Uses of Depnox SR: - Depression - Smoking addiction Depression, smoking cessation 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. Bupropion Hydrochloride is contraindicated in patients who have shown an allergic response to Bupropion or the other ingredients that make up Bupropion Hydrochloride.

Atypical anti-depressant drugs

Bupropion is a selective inhibitor of the neuronal re-uptake of catecholamines (noradrenaline and dopamine) with minimal effect on the re-uptake of indolamines (serotonin) and does not inhibit monoamine oxidase. While the mechanism of action of bupropion, as with other antidepressants is unknown, it is presumed that this action is mediated by noradrenergic and/or dopaminergic mechanisms.

How to use Bupropion Hydrochloride: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Bupropion Hydrochloride may be taken with or without food, but it is better to take it at a fixed time. Administration: Swallow extended/sustained-release tablets whole; do not chew, crush, or split; this may lead to adverse effects including seizures Adult Dose: Oral Smoking cessation Adult: Modified-release preparation: Initially, 150 mg once daily for 6 days then increased to 150 mg bid. Period of treatment: 7-12 wk. To discontinue treatment if abstinence is not achieved by 7th wk. Max: 300 mg/day. Elderly: 150 mg/day. Hepatic impairment: Mild to moderate: 150 mg once daily. Severe hepatic cirrhosis: Contraindicated. Depression Adult: Initially, 100 mg bid increased to 100 mg tid after 3 days if necessary. Increased further to 150 mg tid if no improvement has been observed after several wk of therapy. Max: 150 mg tid. As a modified-release preparation: 150 mg once daily in the morning, increased to 150 mg bid after 3 days if necessary, may further increase to 200 mg bid after several wk if needed. Max: 450 mg as a single dose. Elderly: As immediate-release tab: Initially, 37.5 mg bid. As sustained-release tab: Initially, 100 mg daily. Dose may be increased by 37.5-100 mg every 3-4 days as tolerated. Max: 300 mg daily in divided doses. Hepatic impairment: Mild to moderate: Reduce dose or dosing frequency. Severe: As immediate-release preparation: Max: 75 mg once daily. As modified-release preparation: Max: 100 mg once daily or 150 mg every other day. Renal Dose: Renal impairment: Use caution; consider dose reduction

Neuroleptics, lithium and TCAs, benzodiazepine, alcohol, drugs that lower seizure threshold. Increased risk of side effects when co-admin with levodopa. Reduced hepatic clearance with fluoxetine. Caution when administering with agents that will affect hepatic drug metabolizing enzymes. Increased risk of toxicity when used with ritonavir. Potentially Fatal: Concurrent use with MAO inhibitors may cause acute toxicity symptoms and increased risk of fatality.

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. Bupropion Hydrochloride is contraindicated in patients who have shown an allergic response to Bupropion or the other ingredients that make up Bupropion Hydrochloride.

Common - Insomnia (difficulty in sleeping) - Allergic reaction - Impaired concentration - Sweating - Headache - Nausea - Vomiting - Dizziness - Dryness in mouth - Taste change - Abdominal pain - Agitation - Anxiety - Fever - Constipation - Tremor >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

Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed.Lactation: Bupropion and its metabolites are secreted in human milk. Because Bupropion is excreted in human milk, a decision should be made whether to discontinue breast feeding or to discontinue the drug.

Precaution: It should be used with extreme caution, in patients with history of seizure disorders or in patients with other predisposing factors such as severe hepatic cirrhosis or a CNS tumour, and in those undergoing abrupt withdrawal from alcohol or Benzodiazepines. The use of Bupropion in patients with other risk factors for seizures (for example, alcohol abuse, a history of head trauma, diabetes, and drugs known to lower the seizure threshold) should only be undertaken when there are compelling clinical reasons. Bupropion should be used with caution in patients with bipolar depression or psychoses and in patients with a recent history of myocardial infarction or unstable heart disease and in hepatic or renal impairment. Lactation: Enters breast milk; use caution

Symptoms: In addition to those events reported under Adverse Reactions, overdose has resulted in symptoms including drowsiness, loss of consciousness and electrocardiogram (ECG) changes eg, conduction disturbances or (including QRS prolongation) arrhythmias; cases of fatal outcome have been reported.Treatment: In the event of overdose, hospitalisation is advised. ECG and vital signs should be monitored. Ensure an adequate airway, oxygenation and ventilation. The use of activated charcoal is recommended. No specific antidote for bupropion is known. Further management should be as clinically indicated or as recommended by the national poisons centre, where available.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Atypical anti-depressant drugs

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.

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