Bupropion sustained-release tablets (Depression/Mood Disorders)

What is this medicine?

BUPROPION (byoo PROE pee on) is used to treat depression.

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You can take it with or without food. If it upsets your stomach, take it with food. Do not cut, crush or chew this medicine. Take your medicine at regular intervals. If you take this medicine more than once a day, take your second dose at least 8 hours after you take your first dose. To limit difficulty in sleeping, avoid taking this medicine at bedtime. Do not take your medicine more often than directed. Do not stop taking this medicine suddenly except upon the advice of your doctor. Stopping this medicine too quickly may cause serious side effects or your condition may worsen.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• breathing problems

• changes in vision

• confusion

• elevated mood, decreased need for sleep, racing thoughts, impulsive behavior

• fast or irregular heartbeat

• hallucinations, loss of contact with reality

• increased blood pressure

• rash, fever, and swollen lymph nodes

• redness, blistering, peeling or loosening of the skin, including inside the mouth

• seizures

• suicidal thoughts or other mood changes

• unusually weak or tired

• vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• constipation

• headache

• loss of appetite

• nausea

• tremors

• weight loss

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• linezolid

• MAOIs like Azilect, Carbex, Eldepryl, Marplan, Nardil, and Parnate

• methylene blue (injected into a vein)

• other medicines that contain bupropion like Zyban

This medicine may also interact with the following medications:

• alcohol

• certain medicines for anxiety or sleep

• certain medicines for blood pressure like metoprolol, propranolol

• certain medicines for depression or psychotic disturbances

• certain medicines for HIV or AIDS like efavirenz, lopinavir, nelfinavir, ritonavir

• certain medicines for irregular heart beat like propafenone, flecainide

• certain medicines for Parkinson's disease like amantadine, levodopa

• certain medicines for seizures like carbamazepine, phenytoin, phenobarbital

• cimetidine

• clopidogrel

• cyclophosphamide

• digoxin

• furazolidone

• isoniazid

• nicotine

• orphenadrine

• procarbazine

• steroid medicines like prednisone or cortisone

• stimulant medicines for attention disorders, weight loss, or to stay awake

• tamoxifen

• theophylline

• thiotepa

• ticlopidine

• tramadol

• warfarin

What if I miss a dose?

If you miss a dose, skip the missed dose and take your next tablet at the regular time. There should be at least 8 hours between doses. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F), away from direct sunlight and moisture. Keep tightly closed. Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• an eating disorder, such as anorexia or bulimia

• bipolar disorder or psychosis

• diabetes or high blood sugar, treated with medication

• glaucoma

• head injury or brain tumor

• heart disease, previous heart attack, or irregular heart beat

• high blood pressure

• kidney or liver disease

• seizures

• suicidal thoughts or a previous suicide attempt

• Tourette's syndrome

• weight loss

• an unusual or allergic reaction to bupropion, other medicines, foods, dyes, or preservatives

• breast-feeding

• pregnant or trying to become pregnant

What should I watch for while using this medicine?

Tell your doctor if your symptoms do not get better or if they get worse. Visit your doctor or healthcare provider for regular checks on your progress. Because it may take several weeks to see the full effects of this medicine, it is important to continue your treatment as prescribed by your doctor.

This medicine may cause serious skin reactions. They can happen weeks to months after starting the medicine. Contact your healthcare provider right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your healthcare provider.

Avoid alcoholic drinks while taking this medicine. Drinking excessive alcoholic beverages, using sleeping or anxiety medicines, or quickly stopping the use of these agents while taking this medicine may increase your risk for a seizure.

Do not drive or use heavy machinery until you know how this medicine affects you. This medicine can impair your ability to perform these tasks.

Do not take this medicine close to bedtime. It may prevent you from sleeping.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.