Products
Bupropion is commercially available in the form of sustained-release tablets (Wellbutrin XR, Zyban). The two drugs are used for different indications (see below). The active ingredient has been approved in many countries since 1999.
Structure and properties
Bupropion (C13H18ClNO, Mr = 239.7 g/mol) is present as a racemate and as bupropion hydrochloride, a white crystalline powder that is readily soluble in water.
Effects
Bupropion (ATC N06AX12, ATC N07BA02) has antidepressant, noradrenergic, and dopaminergic properties. It inhibits withdrawal symptoms induced by smoking cessation. The effects are due to inhibition of reuptake of norepinephrine and dopamine. Bupropion and its metabolites have a long half-life between 20 to 37 hours.
Indications
Bupropion is approved in many countries for two indications:
- For the treatment of depressive episodes (Wellbutrin XR).
- For the treatment of nicotine dependence as a support during smoking cessation (Zyban).
For the treatment of ADHD and other indications, bupropion is not yet registered. In the United States, a fixed combination of naltrexone and bupropion (Contrave) was approved in 2014 for the treatment of overweight and obesity.
Dosage
According to the package insert. The tablets depending on the indication taken once or twice a day regardless of meals.
Contraindications
For complete precautions, see the drug label.
Interactions
Bupropion is a substrate and inhibitor of CYP2D6 and corresponding interactions are possible. Biotranformation results in active metabolites. Other interactions have been described with MAO inhibitors, dopaminergic drugs, alcohol, and nicotine.
Adverse effects
The most common possible adverse effects include headache, dry mouth, gastrointestinal symptoms such as nausea and vomiting, and insomnia. Rarely, seizures may occur.
