day, the incidence of seizures was about 0.1%. That is one out of a thousand. The risk goes up as the dose goes up beyond that.

Do not exceed maximum recommended single or total daily dosages of any bupropion product. Patients who are taking bupropion for smoking cessation (e.g., Zyban) should not also take bupropion for depression (e.g., Wellbutrin, Aplenzin), and vice-versa. Tell us the name of every drug because bupropion comes in many names (e.g., Aplenzin, Buproban, Forfivo XL, Wellbutrin SR, Wellbutrin XL, Zyban, Zyban Advantage Pack, Budeprion XL).

Your provider must know if you have had a history of drug abuse with amphetamines. The PDR notes, “During controlled trial evaluation of immediate-release bupropion, an increase in motor activity and agitation/excitement was demonstrated in normal volunteers, subjects with a history of multiple drug abuse, and depressed patients. Results from single-dose studies suggest that the recommended daily dose of bupropion when administered in divided doses is not likely to be significantly reinforcing to amphetamine or CNS stimulant abusers. However, because clinical trial results may not reliably predict the abuse potential of drugs, the benefits of treatment should be weighed against the potential for abuse prior to administering bupropion to patients with a history of substance abuse. It should be noted that bupropion extended-release formulations are intended for oral use only. The inhalation of crushed tablets or injection of dissolved bupropion has resulted in seizures and/or cases of death.”

Never abuse bupropion and let your doctor know if you have abused amphetamines, cocaine, etc., in the past.

 

This information is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.  

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