Smoking - Bupropion: more about side effects

Smoking

Bupropion: more about side effects

In some countries (mainly the United Kingdom, Canada and Australia) there are concerns that bupropion may have caused some deaths. In the United Kingdom, out of 513,000 people who have taken bupropion, 58 have died while taking the drug. In Canada, over a period of three years, there were 1,127 reports of serious side effects in people taking bupropion. These included 19 deaths, 172 seizures and 37 cases of

allergy
If you have an allergy to something, your body overreacts when you're around it. The thing you are allergic to is called an allergen. Most allergens are harmless to most people. But if you're allergic to something, your body's system for fighting infection (your immune system) is too sensitive to that allergen. It triggers changes that we call allergic reactions. For example, pollen is an allergen for many people. If you're allergic to pollen, you'll sneeze and have runny eyes when pollen is in the air.

allergy.

Source:
Wooltorton E.
Bupropion (Zyban, Wellbutrin SR): reports of deaths, seizures, serum sickness.
Canadian Medical Association Journal. 2002; 166: 68.

But so far, scientists haven't been able to show that the drug is connected to the deaths. The Medicines Control Agency (MCA) in the United Kingdom says that the people may have died because of medical problems they had before they took bupropion. (The MCA is like the Food and Drug Administration, the FDA, in the United States.) It may be that people with serious illnesses (like heart disease) who need to quit smoking fast are more likely to take bupropion.

Source:
Wooltorton E.
Bupropion (Zyban, Wellbutrin SR): reports of deaths, seizures, serum sickness.
Canadian Medical Association Journal. 2002; 166: 68.

The FDA has not issued any specific warnings in the United States. However, it's important for you and your doctor to discuss the risks and benefits of using bupropion.

The MCA is looking closely at any side effects people experience while taking bupropion in the United Kingdom, and the agency advises that certain people should not take it.

Source:
Breckenridge A.
Public Health Link/CMO's urgent communication CEM/CMO/2001/07.
2001. Department of Health. Available at http://www.doh.gov.uk.cmo.cmo01_07.htm (accessed on 9 May 2003).

The manufacturer has issued very specific guidelines about who should not take bupropion because of the risk of seizures and other adverse effects.

You should not take bupropion if you:

Have a seizure disorder, such as epilepsy
Are already taking Wellbutrin or Wellbutrin SR (the brand name for bupropion used as an antidepressant), or any other medicines that contain bupropion
Have or have had an

eating disorder
If you have an eating disorder, you may not be eating or thinking about food in a healthy way. People with eating disorders tend to either eat too much or too little and to worry a lot, often about their weight or how they look. Common eating disorders are bulimia and anorexia nervosa.

eating disorder (for example, bulimia or anorexia nervosa)
Are currently taking or have recently taken a drug called a

monoamine oxidase inhibitors
Monoamine oxidase inhibitors (MAOIs) are a group of medicines that are usually used to treat depression. They work by increasing the levels of certain chemicals in your brain.

monoamine oxidase inhibitor (MAOI) (you should have a gap of at least 14 days between stopping the MAOI and starting bupropion)
Are

allergy
If you have an allergy to something, your body overreacts when you're around it. The thing you are allergic to is called an allergen. Most allergens are harmless to most people. But if you're allergic to something, your body's system for fighting infection (your immune system) is too sensitive to that allergen. It triggers changes that we call allergic reactions. For example, pollen is an allergen for many people. If you're allergic to pollen, you'll sneeze and have runny eyes when pollen is in the air.

allergic to bupropion or the other ingredients that make up Zyban (the brand name for the kind of bupropion used to help people quit smoking)
Have suddenly stopped taking benzodiazepines, alcohol, or other

sedation
The word 'sedate' means calm and relaxed. In medicine, sedation means using a medicine to calm someone down: for example, before an operation.

sedatives.

Source:
GlaxoSmithKline.
Important safety information about Zyban.
Available at http://zyban.ibreathe.com (accessed on 7 May 2003).

³

Here are some other things you may want to discuss with your doctor.

Source:
United States Pharmacopeia Dispensing Information (USPDI).
Drug information for the health care professional.
Micromedex. 2002; 1: 1518-23

⁴

Source:
Pesola GR, Avasarala J.
Bupropion seizure proportion among new-onset generalized seizures and drug related seizures presenting to an emergency department.
Journal of Emergency Medicine. 2002; 22: 235-239.

⁵

How much of the drug you should take. Your dose should be less than 300 milligrams a day.
Any head injuries, seizures, tumors you might have had in your brain or spinal cord, or

liver
Your liver is a large organ that sits on the right side of your body, just below your rib cage. It does several important things, including processing and storing nutrients from food, and breaking down chemicals, such as alcohol.

liver disease you may have had in the past. Tell your doctor about them because they may increase your chance of having a seizure while taking bupropion.
Other drugs you may be taking. Some of them might increase your chance of having a seizure. Examples are antidepressants, drugs for asthma (theophylline), steroid pills or shots, and antipsychotic drugs.
Whether alcohol is allowed while you're taking bupropion, and if so, how much. Drinking excessively could increase your risk of having a seizure.
The dangers if you suddenly stop drinking alcohol or taking sedative drugs, opiates, cocaine, over-the-counter stimulants or diet drugs. If you stop drinking or taking any of these drugs while you're taking bupropion, your risk of having a seizure goes up.

Sources for the information on this page:

Wooltorton E.Bupropion (Zyban, Wellbutrin SR): reports of deaths, seizures, serum sickness.Canadian Medical Association Journal. 2002; 166: 68.

Breckenridge A.Public Health Link/CMO's urgent communication CEM/CMO/2001/07.2001. Department of Health. Available at http://www.doh.gov.uk.cmo.cmo01_07.htm (accessed on 9 May 2003).

GlaxoSmithKline.Important safety information about Zyban.Available at http://zyban.ibreathe.com (accessed on 7 May 2003).

United States Pharmacopeia Dispensing Information (USPDI).Drug information for the health care professional.Micromedex. 2002; 1: 1518-23

Pesola GR, Avasarala J.Bupropion seizure proportion among new-onset generalized seizures and drug related seizures presenting to an emergency department.Journal of Emergency Medicine. 2002; 22: 235-239.

This information was last updated on May 11, 2009

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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