Depnox SR Tablet
Bupropion Hydrochloride
150mg
Jayson Pharmaceuticals Ltd.
| Pack size | 30's pack |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 10.10 AED |
Indications
Depnox SR Tablet is used for:
Depression, smoking cessation
Adult Dose
Oral
Smoking cessation
Adult: Modified-release preparation:
Initially 150 mg daily for 6 days, then 150 mg twice daily (max. per dose 150 mg), minimum 8 hours between doses; period of treatment 7–9 weeks, start treatment 1–2 weeks before target stop date, discontinue if abstinence not achieved at 7 weeks, consider maximum 150mg daily in patients with risk factors for seizures;
Maximum 300 mg per day.
Depression
Adult:
Starting dose: 200 mg per day given as 100 mg twice daily
General: Increase dose gradually to reduce seizure risk.
After 3 days, may increase the dose to 300 mg per day, given as 100 mg 3 times daily at an interval of at least 6 hours between doses.
Usual target dose: 300 mg per day as 100 mg 3 times daily.
Maximum dose: 450 mg per day given as 150 mg 3 times daily.
Periodically reassess the dose and need for maintenance treatment.
As a modified-release preparation:
General:
Increase dose gradually to reduce seizure risk.
Periodically reassess the dose and need for maintenance treatment.
Major Depressive Disorder
Starting dose: 150 mg once daily. Usual target dose: 300 mg once daily
After 4 days, may increase the dose to 300 mg once daily.
Seasonal Affective Disorder
Initiate treatment in the autumn prior to onset of seasonal depressive symptoms.
Starting dose: 150 mg once daily.
Usual target dose: 300 mg once daily.
After one week, may increase the dose to 300 mg once daily.
Continue treatment through the winter season
Child Dose
Renal Dose
Renal impairment: Use caution; consider dose reduction
Administration
Swallow extended/sustained-release tablets whole; do not chew, crush, or split; this may lead to adverse effects including seizures
Contra Indications
It is contraindicated in patients with a seizure disorder. Bupropion Hydrochloride is contraindicated in patients treated with other medications that contain Bupropion because the incidence of seizure is dose dependent. Bupropion may induce seizure and consequently its use is contraindicated in patients with epilepsy.
The drug is also contraindicated in patients with a current or prior diagnosis of bulimia or anorexia nervosa because of a higher incidence of seizures noted in such patients treated for bulimia with Bupropion Hydrochloride.
The concurrent administration of Bupropion Hydrochloride and a monoamine oxidase (MAO) inhibitor is contraindicated. At least 14 days should elapse between discontinuation of MAO inhibitor and initiation of treatment with Bupropion Hydrochloride.
Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, antiepileptic drugs.
Bupropion Hydrochloride is contraindicated in patients who have shown an allergic response to Bupropion or the other ingredients that make up Bupropion Hydrochloride.
Precautions
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants.
In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber
Neuropsychiatric Adverse Events During Smoking Cessation:
Postmarketing reports of serious or clinically significant neuropsychiatric adverse events have included changes in mood (including depression and mania), psychosis, hallucinations, paranoia, delusions, homicidal ideation, aggression, hostility, agitation, anxiety, and panic, as well as suicidal ideation, suicide attempt, and completed suicide. Observe patients attempting to quit smoking with Bupropion for the occurrence of such symptoms and instruct them to discontinue Bupropion and contact a healthcare provider if they experience such adverse events.
Seizure Risk: The risk is dose-related. Can minimize risk by limiting daily dose to 450 mg and gradually increasing the dose. Discontinue if seizure occurs.
Hypertension: Bupropion can increase blood pressure.
Activation of Mania/Hypomania: Screen patients for bipolar disorder and monitor for these symptoms.
Psychosis and Other Neuropsychiatric Reactions: Instruct patients to contact a healthcare professional if such reactions occur.
Angle-Closure Glaucoma: Angle-closure glaucoma has occurred in patients with untreated anatomically narrow angles treated with antidepressants
Monitoring Parameters
Monitor for worsening and emergence of suicidal thoughts and behaviors.
Monitor blood pressure before initiating treatment and periodically during treatment.
Pregnancy-Lactation
Pregnancy
Data from epidemiological studies of pregnant women exposed to bupropion in first trimester have not identified an increased risk of congenital malformations overall; there are risks to the mother associated with untreated depression in pregnancy
A prospective, longitudinal study followed 201 pregnant women with a history of major depressive disorder who were euthymic and taking antidepressants during pregnancy at beginning of pregnancy; the women who discontinued antidepressants during pregnancy were more likely to experience a relapse of major depression than women who continued antidepressants; consider risks to the mother of untreated depression and potential effects on tfetus when discontinuing or changing treatment with antidepressant medications during pregnancy and postpartum
Lactation
Data from published literature report presence of drug and its metabolites in human milk; there are no data on effects of bupropion or metabolites on milk production; limited data from postmarketing reports have not identified a clear association of adverse reactions in the breastfed infant; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from underlying maternal condition
Interactions
CYP2B6 inducers: Dose increase may be necessary if coadministered with CYP2B6 inducers (e.g., ritonavir, lopinavir, efavirenz, carbamazepine, phenobarbital, and phenytoin) based on clinical response, but should not exceed the maximum recommended dose.
Drugs metabolized by CYP2D6: Bupropion inhibits CYP2D6 and can increase concentrations of: antidepressants (e.g., venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, sertraline), antipsychotics (e.g., haloperidol, risperidone, thioridazine), beta-blockers (e.g., metoprolol), and Type 1C antiarrhythmics (e.g., propafenone, flecainide).
Consider dose reduction when using with bupropion.
Digoxin: May decrease plasma digoxin levels. Monitor digoxin levels.
Drugs that lower seizure threshold: Dose Bupropion with caution.
Dopaminergic drugs (levodopa and amantadine): CNS toxicity can occur when used concomitantly with Bupropion.
MAOIs: Increased risk of hypertensive reactions can occur when used concomitantly with Bupropion.
Drug-laboratory test interactions: Bupropion can cause false-positive urine test results for amphetamines.
Potentially Fatal: Concurrent use with MAO inhibitors may cause acute toxicity symptoms and increased risk of fatality.
Contraindicated (8)
eliglustat
isocarboxazid
phenelzine
pimozide
rasagiline
selegiline
selegiline transdermal
tranylcypromine
Serious (28)
caffeine
chlorpromazine
clomipramine
clozapine
cyclobenzaprine
duloxetine
escitalopram
fexinidazole
fluoxetine
fluvoxamine
iobenguane I 131
linezolid
lorcaserin
methylene blue
metoclopramide intranasal
milnacipran
nefazodone
olopatadine intranasal
ozanimod
paroxetine
sofpironium topical
tedizolid
theophylline
thioridazine
trazodone
venlafaxine
vortioxetine
zuranolone
Adverse Effects
Side effects of Bupropion Hydrochloride :
>10%
Headache (25-34%),Dry mouth (17-28%),Nausea (1-18%),Weight loss (15-20%),Insomnia (11-20%),Agitation (2-32%),Dizziness (6-22%),Pharyngitis (3-13%)
1-10%
Constipation (5-10%),Infection (8-9%),Abdominal pain (2-9%),Anxiety (5-7%),Diarrhea (5-7%),Tinnitus (3-6%),Tremor (3-6%),Nervousness (3-5%),Anorexia (3-5%),Palpitation (2-6%),Myalgia (2-6%),Sweating (2-5%),Rash (1-5%),Sinusitis (1-5%),Weight gain (4%),Chest pain (3-4%),Urinary frequency (2%),Vaginal hemorrhage (2%),Pruritus (2-4%),Vomiting (2-4%),Arthralgia (1-4%),Flushing (1-4%),Migraine (1-4%),Decreased memory (<3%),Irritability (2-3%),Somnolence (2-3%),Dysphagia (<2%),Arthritis (2%),Paresthesia (1-2%),Fever (1-2%),Twitch (1-2%),Seizures (0.4% [<450 mg/day], >3% [>450 mg/day]; may be increased risk with concomitant ECT)
Frequency Not Defined
Confusion,Cystitis,Erythema,,Ataxia,Coma,EEG abnormality,Euphoria,Gastric reflux
Mechanism of Action
Bupropion HCl is a relatively weak inhibitor of the neuronal uptake of norepinephrine, serotinin and dopamine. The mechanism by which it aids in smoking cessation is presumed to be mediated by its noradrenergic and/or dopaminergic actions.
Note
Depnox 150mg SR Tablet manufactured by Jayson Pharmaceuticals Ltd.. Its generic name is Bupropion Hydrochloride. Depnox is availble in Bangladesh.
Farmaco BD drug index information on Depnox SR Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.