Bupropion oral tablet interactions: A detailed guide

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Overview

This article describes possible interactions with bupropion oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.

Bupropion comes as oral tablets that you swallow. It’s also available as an extended-release tablet. “Extended release” (ER) means the drug is released into your body slowly over time.

The interactions and uses of bupropion may vary depending on the form and dose of bupropion you’re prescribed.

Boxed warning: Risk of suicidal thoughts and behaviors in certain people

Bupropion has a boxed warning for the risk of suicidal thoughts and behaviors in certain people. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the end of this article.

Other drugs and bupropion

The drugs in the list below may interact with bupropion oral tablet. This article doesn’t include all drugs that may interact with bupropion.

Drugs that may interact with bupropion oral tablet include:

• antidepressant drugs:
  • drug examples: sertraline (Zoloft), fluoxetine (Prozac)
  • what might happen: can increase the risk of side effects of bupropion and other antidepressants
• monoamine oxidase inhibitors (MAOIs):*
  • drug examples: linezolid (Zyvox), selegiline (Emsam, Zelapar), methylene blue
  • what might happen: can increase the risk of side effects of bupropion and MAOIs
• stimulant drugs:
  • drug examples: dextroamphetamine/amphetamine (Adderall), lisdexamfetamine (Vyvanse)
  • what might happen: can increase the risk of side effects of bupropion and stimulant drugs
• certain antiepileptic drugs:
  • drug examples: carbamazepine (Tegretol, others), phenytoin (Dilantin)
  • what might happen: can make bupropion less effective
• certain antiretroviral drugs:
  • drug examples: ritonavir (Norvir), efavirenz
  • what might happen: can make bupropion less effective
• certain antipsychotic drugs:
  • drug examples: haloperidol (Haldol), risperidone (Risperdal, others)
  • what might happen: can increase the risk of side effects of antipsychotic drugs
• certain antiarrhythmic drugs:
  • drug examples: flecainide, propafenone (Rythmol SR)
  • what might happen: can increase the risk of side effects of antiarrhythmic drugs
• atomoxetine (Strattera):
  • what might happen: can increase the risk of side effects of atomoxetine
• clopidogrel (Plavix):
  • what might happen: can make bupropion less effective
• digoxin (Lanoxin):
  • what might happen: can make digoxin less effective

* See the “When to avoid bupropion” section to learn more about this interaction.

When to avoid bupropion

Certain health conditions or other factors could increase some risks with bupropion oral tablet. Because of this, doctors may not prescribe bupropion in these cases. These health conditions or other factors are called contraindications.

Here’s a list of contraindications for bupropion oral tablet:

• Anorexia nervosa or bulimia nervosa: If you have anorexia nervosa or bulimia nervosa, bupropion oral tablet may cause a further increased risk of seizures.
• Epilepsy or seizures: If you have epilepsy or experience seizures, taking bupropion oral tablet may worsen your condition. Seizures are a rare side effect of bupropion.
• Recently and suddenly stopped drinking alcohol or taking certain drugs: If you recently and suddenly stopped drinking alcohol or taking certain drugs, you’re at higher risk of seizures if you take bupropion oral tablet. Examples of these drugs include benzodiazepines, such as alprazolam (Xanax). They also include antiepileptic drugs, such as carbamazepine (Tegretol, others).
• Taking a monoamine oxidase inhibitor (MAOI) drug: If you take bupropion and also take an MAOI drug, you’re at higher risk of severely high blood pressure. This is a rare but serious side effect of MAOI drugs, such as phenelzine (Nardil) and linezolid (Zyvox).
• Past allergic reaction to bupropion: If you’ve had an allergic reaction to bupropion oral tablet in the past, taking it again may cause another allergic reaction.

Before starting treatment with bupropion, tell your doctor if anything listed above relates to you. They can recommend whether you should take bupropion.

Alcohol and bupropion

Bupropion oral tablet is known to interact with alcohol. You should minimize or avoid drinking alcohol while taking bupropion.

Taking bupropion oral tablet and drinking alcohol may cause:

• difficulty concentrating
• mood changes, including depression
• hallucinations or delusions

Drinking alcohol also raises your risk of seizure, which is a serious side effect of bupropion.

If you have concerns about avoiding alcohol during bupropion oral tablet treatment, talk with your doctor.

Other interactions and bupropion

Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether bupropion oral tablet has these interactions. The information below doesn’t include all interactions possible with bupropion.

Bupropion and supplements

Before taking bupropion oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Bupropion (Wellbutrin) interactions with vitamins

Bupropion oral tablet isn’t known to interact with any vitamins. Wellbutrin is a brand-name version of bupropion. It’s discontinued, although the forms Wellbutrin SR and Wellbutrin XL* are still available. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.

Because of this, you should ask your doctor or pharmacist before taking any of these products during treatment.

* These two forms release the drug into the body over a period of time. For a dose of Wellbutrin SR (for “sustained release”), this is typically 8 to 12 hours. For a dose of Wellbutrin XL (for “extended release”), this is typically 24 hours.

Bupropion (Wellbutrin) interactions with herbs or herbal supplements

Bupropion oral tablet isn’t known to interact with any herbs. Wellbutrin is a brand-name version of bupropion. It’s discontinued, although the forms Wellbutrin SR and Wellbutrin XL are still available. But this doesn’t mean interactions with herbs can’t happen or won’t be identified later.

Because of this, you should ask your doctor or pharmacist before taking any of these products during treatment.

Bupropion and food

Caffeine can interact with bupropion. Ingesting caffeine increases the risk of seizure as a side effect of bupropion. This includes caffeine consumed from food, such as coffee. Seizure is a rare, serious side effect reported with bupropion.

Caffeine is also an ingredient in some medications, such as over-the-counter (OTC) Excedrin. It’s also an ingredient in some dietary supplements.

It’s important to avoid consuming an excessive amount of caffeine if you take bupropion. Talk with your doctor to determine how much caffeine is safe to consume during your bupropion treatment.

Bupropion and vaccines

Bupropion oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.

Because of this, you should talk with your doctor or pharmacist before receiving any vaccines during treatment.

Bupropion and lab tests

Bupropion oral tablet may interact with a urine test used to check for amphetamines in your system.

Taking bupropion may cause a false-positive result in these tests. This means the test shows amphetamines in your urine even if you’ve taken none. These false-positive results can occur in urine tests even after you stop taking bupropion.

If you take bupropion and need a test to check for amphetamines, talk with your doctor. They can suggest other lab tests to check for amphetamines that don’t interact with bupropion.

Bupropion and cannabis or CBD

In studies, cannabis (commonly called marijuana) and cannabis products have been shown to interact with bupropion. Cannabidiol (CBD) is an example of a cannabis product.

Taking bupropion along with cannabis or cannabis products may lead to high or low levels of bupropion in your body. High levels can raise your risk of side effects from bupropion. Low levels may mean bupropion doesn’t work as well.

Before you take bupropion, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Health factors and bupropion

Certain medical conditions or other health factors may increase the risk of interactions with bupropion oral tablet. Before taking bupropion, tell your doctor about your health history. They’ll determine whether bupropion is right for you.

Here’s a list of health conditions or other factors that might interact with bupropion oral tablet:

• anorexia nervosa or bulimia nervosa*
• epilepsy or seizures*
• previous head injury
• heart condition
• recently and suddenly stopped drinking alcohol or taking certain drugs, including benzodiazepines such as alprazolam (Xanax)*
• pregnancy or breastfeeding
• past allergic reaction to bupropion*

* See the “When to avoid bupropion” section to learn more.

Questions about bupropion and interactions

Here you’ll find answers to some common questions about bupropion and possible interactions.

What allergy medication can I take with bupropion (Wellbutrin)?

Most allergy medications that contain only an antihistamine are safe to take with Wellbutrin. Examples are plain Zyrtec (cetirizine) and Claritin (loratadine). Wellbutrin is a brand-name version of bupropion. It’s discontinued, although the forms Wellbutrin SR and Wellbutrin XL* are still available.

But some allergy medications contain additional ingredients that may interact with bupropion.

For example, some allergy medications, such as Zyrtec-D and Claritin-D, contain pseudoephedrine. Pseudoephedrine interacts with bupropion. Bupropion or pseudoephedrine can raise your risk of seizure as a side effect. Taking these two medications together can increase this risk further.

If you’re taking bupropion, it’s best to avoid allergy medications that contain pseudoephedrine. Your pharmacist or doctor can help you choose an allergy medication that’s safe to take with bupropion.

* These two forms release the drug into your body over a period of time. For a dose of Wellbutrin SR (for “sustained release”), it’s typically 8 to 12 hours. For a dose of Wellbutrin XL (for “extended release”), it’s typically 24 hours.

Can I take acetaminophen (Tylenol) with bupropion (Wellbutrin)?

Yes, this is generally considered safe. Wellbutrin is a brand-name version of bupropion. It’s discontinued, although the forms Wellbutrin SR and Wellbutrin XL* are still available. Acetaminophen (Tylenol) and bupropion aren’t known to interact.

But some drugs containing acetaminophen interact with bupropion because of other ingredients they include. To be safe, talk with your pharmacist or doctor before taking OTC drugs containing acetaminophen.

* These two forms release the drug into the body over a period of time. For a dose of Wellbutrin SR (for “sustained release”), this is typically 8 to 12 hours. For a dose of Wellbutrin XL (for “extended release”), this is typically 24 hours.

Does bupropion oral tablet have interactions different from bupropion extended-release oral tablet?

No, interactions for bupropion oral tablet and bupropion extended-release oral tablet are expected to be the same. (“Extended release” means the drug releases into your body slowly over a long period of time.)

Talk with your pharmacist or doctor to learn more about how both forms of bupropion compare.

Preventing bupropion interactions

You may be able to avoid certain interactions with bupropion oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.

Things to consider include:

• Whether you drink alcohol or use cannabis.
• Other medications or herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
• Caffeine in your foods, medications, and supplements.
• What to do if you’re prescribed a new drug during your bupropion oral tablet treatment.

Taking bupropion exactly as prescribed can also help prevent interactions.

Boxed warning for bupropion

Bupropion has a boxed warning for the risk of suicidal thoughts and behaviors in certain people. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Bupropion and other antidepressant medications were studied. In the studies, researchers observed a small increase in the risk of suicidal thoughts and behaviors. This occurred in children and adults through ages 24 years. It’s believed that this risk is highest when starting treatment with bupropion and whenever the dosage changes. Further, the studies noted that the risk was not increased in adults ages 25 years and older.

It’s important to note that bupropion is not approved for use in children. The drug is approved for use only in adults.

Symptoms of this risk include:

• thoughts about self-harm or dying
• new or worsened depression, anxiety, or panic attacks
• irritability
• restlessness
• agitation
• hostile, aggressive, or violent behavior

Due to this risk, your doctor will monitor you for changes in your mood, behavior, or thinking during treatment. It may be helpful to have a friend or family member watch. They may also notice these types of changes while you’re taking the medication.

If you have thoughts of suicide during bupropion oral tablet treatment, call the Suicide and Crisis Lifeline by dialing 988 or tell your doctor right away. You can also refer to this Suicide Prevention Resource Guide for ways to seek support.

To learn more about this boxed warning, talk with your doctor.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek immediate support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.