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Bupropion

Pronunciation: byoo-PRO-pee-on
Generic name: bupropion
Brand names: Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban, Aplenzin, Budeprion XL, Forfivo XL
Drug classes: Miscellaneous antidepressants, Smoking cessation agents

Medically reviewed by Melisa Puckey, BPharm. Last updated on Sep 22, 2023.

What is bupropion?

Bupropion is an antidepressant medication used to treat depression and seasonal affective disorder, it also supports smoking cessation and weight management. Bupropion is the active ingredient in Wellbutrin and Zyban, Auvelity contains bupropion and dextromethorphan, and Contrave contains bupropion and naltrexone. Bupropion improves mood regulation and nicotine cravings and, when combined with naltrexone, helps reduce food intake.

Bupropion is thought to work by changing levels of certain chemicals in the brain, including noradrenaline and dopamine.

Bupropion first became an FDA-approved medicine on 30 December 1985.

What is bupropion used to treat?

The brands of bupropion are FDA-approved for specific conditions. 

The information on this page is only about bupropion, and not bupropion with dextromethorphan (Auvelity) or bupropion with naltrexone (Contrave).

Bupropion side effects

Common bupropion side effects

 The most common side effects may include:

Serious bupropion side effects

Get emergency medical help if you have any of these signs of an allergic reaction to bupropion: (hives, itching, fever, swollen glands, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Warnings

You should not take bupropion if you have seizures, an eating disorder, or suddenly stopped using alcohol, seizure medication, or sedatives. You should not take two medicines together that contain bupropion for example, if you take Wellbutrin for depression, you should not also take Contrave for weight control.

Do not use bupropion within 14 days before or 14 days after you have used a MAO inhibitors , such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people (up to 24 years of age) have thoughts about suicide when first taking this medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

You should know that your mental health may change in unexpected ways when you take bupropion or other antidepressants even if you are an adult over age 24 or if you do not have a mental illness and you are taking bupropion to treat a different type of condition. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should 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 seek treatment on your own.

This medicine may cause seizures, especially in people with certain medical conditions or when using certain drugs. Tell your doctor about all of your medical conditions and the drugs you use.

Bupropion can cause mild pupillary dilation, which can lead to an episode of angle-closure glaucoma in susceptible individuals. Angle-closure glaucoma has occurred in patients with untreated anatomically narrow angles treated with antidepressants.

Before taking this medicine

Do not use this medicine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

You should not take this medicine if you are allergic to it or if you have ever had:

Do not take this medicine to treat more than one condition at a time. If you take bupropion for depression, do not also take this medicine to quit smoking or for weight management.

Tell your doctor about all of your medical conditions and the drugs you use.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using this medicine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Pregnancy

Talk to your healthcare provider if you are pregnant or plan to become pregnant about the risk to your unborn baby. It is not known whether this medicine will harm an unborn baby. Tell your doctor right away if you become pregnant. Do not start or stop taking bupropion without your doctor's advice.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of this medicine on the baby.

Breastfeeding

Tell your healthcare provider if you are breastfeeding or plan to breastfeed while taking this medicine. This medicine passes into breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment with this medicine.

How should I take bupropion?

Take bupropion exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Too much of this medicine can increase your risk of a seizure.

Do not crush, chew, or break tablets. Swallow the tablet whole.

Take bupropion with food if the medication upsets your stomach. 

If you have trouble falling asleep or staying asleep, do not take tablets too close to bedtime. 

Your doctor will probably start you on a low dose of this medicine and gradually increase your dose.

It may take 4 weeks or longer before you feel the full benefit of this medicine. Continue to take your tablets even if you feel well. Do not stop taking this medicine without talking to your doctor. Your doctor may decrease your dose gradually.

You should not change your dose or stop using bupropion suddenly unless you have a seizure while taking this medicine. Stopping suddenly can cause unpleasant withdrawal symptoms.

Ask your doctor how to stop using bupropion safely.

Some people taking bupropion have severe high blood pressure, especially when using a nicotine replacement product (patch or gum). Your blood pressure may need to be checked before and during treatment with this medicine.

This medicine can cause you to have a false positive drug screening test ( amphetamines). If you provide a urine sample for drug screening, tell the laboratory staff you are taking this medicine.

For smoking cessation.

If you take bupropion to help you stop smoking, you may continue to smoke for about 1 week after you start the medicine. Set a date to quit smoking during the second week of treatment. Talk to your doctor if you are having trouble quitting after you have used bupropion for at least 7 to 12 weeks.

Your doctor may prescribe a nicotine replacement product (such as patches or gum) to help you stop smoking. Start using the nicotine replacement product on the same day you stop (quit) smoking or using tobacco products.

You may have nicotine withdrawal symptoms when you stop smoking, including increased appetite, weight gain, trouble sleeping, trouble concentrating, slower heart rate, having the urge to smoke, and feeling anxious, restless, depressed, angry, frustrated, or irritated. These symptoms may occur with or without using medication such as bupropion.

Smoking cessation may also cause new or worsening mental health problems, such as depression.

Bupropion hydrochloride dosing information

Usual Adult Bupropion Dose for Depression:


Immediate-release tablets:

Sustained-release tablets:

Extended-release tablets:

Comments:

So as not to exceed the maximum single dose of 150 mg for immediate-release tablets, a dose of 100 mg orally four times a day (using the 100 mg tablet) may be administered.
Patients who are taking 300 mg/day for at least 2 weeks (OR are currently taking 450 mg/day) of any formulation may be switched to the extended-release 450 mg dose.
Bupropion hydrobromide 174 mg oral tablet is equivalent to bupropion hydrochloride 150 mg.
Patients should be periodically reviewed to determine the need for maintenance treatment and the appropriate dose for such treatment.

Usual Adult Bupropion Dose for Seasonal Affective Disorder:


Extended-release tablets:

Comments:

Treatment should be initiated in the autumn prior to the onset of depressive symptoms, continued through the winter season, and discontinued in early spring.
If bupropion hydrochloride 300 mg orally per day is not tolerated, it should be reduced to 150 mg once a day before discontinuing treatment.
Patients taking bupropion hydrochloride 300 mg orally per day during the autumn-winter season should have their dose tapered to 150 mg once a day for 2 weeks prior to discontinuation.
The timing of initiation and treatment duration for seasonal affective disorder should be individualized according to the patient's historical pattern of seasonal major depressive episodes.

Usual Adult Dose for Smoking Cessation:


Sustained-release tablets:

Comments:
Begin dosing one week before quit day; the target stop date should be set within the first 2 weeks of treatment, preferably in the second week.
There should be an interval of at least 8 hours between doses.
May be used with a nicotine transdermal system.
If there is no effect after 12 weeks, treatment should be discontinued; longer treatment should be guided by the relative benefits and risks for the individual patient.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of bupropion can be fatal. Overdose symptoms may include muscle stiffness, hallucinations, fast or uneven heartbeat, shallow breathing, or fainting.

What to avoid

Drinking alcohol with bupropion may increase your risk of seizures. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. This medicine can also cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.

Bupropion may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What other drugs will affect bupropion?

You may have a higher risk of seizures if you use certain other medicines while taking bupropion.

Many drugs can interact with bupropion. Tell your doctor about all medicines you use, and those you start or stop using during your treatment. This includes prescription and over-the-counter medicines, vitamins, and herbal products. 

Some examples of drugs that interact with bupropion are:

Not all possible interactions are listed in this medication guide.

Storage

Store at room temperature, 20° to 25°C (68° to 77°F).

Popular FAQ

You may notice an improvement in your sleep, energy and appetite in the first week or two of taking Wellbutrin and this can be an important sign that the drug is working. But, like other antidepressants, improvements in your mood or motivation may take 6 to 8 weeks to develop. Continue reading

Auvelity worked significantly better than Wellbutrin (bupropion) at relieving symptoms of depression in a small randomized double-blind, parallel trial that lasted for 6 weeks. It also had a faster onset of effect, with improvement in the Montgomery-Åsberg Depression Rating Scale (MADRS) score being observed as early as week 1 and differences being statistically significant by week 2. Continue reading

Both Auvelity and Wellbutrin are effective for depression but a small RCT (n=80) reported that Auvelity worked significantly better than Wellbutrin and took less time to start working. 43 people prescribed Auvelity experienced an overall decrease in their Montgomery-Åsberg Depression Rating Scale (MADRS) score of 13.7 points after 6 weeks compared to a decrease of 8.8 points in the 37 people prescribed bupropion (least-squares mean difference=-4.9; 95% CI=-3.1, -6.8). Continue reading

View more FAQ

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.