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

Suicidality and Antidepressant Drugs
Use in Treating Psychiatric Disorders:
WARNINGS: Clinical Worsening and Suicide Risk in Treating Psychiatric DisordersPRECAUTIONS: Information for PatientsPRECAUTIONS: Pediatric Use
Use in Smoking Cessation Treatment:

Advise patients and caregivers that the patient using bupropion for smoking cessation should stop taking bupropion and contact a healthcare provider immediately if agitation, hostility, depressed mood, or changes in thinking or behavior that are not typical for the patient are observed, or if the patient develops suicidal ideation or suicidal behavior
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
PRECAUTIONS: Drug Interactions



Elimination


Populations Subgroups


Hepatic

WARNINGSPRECAUTIONSDOSAGE AND ADMINISTRATION

Renal
PRECAUTIONS: 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







All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases.


Families and caregivers of patients being treated with antidepressants for major depressive disorder or other indications, both psychiatric and nonpsychiatric, should be alerted about the need to monitor patients for the emergence of agitation, irritability, unusual changes in behavior, and the other symptoms described above, as well as the emergence of suicidality, and to report such symptoms immediately to healthcare providers. Such monitoring should include daily observation by families and caregivers.

Neuropsychiatric Symptoms and Suicide Risk in Smoking Cessation Treatment
BOXED WARNINGADVERSE REACTIONSThese have included changes in mood (including depression and mania), psychosis, hallucinations, paranoia, delusions, homicidal ideation, hostility, agitation, aggression, anxiety, and panic, as well as suicidal ideation, suicide attempt, and completed suicide.


Advise patients and caregivers that the patient using bupropion for smoking cessation should stop taking bupropion and contact a healthcare provider immediately if agitation, depressed mood, or changes in behavior or thinking that are not typical for the patient are observed, or if the patient develops suicidal ideation or suicidal behavior. In many postmarketing cases, resolution of symptoms after discontinuation of ZYBAN was reported, although in some cases the symptoms persisted, therefore, ongoing monitoring and supportive care should be provided until symptoms resolve.


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 hydrochloride tablets 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



CLINICAL PHARMACOLOGY: Metabolism




Drugs Metabolized by Cytochrome P450IID6 (CYP2D6)




MAO Inhibitors
CONTRAINDICATIONS

Levodopa and Amantadine


Drugs that Lower Seizure Threshold
WARNINGS

Nicotine Transdermal System
PRECAUTIONS: Cardiovascular Effects

Alcohol
CONTRAINDICATIONS

CARCINOGENESIS & MUTAGENESIS & IMPAIRMENT OF FERTILITY





PREGNANCY

Teratogenic Effects

Pregnancy Category C

When rats were administered bupropion at oral doses of up to 300 mg/kg/day (approximately 7 times the MRHD on a mg/m2 basis) prior to mating and throughout pregnancy and lactation, there were no apparent adverse effects on offspring development.
One study has been conducted in pregnant women. This retrospective, managed-care database study assessed the risk of congenital malformations overall and cardiovascular malformations specifically, following exposure to bupropion in the first trimester compared to the risk of these malformations following exposure to other antidepressants in the first trimester and bupropion outside of the first trimester. This study included 7,005 infants with antidepressant exposure during pregnancy, 1,213 of whom were exposed to bupropion in the first trimester. The study showed no greater risk for congenital malformations overall or cardiovascular malformations specifically, following first trimester bupropion exposure compared to exposure to all other antidepressants in the first trimester, or bupropion outside of the first trimester. The results of this study have not been corroborated. Bupropion hydrochloride tablets should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

LABOR & DELIVERY



NURSING MOTHERS



PEDIATRIC USE

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

GERIATRIC USE


CLINICAL PHARMACOLOGY
PRECAUTIONS: Renal ImpairmentDOSAGE AND ADMINISTRATION

BUPROPION HYDROCHLORIDE ADVERSE REACTIONS

WARNINGSPRECAUTIONS



WARNINGSPRECAUTIONS

*
*
Other Events Observed During the Development of Bupropion Hydrochloride Tablets
WARNINGSPRECAUTIONS


Cardiovascular


Dermatologic


Endocrine


Gastrointestinal


Genitourinary


Hematologic/Oncologic


Musculoskeletal


Neurological
WARNINGS


Neuropsychiatric
PRECAUTIONS


Oral Complaints


Respiratory


Special Senses


Nonspecific


Postintroduction Reports


Body (General)
PRECAUTIONS

Cardiovascular
PRECAUTIONS

Endocrine


Gastrointestinal


Hemic and Lymphatic


Musculoskeletal


Nervous


Skin and Appendages


Special Senses


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














SPL MEDGUIDE






  • ●     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



  • ●     Seizures. There is a chance of having a seizure (convulsion, fit) with bupropion hydrochloride tablets, especially in people:
  • ●               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 hydrochloride tablets. 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 reaction to bupropion hydrochloride tablets. Stop taking bupropion hydrochloride tablets 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 hydrochloride tablets, 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 SR Sustained-Release Tablets or Wellbutrin XL Extended-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 hydrochloride tablets can harm your unborn baby.
  • ●     are breastfeeding. Bupropion hydrochloride tablets passes through your milk. It is not known if bupropion hydrochloride 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 hydrochloride tablets.

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

  • ●     Do not drink a lot of alcohol while taking bupropion hydrochloride tablets. 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 hydrochloride tablets affects you. Bupropion hydrochloride tablets 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 hydrochloride tablets for a condition for which it was not prescribed. Do not give bupropion hydrochloride tablets to other people, even if they have the same symptoms you have. It may harm them. Keep bupropion hydrochloride tablets out of the reach of children.














PACKAGE LABEL.PRINCIPAL DISPLAY PANEL SECTION






















Bupropion Hydrochloride

Bupropion Hydrochloride

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL















Bupropion Hydrochloride

Bupropion Hydrochloride TABLET

Product Information

Product Type Human prescription drug label Item Code (Source) NDC:49349-497(NDC:0781-1064)
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
cellulose, microcrystalline
FD&C BLUE NO. 2
FD&C RED NO. 40
HYPROMELLOSE 2910 (15 MPA.S)
potassium chloride
STARCH, CORN
STEARIC ACID
titanium dioxide
TRIETHYL CITRATE

Product Characteristics

Color Size Imprint Code Shape
purple 11 mm GG930 ROUND

Packaging

# Item Code Package Description Marketing Start Date Marketing End Date
1 NDC:49349-497-02 30 in 1 BLISTER PACK
2 NDC:49349-497-24 200 in 1 BLISTER PACK

Marketing Information

Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
ANDA ANDA075584 2011-08-18


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Be sure to consult your doctor before taking any medication!
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