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What are the side effects of bupropion XL?

What are the side effects of bupropion XL?

Bupropion XL is an antidepressant medication that is the generic version of the brand-name Wellbutrin XL. It is approved by the FDA to treat adults with major depressive disorder (MDD) and seasonal affective disorder (SAD). The active ingredient, bupropion, is also available as an immediate-release and sustained-release tablet. It can be used to treat smoking cessation and other medical conditions.

While it is generally well tolerated, bupropion XL can cause some side effects. However, compared to other medications for depression like SSRIs, bupropion XL is less likely to cause sexual side effects. This is why some people may prefer it over other antidepressants.

Bupropion XL can cause common side effects such as dry mouth and nausea. It may also rarely cause serious side effects such as an increase in the risk of seizures and manic episodes. Your dose of bupropion XL is gradually increased to help reduce your risk of these side effects. Keep reading as we go into more detail about what side effects may occur with bupropion XL and other important information you should know.

What are the most common side effects of bupropion XL?

Most common side effects of bupropion XL

  • Dry mouth

  • Nausea

  • Weight loss

  • Sore throat

  • Anxiety

  • Abdominal pain

  • Sweating

  • Dizziness

  • Trouble sleeping

  • Muscle pain

  • Skin rash

  • Agitation

  • Tremor

  • Ringing in your ears

  • Increased urinary frequency

  • Increased heart rate

Other side effects of bupropion XL

  • Weight gain

  • Blurred vision

  • Constipation

  • Infection

  • Sinusitis (inflammation of your sinuses)

  • Chest pain

  • Vomiting

  • Joint pain

  • Migraine

What are the worst side effects of bupropion XL?

Rarely, bupropion XL may cause some serious side effects, including:

  • Increased risk of seizures, especially at higher doses

  • Increased risk of suicidal thoughts and behaviors, especially in children, adolescents, and young adults

  • Mood changes such as worsening depression, panic attacks, agitation, and anxiety

  • High blood pressure (hypertension)

  • Increased risk of manic episodes (excessive happiness or sadness, racing thoughts, and overactivity)

  • Vision problems including eye pain and blurred vision

  • Serious, sometimes life-threatening allergic reactions (hives, swelling of your face, throat, tongue, or lips, chest pain, and shortness of breath)

Contact your healthcare professional for medical advice about any possible adverse effects you experience while taking bupropion XL. You can report your adverse effects to the U.S. Food and Drug Administration at 1-800-FDA-1088 or www.fda.gov/medwatch. 

Bupropion XL FAQs

How does bupropion XL work?

Bupropion XL is considered an aminoketone or atypical antidepressant. The exact mechanism of action of this medication is not known. However, it is thought to increase the levels of neurotransmitters in your brain including dopamine and norepinephrine. Increasing the levels of these chemicals may help improve your mood and reduce depression symptoms.

What drugs interact with bupropion XL?

When bupropion XL is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the risk of side effects. Some drug interactions with bupropion XL may include:

  • Other medications that increase your risk of seizures. This includes other products containing bupropion, antipsychotics, tricyclic antidepressants (TCAs), theophylline, and systemic corticosteroids.

  • Medications that induce the CYP2B6 enzyme. This includes phenytoin, phenobarbital, ritonavir, efavirenz, carbamazepine, and lopinavir.

  • Medications that are metabolized by the CYP2D6 enzyme such as fluoxetine, sertraline, paroxetine, venlafaxine, nortriptyline, risperidone, desipramine, haloperidol, metoprolol, thioridazine, propafenone, and flecainide.

  • Monoamine oxidase inhibitors (MAOIs) such as phenelzine, isocarboxazid, and selegiline

  • Anticoaglulants such as ticlopidine or clopidogrel

Who should not take bupropion XL?

You should not take bupropion XL if you are allergic to bupropion or any of the inactive ingredients in the product’s formulation. You should also avoid this medication if you:

  • Have a seizure disorder.

  • Have a current diagnosis or history of anorexia or bulimia.

  • Are undergoing an abrupt discontinuation of alcohol, barbiturates, benzodiazepines, or medications used to treat seizures.

  • Have taken an MAOI within the last 14 days.

Bupropion XL also carries a boxed warning from the FDA that states there is an increased risk of suicidal thinking and behaviors in children, adolescents, and young adults taking antidepressants. You should be monitored for new or worsening suicidal thoughts and behaviors while on this medication.

What should you tell your healthcare provider before starting bupropion XL?

You should be sure that your healthcare provider is aware of all your medical conditions, such as:

  • A seizure disorder or if you have a medical condition that increases your risk of seizures such as a head injury, eating disorder (anorexia or bulimia), or brain tumor

  • Pregnant, plan on becoming pregnant

  • Are breastfeeding, as bupropion XL is found in breast milk

  • Using an MAOI inhibitor such as linezolid, phenelzine, selegiline, or tranylcypromine within 14 days of starting bupropion XL

  • Drink alcohol, use illicit street drugs or sedatives such as barbiturates or benzodiazepines

  • Personal or family history of angle-closure glaucoma

  • High blood pressure, previous heart attack, heart disease, or irregular heartbeat

  • History of bipolar disorder or other mental health disorder

  • Diabetes or kidney disease

  • Liver disease

  • Are taking Zyban for smoking cessation or other medications that contain bupropion hydrochloride

What time should I take bupropion XL?

Bupropion XL is an extended-release tablet that is only taken once a day in the morning. It should be taken around the same time each morning for the best results. You can take bupropion XL with or without food. If you experience nausea or upset stomach when taking bupropion XL, take it with a meal or snack.

How long does it take bupropion XL to start working?

Most people taking bupropion XL for depression will see some improvements in their symptoms within the first 2 weeks of treatment. However, it typically takes between 6 to 8 weeks before you see the full benefits of this medication. The signs that bupropion XL is working for you include improved mood, decreased feelings of hopelessness or sadness, increased energy, better sleep habits, increased appetite, and more interest in daily activities.

Does bupropion XL cause false positives on a drug test?

Although drug tests are typically very accurate, you can sometimes get a false positive result due to the medications you are taking. Bupropion XL is a medication that can cause a false positive on a urine drug screen.

Bupropion XL is known to cause a false positive result for methamphetamine or amphetamines. This includes amphetamines such as Vyvanse (lisdexamfetamine) and Adderall (mixed amphetamine salts) that are prescribed to treat ADHD. Contact your healthcare provider if you think you have a false positive result on a drug test. 

Does bupropion XL cause withdrawal symptoms?

You should not change your dose of bupropion XL or stop taking this medication without discussing it with your healthcare provider first. Abruptly stopping antidepressants such as bupropion XL can cause your depression symptoms to come back or worsen.

Stopping bupropion XL “cold turkey” may also lead to discontinuation syndrome. This can cause you to experience a variety of flu-like symptoms such as headache, nausea, vomiting, and muscle aches. You may also have increased agitation, anxiety, and trouble sleeping. If you need to stop taking bupropion XL, your healthcare provider can help you gradually taper off.

How do you store bupropion XL?

Store bupropion XL at room temperature between 59°F to 86°F (15°C to 30°C). Keep it in its tightly closed container, out of direct sunlight, and out of the reach of children.

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