Bupropion Hydrochloride description, usages, side effects, indications, overdosage, supplying and lots more!

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Bupropion Hydrochloride

REMEDYREPACK INC.


FULL PRESCRIBING INFORMATION: CONTENTS*




FULL PRESCRIBING INFORMATION

BOXED WARNING



WARNINGS: Clinical Worsening and Suicide Risk in Treating Psychiatric DisordersPRECAUTIONS: Information for PatientsPRECAUTIONS: Pediatric Use



WARNINGS: Neuropsychiatric Symptoms and Suicide Risk in Smoking Cessation TreatmentPRECAUTIONS: Information for Patients

BUPROPION HYDROCHLORIDE DESCRIPTION


Bupropion Hydrochloride



CLINICAL PHARMACOLOGY


Pharmacodynamics




Pharmacokinetics


Absorption


Distribution


Metabolism

PRECAUTIONS: Drug Interactions



Elimination


Populations Subgroups


Hepatic

WARNINGSPRECAUTIONSDOSAGE AND ADMINISTRATION

Renal
PRECAUTIONS: General: Renal Impairment

Left Ventricular Dysfunction


Age
PRECAUTIONS: Geriatric Use

Gender


Smokers


INDICATIONS & USAGE

WARNINGS




BUPROPION HYDROCHLORIDE CONTRAINDICATIONS








WARNINGS


Clinical Worsening and Suicide Risk in Treating Psychiatric Disorders











Neuropsychiatric Symptoms and Suicide Risk in Smoking Cessation Treatment
BOXED WARNINGADVERSE REACTIONS





Screening Patients for Bipolar Disorder


Bupropion-Containing Products


Seizures





  • ●     Patient factors: Predisposing factors that may increase the risk of seizure with bupropion use include history of head trauma or prior seizure, central nervous system (CNS) tumor, the presence of severe hepatic cirrhosis, and concomitant medications that lower seizure threshold.
  • ●     Clinical situations: Circumstances associated with an increased seizure risk include, among others, excessive use of alcohol or sedatives (including benzodiazepines); addiction to opiates, cocaine, or stimulants; use of over-the-counter stimulants and anorectics; and diabetes treated with oral hypoglycemics or insulin.
  • ●     Concomitant medications: Many medications (e.g., antipsychotics, antidepressants, theophylline, systemic steroids) are known to lower seizure threshold.

Recommendations for Reducing the Risk of Seizure

  • ●     the total daily dose of bupropion does not exceed 450 mg,
  • ●     the daily dose is administered 3 times daily, with each single dose not to exceed 150 mg to avoid high peak concentrations of bupropion and/or its metabolites, and;
  • ●     the rate of incrementation of dose is very gradual.


Hepatic Impairment
CLINICAL PHARMACOLOGYPRECAUTIONSDOSAGE AND ADMINISTRATION

Potential for Hepatotoxicity


PRECAUTIONS

General

Agitation and Insomnia


Psychosis, Confusion, and Other Neuropsychiatric Phenomena


Activation of Psychosis and/or Mania


Altered Appetite and Weight


Allergic Reactions



Cardiovascular Effects




Hepatic Impairment

CLINICAL PHARMACOLOGYWARNINGSDOSAGE AND ADMINISTRATION

Renal Impairment


INFORMATION FOR PATIENTS




Clinical Worsening and Suicide Risk in Treating Psychiatric Disorders


Neuropsychiatric Symptoms and Suicide Risk in Smoking Cessation Treatment


Bupropion-Containing Products








LABORATORY TESTS



DRUG INTERACTIONS







Drugs Metabolized by Cytochrome P450IID6 (CYP2D6)



MAO Inhibitors
CONTRAINDICATIONS

Levodopa and Amantadine


Drugs that Lower Seizure Threshold
WARNINGS

Nicotine Transdermal System
PRECAUTIONS: General: Cardiovascular Effects

Alcohol
CONTRAINDICATIONS

CARCINOGENESIS & MUTAGENESIS & IMPAIRMENT OF FERTILITY





PREGNANCY

Teratogenic Effects. Pregnancy Category C




LABOR & DELIVERY



NURSING MOTHERS



PEDIATRIC USE

BOX WARNINGWARNINGS: Clinical Worsening and Suicide Risk in Treating Psychiatric Disorders

GERIATRIC USE


CLINICAL PHARMACOLOGY
PRECAUTIONS: General: Renal ImpairmentDOSAGE AND ADMINISTRATION

BUPROPION HYDROCHLORIDE ADVERSE REACTIONS

WARNINGSPRECAUTIONS



WARNINGSPRECAUTIONS

*
*
Other Events Observed During the Development of Bupropion
WARNINGSPRECAUTIONS








WARNINGS
Neuropsychiatric: (SeePRECAUTIONS
Oral Complaints: Frequent was stomatitis; infrequent were toothache, bruxism, gum irritation, and oral edema; rare was glossitis.
Respiratory: Infrequent were bronchitis and shortness of breath/dyspnea; rare were epistaxis, rate or rhythm disorder, pneumonia, and pulmonary embolism.
Special Senses: Infrequent was visual disturbance; rare was diplopia.
Nonspecific: Frequent were flu-like symptoms; infrequent was nonspecific pain; rare were body odor, surgically related pain, infection, medication reaction, and overdose.

Postintroduction Reports
Voluntary reports of adverse events temporally associated with bupropion that have been received since market introduction and which may have no causal relationship with the drug include the following:
Body (General): arthralgia, myalgia, and fever with rash and other symptoms suggestive of delayed hypersensitivity. These symptoms may resemble serum sickness (seePRECAUTIONS).
Cardiovascular: hypertension (in some cases severe, seePRECAUTIONS), orthostatic hypotension, third degree heart block
Endocrine: syndrome of inappropriate antidiuretic hormone secretion, hyperglycemia, hypoglycemia
Gastrointestinal: esophagitis, hepatitis, liver damage
Hemic and Lymphatic: ecchymosis, leukocytosis, leukopenia, thrombocytopenia. Altered PT and/or INR, infrequently associated with hemorrhagic or thrombotic complications, were observed when bupropion was coadministered with warfarin.
Musculoskeletal: arthralgia, myalgia, muscle rigidity/fever/rhabdomyolysis, muscle weakness
Nervous: aggression, coma, completed suicide, delirium, dream abnormalities, paranoid ideation, paresthesia, restlessness, suicide attempt, unmasking of tardive dyskinesia
Skin and Appendages: Stevens-Johnson Syndrome, angioedema, exfoliative dermatitis, urticaria
Special Senses: tinnitus, increased intraocular pressure

DRUG ABUSE AND DEPENDENCE

Humans




Animals


OVERDOSAGE

Human Overdose Experience



Overdosage Management





DOSAGE & ADMINISTRATION


General Dosing Considerations
WARNINGS


Usual Dosage for Adults




Increasing the Dosage Above 300 mg/day


Maintenance Treatment


Dosage Adjustment for Patients with Impaired Hepatic Function
CLINICAL PHARMACOLOGYWARNINGSPRECAUTIONS

Dosage Adjustment for Patients with Impaired Renal Function
CLINICAL PHARMACOLOGYPRECAUTIONS

HOW SUPPLIED













STORAGE AND HANDLING






SPL MEDGUIDE


MEDICATION GUIDE BUPROPION HYDROCHLORIDE TABLETS, USP




  • ●     all risks and benefits of treatment with antidepressant medicines
  • ●     all treatment choices for depression or other serious mental illness




  • ●               Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant medicine is started or when the dose is changed.
  • ●               Call the healthcare provider right away to report new or sudden changes in mood, behavior, thoughts, or feelings.
  • ●               Keep all follow-up visits with the healthcare provider as scheduled. Call the healthcare provider between visits as needed, especially if you have concerns about symptoms.

  • ●     thoughts about suicide or dying
  • ●     attempts to commit suicide
  • ●     new or worse depression
  • ●     new or worse anxiety
  • ●     feeling very agitated or restless
  • ●     panic attacks
  • ●     trouble sleeping (insomnia)
  • ●     new or worse irritability
  • ●     acting aggressive, being angry, or violent
  • ●     acting on dangerous impulses
  • ●     an extreme increase in activity and talking (mania)
  • ●     other unusual changes in behavior or mood

  • ●     Never stop an antidepressant medicine without first talking to a healthcare provider. Stopping an antidepressant medicine suddenly can cause other symptoms.
  • ●     Antidepressants are medicines used to treat depression and other illnesses. It is important to discuss all the risks of treating depression and also the risks of not treating it. Patients and their families or other caregivers should discuss all treatment choices with the healthcare provider, not just the use of antidepressants.
  • ●     Antidepressant medicines have other side effects. Talk to the healthcare provider about the side effects of the medicine prescribed for you or your family member.
  • ●     Antidepressant medicines can interact with other medicines. Know all of the medicines that you or your family member takes. Keep a list of all medicines to show the healthcare provider. Do not start new medicines without first checking with your healthcare provider.
  • ●     Not all antidepressant medicines prescribed for children are FDA approved for use in children. Talk to your child's healthcare provider for more information.






  • ●     thoughts about suicide or dying
  • ●     attempts to commit suicide
  • ●     new or worse depression
  • ●     new or worse anxiety
  • ●     panic attacks
  • ●     feeling very agitated or restless
  • ●     acting aggressive, being angry, or violent
  • ●     acting on dangerous impulses
  • ●     an extreme increase in activity and talking (mania)
  • ●     abnormal thoughts or sensations
  • ●     seeing or hearing things that are not there (hallucinations)
  • ●     feeling people are against you (paranoia)
  • ●     feeling confused
  • ●     other unusual changes in behavior or mood




  • ●     with certain medical problems.
  • ●     who take certain medicines.


  • ●     High blood pressure (hypertension). Some people get high blood pressure, that can be severe, while taking bupropion. The chance of high blood pressure may be higher if you also use nicotine replacement therapy (such as a nicotine patch) to help you stop smoking.
  • ●     Severe allergic reactions: Some people have severe allergic reactions to bupropion. Stop taking bupropion and call your doctor right away if you get a rash, itching, hives, fever, swollen lymph glands, painful sores in the mouth or around the eyes, swelling of the lips or tongue, chest pain or have trouble breathing. These could be signs of a serious allergic reaction.
  • ●     Unusual thoughts or behaviors. Some patients have unusual thoughts or behaviors while taking bupropion, including delusions (believe you are someone else), hallucinations (seeing or hearing things that are not there), paranoia (feeling that people are against you) or feeling confused. If this happens to you, call your doctor.




  • ●     have or had a seizure disorder or epilepsy.
  • ●     are taking ZYBAN(used to help people stop smoking) or any other medicines that contain bupropion hydrochloride, such as WELLBUTRIN SRSustained-Release Tablets or WELLBUTRIN XLExtended-Release Tablets. Bupropion is the same ingredient that is in bupropion hydrochloride tablets, USP.
  • ●     drink a lot of alcohol and abruptly stop drinking, or use medicines called sedatives (these make you sleepy) or benzodiazepines and you stop using them all of a sudden.
  • ●     have taken within the last 14 days medicine for depression called a monoamine oxidase inhibitor (MAOI), such as NARDIL(phenelzine sulfate), PARNATE(tranylcypromine sulfate), or MARPLAN(isocarboxazid).
  • ●     have or had an eating disorder such as anorexia nervosa or bulimia.
  • ●     are allergic to the active ingredient in bupropion hydrochloride tablets, bupropion, or to any of the inactive ingredients. See the end of this leaflet for a complete list of ingredients in bupropion hydrochloride tablets.


  • ●     Tell your doctor about your other medical conditions including if you:
  • ●               are pregnant or plan to become pregnant. It is not known if bupropion can harm your unborn baby.
  • ●               are breast-feeding. Bupropion passes through your milk. It is not known if bupropion can harm your baby.
  • ●               have liver problems, especially cirrhosis of the liver.
  • ●               have kidney problems.
  • ●               have an eating disorder, such as anorexia nervosa or bulimia.
  • ●               have had a head injury.
  • ●               have had a seizure (convulsion, fit).
  • ●               have a tumor in your nervous system (brain or spine).
  • ●               have had a heart attack, heart problems, or high blood pressure.
  • ●               are a diabetic taking insulin or other medicines to control your blood sugar.
  • ●               drink a lot of alcohol.
  • ●               abuse prescription medicines or street drugs.
  • ●     Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Many medicines increase your chances of having seizures or other serious side effects if you take them while you are using bupropion.

  • ●     Take bupropion exactly as prescribed by your doctor.
  • ●     Take bupropion at the same time each day.
  • ●     Take your doses of bupropion at least 6 hours apart.
  • ●     You may take bupropion with or without food.
  • ●     If you miss a dose, do not take an extra tablet to make up for the dose you forgot. Wait and take your next tablet at the regular time. This is very important. Too much bupropion can increase your chance of having a seizure.
  • ●     If you take too much bupropion, or overdose, call your local emergency room or poison control center right away.
  • ●     Do not take any other medicines while using bupropion unless your doctor has told you it is okay.
  • ●     It may take several weeks for you to feel that bupropion is working. Once you feel better, it is important to keep taking bupropion exactly as directed by your doctor. Call your doctor if you do not feel bupropion is working for you.
  • ●     Do not change your dose or stop taking bupropion without talking with your doctor first.

  • ●     Do not drink a lot of alcohol while taking bupropion. If you usually drink a lot of alcohol, talk with your doctor before suddenly stopping. If you suddenly stop drinking alcohol, you may increase your risk of having seizures.
  • ●     Do not drive a car or use heavy machinery until you know how bupropion affects you. Bupropion can impair your ability to perform these tasks.







  • ●     Store bupropion hydrochloride tablets at room temperature. Store out of direct sunlight. Keep bupropion hydrochloride tablets in its tightly closed bottle.

  • ●     Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use bupropion for a condition for which it was not prescribed. Do not give bupropion to other people, even if they have the same symptoms you have. It may harm them. Keep bupropion out of the reach of children.







PACKAGE LABEL.PRINCIPAL DISPLAY PANEL SECTION














Bupropion Hydrochloride

Bupropion Hydrochloride

Bupropion Hydrochloride

Bupropion Hydrochloride TABLET

Product Information

Product Type Human prescription drug label Item Code (Source) NDC:49349-774(NDC:0378-0435)
Route of Administration ORAL DEA Schedule

Active Ingredient/Active Moiety

Ingredient Name Basis of Strength Strength
BUPROPION HYDROCHLORIDE BUPROPION 100 mg

Inactive Ingredients

Ingredient Name Strength
ANHYDROUS LACTOSE
SILICON DIOXIDE
CROSPOVIDONE
HYDROCHLORIC ACID
HYPROMELLOSES
cellulose, microcrystalline
POLYDEXTROSE
polyethylene glycol
STEARIC ACID
titanium dioxide
triacetin
FD&C BLUE NO. 2
FD&C YELLOW NO. 6

Product Characteristics

Color Size Imprint Code Shape
blue 12 mm M;435 ROUND

Packaging

# Item Code Package Description Marketing Start Date Marketing End Date
1 NDC:49349-774-02 30 in 1 BLISTER PACK

Marketing Information

Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
ANDA ANDA075491 2011-09-08


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Be sure to consult your doctor before taking any medication!
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