Dosage ; Depression: 150 mg OD x 3/7, then 150mg BD
(up to 200 mg BD) in the morning.
As a smoking cessation adjunct: 150mg OD x 3/7,
then 150 mg BD for 7-12 weeks.
(To reduce the risks of the frequent side effects of agitation,
anxiety, and insomnia initiation of therapy must be made gradually).
| Brand Name | Manufacturer Name | Distributor | Drug Strength | Packaging | Formulation | Formulation Strength | Price |
|---|---|---|---|---|---|---|---|
| Zyban | GlaxoSmithkline | GlaxoSmithKline | 150mg | 60 | Tablet | per tablet | KES 4,527.10 |
| Bupropion More info | |
|---|---|
| Mode Of Action | The exact mechanism of antidepressant action of bupropion is unknown but it is thought to be mediated by bupropion's noradrenergic and/or dopaminergic effects. |
| Drug Indication | Major depressive disorder; non-nicotine aid of smoking cessation |
| Contra-Indications | Patients with a seizure disorders; medications containing bupropion; patients with bulimia or anorexia nervosa; concurrent administration with MAOI; patient allergic to bupropion. |
| Side Effects | Agitation; anxiety; severe headache; skin rash, hives, or itching; tinnitus; fainting; neuropsychiatric effects; seizures; abdominal pain; anorexia; constipation; dizziness; dryness of mouth increased sweating; insomnia; myalgia; nausea or vomiting; pharyngitis; tremor; weight loss. |
| Dosage | Depression: 150 mg OD x 3/7, then 150mg BD (up to 200 mg BD) in the morning. As a smoking cessation adjunct: 150mg OD x 3/7, then 150 mg BD for 7-12 weeks. (To reduce the risks of the frequent side effects of agitation, anxiety, and insomnia initiation of therapy must be made gradually). |
| Pregnancy Category | Category B2 |
| Pregnancy Category Description | Drugs which have been taken by only a small number of pregnant women and women of child-bearing age with no any established rise in the frequency of malformations or other direct or indirect detrimental effects on the foetus having been noted. Studies in animals are inadequate or lacking but available data show no evi-dence of an increased occurrence of foetal damage. Studies in animals are inadequate or lacking but available data show no evi-dence of an increased occurrence of foetal damage. |
| Drug Category | DRUGS ACTING ON CNS |
| Drug Sub-Category | Antidepressants, anxiolytics
Dosing: Adult Depression: Oral: Immediate release hydrochloride salt: 100 mg 3 times/day; begin at 100 mg twice daily; may increase to a maximum dose of 450 mg/day Sustained release hydrochloride salt: Initial: 150 mg/day in the morning; may increase to 150 mg twice daily by day 4 if tolerated; target dose: 300 mg/day given as 150 mg twice daily; maximum dose: 400 mg/day given as 200 mg twice daily Extended release: Hydrochloride salt: Initial: 150 mg/day in the morning; may increase as early as day 4 of dosing to 300 mg/day; maximum dose: 450 mg/day Hydrobromide salt (Aplenzin™): Target dose: 348 mg/day in the morning. Patients not previously on bupropion: Initial: 174 mg/day in the morning; may increase as early as day 4 of dosing to 348 mg/day; maximum dose: 522 mg/day. Note: 174 mg strength not currently available; 348 mg tablet cannot be split. Switching from hydrochloride salt formulation (eg, Wellbutrin® immediate release, SR®, XL®) to hydrobromide salt formulation (Aplenzin™): Note: Patients being treated twice daily with bupropion hydrochloride would be switched to the equivalent once daily dose of bupropion hydrobromide. Bupropion hydrochloride 150 mg is equivalent to bupropion hydrobromide 174 mg Bupropion hydrochloride 300 mg is equivalent to bupropion hydrobromide 348 mg Bupropion hydrochloride 450 mg is equivalent to bupropion hydrobromide 522 mg SAD (Wellbutrin XL®): Oral: Initial: 150 mg/day in the morning; if tolerated, may increase after 1 week to 300 mg/day Note: Prophylactic treatment should be reserved for those patients with frequent depressive episodes and/or significant impairment. Initiate treatment in the Autumn prior to symptom onset, and discontinue in early Spring with dose tapering to 150 mg/day for 2 weeks Smoking cessation (Zyban®): Oral: Initiate with 150 mg once daily for 3 days; increase to 150 mg twice daily; treatment should continue for 7-12 weeks. Note: Therapy should begin at least 1 week before target quit date. Target quit dates are generally in the second week of treatment. If patient successfully quits smoking after 7-12 weeks, may consider ongoing maintenance therapy based on individual patient risk:benefit. Efficacy of maintenance therapy (300 mg/day) has been demonstrated for up to 6 months. Conversely, if significant progress has not been made by the seventh week of therapy, success is unlikely and treatment discontinuation should be considered. Dosing conversion between hydrochloride salt (eg, Wellbutrin®) immediate, sustained, and extended release products: Convert using same total daily dose (up to the maximum recommended dose for a given dosage form), but adjust frequency as indicated for sustained (twice daily) or extended (once daily) release products. Dosing: Pediatric (For additional information see "Bupropion: Pediatric drug information") ADHD (unlabeled use): Oral (hydrochloride salt): Children and Adolescents: 1.4-6 mg/kg/day Dosing: Geriatric Depression: Oral (hydrochloride salt): Initial: 37.5 mg of immediate release tablets twice daily or 100 mg/day of sustained release tablets; increase by 37.5-100 mg every 3-4 days as tolerated. There is evidence that the elderly respond at 150 mg/day in divided doses, but some may require a higher dose. Note: Patients with Alzheimer’s dementia-related depression may require a lower starting dosage of 37.5 mg once or twice daily (100 mg/day sustained release), increased as needed up to 300 mg/day in divided doses (300 mg/day for sustained release) Smoking cessation: Refer to adult dosing. |