Bupropion
Mechanism :
Bupropion is a relatively weak inhibitor of the neuronal uptake of norepinephrine, serotonin, and dopamine, and does not inhibit monoamine oxidase.
Indication :
- Attention deficit hypersensitivity disorder
Contraindications :
Contraindicated in patients with a seizure disorder, in patients with a current or prior diagnosis of bulimia or anorexia nervosa, in patients undergoing abrupt discontinuation of alcohol or sedatives, and in patients who have shown an allergic response to bupropion.
Dosing :
Oral: 6-18 years of age: Initial: 3 mg/kg/day or 150 mg/day. Can increase to 6 mg/kg/day or 300 mg/day in 2-3 divided doses.
Adverse Effect :
Dry mouth, tinnitus, insomnia, sweating, anorexia, skin rash and light headedness.
Interaction :
MAO Inhibitors: The acute toxicity of bupropion is enhanced by the MAO inhibitor phenelzine.
Levodopa and Amantadine: Higher incidence of adverse effects is seen.
Drugs that Lower Seizure Threshold: Antipsychotics, antidepressants, theophylline, systemic steroids, etc should be undertaken only with extreme caution.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | 150 mg daily |
| 10-20 | 150 mg daily |
| <10 | 150 mg daily |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in GFR<10 mL/min |
| HD | Not dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Not dialysed. Dose as in GFR<10 mL/min |
| CAV/VVHD | Unlikely to be dialysed. Dose as in GFR=10–20 mL/min |
Hepatic Dose :
Moderate to severe hepatic impairment: Start therapy at a lower dosage and do not exceed 75 mg/day PO.
Mild hepatic impairment: Use dose at reduced level.