Formulary
Bupropion hydrochloride: Indications, Dosing, Side Effects and Interactions
Bupropion hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
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Bupropion hydrochloride: Indications, Dosing, Side Effects and Interactions
Bupropion hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**To aid smoking cessation in combination with motivational support in nicotine-dependent patients**
- **Adult** (By Mouth): Initially 150 mg daily for 6 days, then 150 mg twice daily (max. per dose 150 mg), minimum 8 hours between doses; period of treatment 7-9 weeks, start treatment 1-2 weeks before target stop date, discontinue if abstinence not achieved at 7 weeks, consider maximum 150 mg daily in patients with risk factors for seizures; maximum 300 mg per day.
- **Elderly** (By Mouth): 150 mg daily for 7-9 weeks, start treatment 1-2 weeks before target stop date, discontinue if abstinence not achieved at 7 weeks; maximum 150 mg per day.
Cautions
Alcohol abuse; diabetes; elderly; history of head trauma; predisposition to seizures (prescribe only if benefit clearly outweighs risk)
Contraindications
Acute alcohol withdrawal; acute benzodiazepine withdrawal; bipolar disorder; CNS tumour; eating disorders; history of seizures; severe hepatic cirrhosis
Side effects
Common or very common Abdominal pain; anxiety; concentration impaired; constipation; dizziness; dry mouth; fever; gastrointestinal disorder; headache; hyperhidrosis; hypersensitivity; insomnia (reduced by avoiding dose at bedtime); nausea; skin reactions; taste altered; tremor; vomiting Uncommon Appetite decreased; asthenia; chest pain; confusion; tachycardia; tinnitus; vasodilation; visual impairment Rare or very rare Angioedema; arthralgia; behaviour abnormal; bronchospasm; delusions; depersonalisation; dyspnoea; hallucination; hepatic disorders; irritability; memory loss; movement disorders; muscle complaints; palpitations; paraesthesia; parkinsonism; postural hypotension; seizure; sleep disorders; Stevens-Johnson syndrome; syncope; urinary disorders Frequency not known Anaemia; hyponatraemia; leucopenia; psychosis; suicidal behaviours; thrombocytopenia
Interactions
**Severe interactions:**
- There have been post-marketing reports of serotonin syndrome, a potentially life-threatening condition, when naltrexone/bupropion was co-administered with a serotonergic agent, such as Selective...
**Other interactions (19):**
- Similar clinical drug interactions resulting in increased pharmacokinetic exposure of CYP2D6 substrates have also been observed with bupropion as a single medicinal product with desipramine and...
- Co-administration of bupropion with drugs that are metabolised by CYP2D6 isozyme including certain antidepressants (SSRIs and many tricyclic antidepressants, e.g.
- Although citalopram is not primarily metabolised by CYP2D6, in one study, bupropion increased the C max and AUC of citalopram by 30% and 40%, respectively.
- Drugs which require metabolic activation by CYP2D6 in order to be effective (e.g., tamoxifen), may have reduced efficacy when administered concomitantly with inhibitors of CYP2D6 such as bupropion.
- When feasible, the option of therapeutic drug monitoring should be considered for medicinal products with a narrow therapeutic index, such as tricyclic antidepressants.
- Since bupropion is extensively metabolised, caution is advised when naltrexone/bupropion is co-administered with medicinal products known to induce CYP2B6 (e.g., carbamazepine, phenytoin, ritonavir,...
Pregnancy
Avoid-no information available.
Breast feeding
Present in milk-avoid.
Hepatic impairment
Manufacturer advises use with caution-monitor closely for adverse effects; avoid in severe cirrhosis. Dose adjustments Manufacturer advises reduce dose to 150 mg daily in mild to moderate impairment.
Renal impairment
Use with caution. M Dose adjustments Reduce dose to 150 mg daily. M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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