Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Bupropion Sr.
Drowsiness/reduced alertness: Bupropion may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how Bupropion Sr affects you.
Glaucoma: Bupropion Sr may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how Bupropion Sr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bupropion Sr, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking Bupropion Sr.
Heart disease: It is not known whether bupropion is safe for use by people with a recent history of Heart Attack or unstable heart disease, as it can cause increased blood pressure. If you have heart problems, discuss with your doctor how Bupropion Sr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bupropion Sr, and whether any special monitoring is needed.
Identical medications: Wellbutrin®, Zyban®, and several other medications contain the same active ingredient (bupropion). If you are taking one of these medications, do not take the other or any other product containing bupropion, as the risk of seizures increases with an increased dosage. To reduce the risk of seizures, the total daily dose of Bupropion Sr should not be greater than 300 mg.
Kidney function: Bupropion is removed from the body by the kidney. Decreased kidney function can cause Bupropion Sr to build up in the body, causing side effects. If you have Kidney Disease, discuss with your doctor how Bupropion Sr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bupropion Sr, and whether any special monitoring is needed.
Liver function: Bupropion is removed from the body by the liver. Decreased liver function can cause Bupropion Sr to build up in the body, causing side effects. If you have liver disease, discuss with your doctor how Bupropion Sr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bupropion Sr, and whether any special monitoring is needed.
Bupropion Sr may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Seizure risk: Bupropion Sr may increase the risk of seizures. If you are at risk of seizures, discuss with your doctor how Bupropion Sr may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bupropion Sr, and whether any special monitoring is needed.
Things which increase the risk of seizures include:
- addiction to cocaine, stimulants, or opiates (such as Morphine)
- Diabetes treated with oral medications or insulin
- excessive alcohol use
- history of head trauma
- history of seizures (including Epilepsy)
- severe liver problems
- tumours of the brain or spinal cord
- use of other medications that make seizures more likely (e.g., antipsychotics, antidepressants, lithium, Theophylline, steroids)
- use of over-the-counter stimulants or appetite suppressants
Serotonin syndrome: Severe reactions are possible when bupropion is combined with other medications that act on serotonin, such as tricyclic antidepressants and serotonin reuptake inhibitors – other medications used to treat depression. Similar effects occur when too much bupropion is taken or is allowed to build up in the body. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. These reactions should be treated as a medical emergency and immediate medical treatment should be obtained as coma and death are possible.
Stopping the medication: Stopping Bupropion Sr suddenly may lead to side effects. If you are thinking of stopping the medication, check with your doctor first.
Suicidal or agitated behaviour, or other behaviour changes: Adults and children taking Bupropion Sr may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after people start taking Bupropion Sr. If you experience these side effects or notice them in a family member who is taking Bupropion Sr, contact your doctor immediately. Your doctor will monitor you for emotional and behavioural changes while you are taking bupropion.
Pregnancy: The safety of bupropion during pregnancy has not been established. It has been reported that babies born to pregnant women who have taken medications of this kind during the last trimester of pregnancy may be adversely affected. Physicians and pregnant women should carefully consider the benefits and the risks of all treatment options. If you become pregnant while taking Bupropion Sr, contact your doctor immediately.
Breast-feeding: Bupropion passes into breast milk. Because Bupropion Sr presents risks to breast-feeding infants, a decision should be made whether to discontinue breast-feeding or to discontinue bupropion, taking into account the importance of the medication to the mother. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of bupropion have not been established for children and adolescents under 18 years old. The use of Bupropion Sr in children below the age of 18 may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.
Seniors: Because Bupropion Sr is removed from the body by the kidney and liver, seniors may be at an increased risk of side effects, including seizures, if they use Bupropion Sr. If you are over 65, discuss with your doctor whether any special monitoring is required.