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What to avoid when taking bupropion XL?

What to avoid when taking bupropion XL?

Bupropion XL is an extended-release tablet that is prescribed to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). It is the generic version of the brand name medications Wellbutrin XL and Forfivo XL. Bupropion is also available in an immediate-release and sustained-release tablet approved for depression and smoking cessation. It is sometimes used off-label to treat obesity and ADHD.

Bupropion XL can be an effective treatment option for some people, but it can interact with other foods, beverages, and medications. Drug and food interactions can change how well each medication works or increase your risk of side effects. Some interactions may require you to stop taking one of the interacting medications, while others will just need close monitoring by your doctor.

If you regularly drink alcohol, consume large amounts of caffeine, or take other medications, you should be aware of the potential interactions with bupropion XL.

What foods should you avoid while taking bupropion XL?

Alcohol

It is best to avoid alcohol while you are taking bupropion XL. Drinking alcohol with this medication can increase your risk of side effects such as dizziness, nausea, blurred vision, and headaches. Alcohol abuse and abruptly stopping alcohol consumption have also been associated with seizures. Combining these with bupropion XL increases this risk even more.

Alcohol use can cause symptoms of depression which will decrease the effectiveness of bupropion XL. This can lead to a higher risk of having suicidal thoughts or behaviors.

According to some postmarketing reports, bupropion XL may reduce your alcohol tolerance. This means you may not be able to drink as much as you did when you weren’t taking bupropion XL. This can lead to alcohol poisoning. Call 911 immediately if you suspect alcohol poisoning. Symptoms include confusion, seizures, vomiting, slow or irregular breathing, blue, gray, or pale skin, low body temperature, and trouble staying awake.

Caffeine

Some side effects of Bupropion XL such as irritability, nervousness, trouble sleeping, tremors, and increased blood pressure can worsen if you consume large amounts of caffeine.

Bupropion XL is also associated with a dose-related risk of seizures. The excessive use of caffeine will increase your seizure risk while taking this medication. Many weight loss supplements and over-the-counter medications contain caffeine, so be sure to read the labels carefully. Some common foods and beverages that also contain caffeine include coffee, tea, soda, and energy drinks.

What medications should you avoid while taking bupropion XL?

Medications that lower your seizure threshold

Drugs that make you more likely to have a seizure can significantly increase your risk if taken along with bupropion XL. Your doctor may adjust your dose of bupropion XL or change you to a different antidepressant. Examples of medications that increase your risk of seizures include:

Medications broken down in your liver

Bupropion XL is metabolized (broken down) in your liver by the CYP2B6 enzyme. Other drugs that affect this enzyme can increase or decrease the levels of bupropion XL in your body. Your doctor may need to adjust your dose based on this drug interaction and the effect the other medications have. Some of these medications include:

Bupropion XL also inhibits (blocks) the CYP2D6 enzyme in your liver. This may cause higher levels of other drugs metabolized by this enzyme. Your doctor may need to adjust the dose of the affected meds or discontinue one of them. Some of these medications include:

Monoamine oxidase inhibitors (MAOIs)

Using an MAOI along with bupropion XL can raise your risk of having dangerously high blood pressure and even send you into a life-threatening hypertensive crisis. It is thought that this is because both MAOIs and bupropion XL increase the levels of norepinephrine and dopamine. MAOIs include Emsam (selegiline), Nardil (phenelzine), Marplan (isocarboxazid), ProvayBlue (methylene blue), and Parnate (tranylcypromine). You should never take bupropion XL and an MAOI at the same time or within 14 days of each other.

Medications that increase your dopamine levels

Taking a medication that raises your dopamine levels such as Symmetrel (amantadine) or Sinemet (carbidopa/levodopa) with bupropion XL increases your risk of central nervous system (CNS) toxicity. This can cause symptoms such as tremors, restlessness, agitation, dizziness, and loss of coordination.

Other prescription drugs containing bupropion

If you are taking another product that contains bupropion such as Zyban, you should not start bupropion XL. Taking 2 medications that contain the same active ingredient increases your risk of overdose.

Bupropion XL FAQs

How does bupropion work?

Bupropion XL is an atypical antidepressant. It is sometimes referred to as a norepinephrine and dopamine reuptake inhibitor (NDRI). The exact way bupropion XL works is not fully known. However, it is thought that it increases the activity of certain neurotransmitters in your brain, including dopamine and norepinephrine. This helps improve your mood and relieve the symptoms of SAD or MDD.

What are the possible side effects of taking bupropion XL?

The most common side effects of bupropion XL include:

  • Dry mouth

  • Weight loss

  • Anxiety

  • Nausea

  • Sweating

  • Trouble sleeping

  • Abdominal pain

  • Sore throat

  • Dizziness

  • Muscle pain

  • Ringing in your ears (tinnitus)

  • Skin rash

  • Constipation

What severe side effects are there with bupropion XL?

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

  • Increased risk of suicidal thoughts and behaviors

  • Mood swings or changes such as agitation, panic attacks, or worsening symptoms of depression

  • Extremely high blood pressure

  • Manic episodes (overactivity, excessive happiness or sadness, and racing thoughts), especially in bipolar patients

  • Increased risk of seizures

  • 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. Be sure to read the medication guide and patient information that comes with your medication. You can report any adverse effects to the U.S. Food and Drug Administration at 1-800-FDA-1088 or www.fda.gov/medwatch. 

What should you tell your doctor before starting bupropion XL?

There is an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults taking antidepressants like bupropion XL. Continued monitoring for new or worsening suicidal thoughts and behaviors is important while taking this medication.

You should be sure that your healthcare provider is aware of all your medical conditions, including if you have a history of:

  • A seizure disorder. Bupropion XL should be avoided if you have this condition.

  • An eating disorder such as bulimia or anorexia. You should not take bupropion XL if you currently are struggling with, or have a serious history with an eating disorder.

  • Pregnancy, plan on becoming pregnant, or are breastfeeding.

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

  • History of alcohol abuse.

  • History of illicit substance abuse or are currently taking sedatives such as benzodiazepines.

  • Have a known allergic reaction to bupropion XL or any of the inactive ingredients in its formulation.

  • Personal or family history of angle-closure glaucoma.

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

  • Diabetes.

  • Bipolar disorder or a history of other mental health disorders.

  • Are taking Zyban to help you stop smoking or other medicines that contain bupropion hydrochloride.

  • A brain tumor, head injury, or other condition that increases your risk of seizures.

Can you drink coffee while taking bupropion XL?

Drinking too much coffee can worsen nervousness, irritability, trouble sleeping, increased blood pressure, and tremor sometimes seen with the use of bupropion XL. Drinking excessive amounts of coffee while taking this medication may increase your risk of seizures as well. You should try and limit your coffee intake while on bupropion XL to minimize this risk.

What happens if you overdose on bupropion XL?

If you or someone you know takes too much bupropion XL, seek immediate medical attention as it can be life-threatening. Symptoms of a bupropion XL overdose can include seizures, agitation, increased heart rate and blood pressure, dilated pupils, and arrhythmias.

The extended-release formulation of bupropion can cause delayed seizures for up to 24 hours after taking the medication. The seizures associated with bupropion XL overdose may be single or multiple but are usually quick in onset and only last a short time.

Does bupropion XL cause weight gain?

Bupropion XL may either cause weight loss or weight gain, though weight loss is more common. Short-term use of bupropion may not cause you to gain any weight. Long-term use, however, may lead to changes in your weight.

Bupropion increases dopamine and norepinephrine levels, which play an important role in controlling your appetite. Taking bupropion XL may increase your desire for carbohydrate-rich foods, such as desserts, bread, and pasta. This can lead to weight gain.

What should you do if you miss a dose of bupropion XL?

Do not take an extra tablet to make up for a missed dose of bupropion XL. Skip the dose you missed and go back to your regular dosing schedule.

How should you store bupropion XL tablets?

Store at room temperature between 59°F to 86°F (15°C to 30°C), away from heat, moisture, and direct light.

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