Bupropion Sustained-Release Tablets (Depression/Mood Disorders)

What is this medication?

BUPROPION (byoo PROE pee on) treats depression. It increases norepinephrine and dopamine in the brain, hormones that help regulate mood. It belongs to a group of medications called NDRIs.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Budeprion SR, Wellbutrin SR

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• An eating disorder, such as anorexia or bulimia
• Bipolar disorder or psychosis
• Diabetes or high blood sugar, treated with medication
• Glaucoma
• Head injury or brain tumor
• Heart disease, previous heart attack, or irregular heart beat
• High blood pressure
• Kidney or liver disease
• Seizures
• Suicidal thoughts or a previous suicide attempt
• Tourette's syndrome
• Weight loss
• An unusual or allergic reaction to bupropion, other medications, foods, dyes, or preservatives
• Pregnant or trying to become pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth with a glass of water. Follow the directions on the prescription label. You can take it with or without food. If it upsets your stomach, take it with food. Do not cut, crush or chew this medicine. Take your medication at regular intervals. If you take this medication more than once a day, take your second dose at least 8 hours after you take your first dose. To limit difficulty in sleeping, avoid taking this medication at bedtime. Do not take your medication more often than directed. Do not stop taking this medication suddenly except upon the advice of your care team. Stopping this medication too quickly may cause serious side effects or your condition may worsen.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, skip the missed dose and take your next tablet at the regular time. There should be at least 8 hours between doses. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Linezolid
• MAOIs like Azilect, Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Methylene blue (injected into a vein)
• Other medications that contain bupropion like Zyban

This medication may also interact with the following:

• Alcohol
• Certain medications for anxiety or sleep
• Certain medications for blood pressure like metoprolol, propranolol
• Certain medications for depression or psychotic disturbances
• Certain medications for HIV or AIDS like efavirenz, lopinavir, nelfinavir, ritonavir
• Certain medications for irregular heart beat like propafenone, flecainide
• Certain medications for Parkinson's disease like amantadine, levodopa
• Certain medications for seizures like carbamazepine, phenytoin, phenobarbital
• Cimetidine
• Clopidogrel
• Cyclophosphamide
• Digoxin
• Furazolidone
• Isoniazid
• Nicotine
• Orphenadrine
• Procarbazine
• Steroid medications like prednisone or cortisone
• Stimulant medications for attention disorders, weight loss, or to stay awake
• Tamoxifen
• Theophylline
• Thiotepa
• Ticlopidine
• Tramadol
• Warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Tell your care team if your symptoms do not get better or if they get worse. Visit your care team for regular checks on your progress. Because it may take several weeks to see the full effects of this medication, it is important to continue your treatment as prescribed.

Watch for new or worsening thoughts of suicide or depression. This includes sudden changes in mood, behavior, or thoughts. These changes can happen at any time but are more common in the beginning of treatment or after a change in dose. Call your care team right away if you experience these thoughts or worsening depression.

Manic episodes may happen in patients with bipolar disorder who take this medication. Watch for changes in feelings or behaviors such as feeling anxious, nervous, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or trouble sleeping. These symptoms can happen at anytime but are more common in the beginning of treatment or after a change in dose. Call your care team right away if you notice any of these symptoms.

This medication may cause serious skin reactions. They can happen weeks to months after starting the medication. Contact your care team right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms.

Avoid drinks that contain alcohol while taking this medication. Drinking large amounts of alcohol, using sleeping or anxiety medications, or quickly stopping the use of these agents while taking this medication may increase your risk for a seizure.

Do not drive or use heavy machinery until you know how this medication affects you. This medication can impair your ability to perform these tasks.

Do not take this medication close to bedtime. It may prevent you from sleeping.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your care team if the problem does not go away or is severe.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Increase in blood pressure
• Mood and behavior changes—anxiety, nervousness, confusion, hallucination, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
• Redness, blistering, peeling, or loosening of the skin, including inside the mouth
• Seizures
• Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Constipation
• Dizziness
• Dry mouth
• Loss of appetite
• Nausea
• Tremors or shaking
• Trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F), away from direct sunlight and moisture. Keep tightly closed. Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.