Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban

Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL) is used to treat depression. Bupropion (Wellbutrin XL) is also used to treat seasonal affective disorder (SAD; episodes of depression that occur in the fall and winter each year). Bupropion (Zyban) is used to help people stop smoking. Bupropion is in a class of medications called antidepressants. It works by increasing certain types of activity in the brain.

Bupropion comes as a tablet and a sustained-release or extended-release (long-acting) tablet to take by mouth. The regular tablet (Wellbutrin) is usually taken three or four times a day, with doses at least 6 hours apart. The sustained-release tablet (Wellbutrin SR, Zyban) is usually taken twice a day, with doses at least 8 hours apart. The extended-release tablet (Wellbutrin XL) is usually taken once daily in the morning.When bupropion is used to treat seasonal affective disorder, it is usually taken once a day in the morning beginning in the early fall, continuing through the winter, and stopping in the early spring. Sometimes a lower dose of bupropion is taken for 2 weeks before the medication is stopped. Take bupropion with food if the medication upsets your stomach. Take bupropion at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take bupropion exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the sustained-release and extended-release tablets whole; do not split, chew, or crush them.

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

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

Bupropion may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• drowsiness
• excitement
• dry mouth
• dizziness
• headache
• nausea
• vomiting
• uncontrollable shaking of a part of the body
• weight loss
• constipation
• excessive sweating

Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• seizures
• confusion
• hallucinating (seeing things or hearing voices that do not exist)
• irrational fears
• fever
• rash or blisters
• itching
• hives
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• difficulty breathing or swallowing
• chest pain
• muscle or joint pain
• rapid, pounding, or irregular heartbeat

Bupropion may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].

Before taking bupropion,

• tell your doctor and pharmacist if you are allergic to bupropion or any other medications.
• tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Your doctor will probably tell you not to take bupropion.
• do not take more than one product containing bupropion at a time. You could receive too much medication and experience severe side effects.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amantadine (Symmetrel); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); cyclophosphamide (Cytoxan, Neosar); diet pills; insulin or oral medications for diabetes; medications for irregular heartbeat such as flecainide (Tambocor) and propafenone (Rythmol); medications for mental illness such as haloperidol (Haldol), risperidone (Risperdal), and thioridazine (Mellaril); medications for seizures such as carbamazepine (Tegretol), phenobarbital (Luminal, Solfoton), and phenytoin (Dilantin); levodopa (Sinemet, Larodopa); nicotine patch; oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); orphenadrine (Norflex); other antidepressants such as desipramine (Norpramin), fluoxetine (Prozac), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), paroxetine (Paxil) and sertraline (Zoloft); sedatives; sleeping pills; theophylline (Theobid, Theo-Dur, others) and thiotepa. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had seizures, anorexia nervosa (an eating disorder) or bulimia (an eating disorder). Also tell your doctor if you drink large amounts of alcohol but expect to suddenly stop drinking or you take sedatives but expect to suddenly stop taking them. Your doctor will probably tell you not to take bupropion.
• tell your doctor if you drink large amounts of alcohol, use street drugs, or overuse prescription medications and if you have or have ever had a heart attack; a head injury; a tumor in your brain or spine; high blood pressure; diabetes; or liver, kidney, or heart disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking bupropion, call your doctor.
• you should know that bupropion may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• talk to your doctor about the safe use of alcoholic beverages while you are taking bupropion. Alcohol can make the side effects from bupropion worse.

Unless your doctor tells you otherwise, continue your normal diet.

Skip the missed dose and continue your regular dosing schedule. Always allow the full scheduled amount of time to pass between doses of bupropion. Do not take a double dose to make up for a missed one.

Bupropion is also sometimes used to treat episodes of depression in patients with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods) and to treat attention deficit disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age). Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• difficulty breathing or swallowing
• dizziness
• fainting
• shakiness
• sweating
• confusion
• blurred vision
• seizure
• hallucinating (seeing things or hearing voices that do not exist)
• loss of consciousness
• rapid or pounding heartbeat
• blurred vision
• lightheadedness
• confusion
• lack of energy
• upset stomach
• jitteriness

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

If you are taking the extended-release tablet, you may notice something that looks like a tablet in your stool. This is just the empty tablet shell and does not mean that you did not get your complete dose of medication.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.