Maois
Contraindicated
Database
Hypertensive reaction/serotonin-independent crisis
Do not use within 14 days of an MAOI
Source: Kimi deep-research + Cla
Drug reference
Bupropion
Norepinephrine–dopamine reuptake inhibitor (aminoketone) · Antidepressant, Smoking Cessation Aid
Also known as Bupropion Hydrochloride
START
Depression XL 150 mg AM → 300 mg/day; smoking cessation 150 mg/day ×3 days → 150 mg BID
TYPICAL MAX
450 mg/day (XL); single dose ≤150 mg SR / ≤450 mg XL — minimise seizure risk
STOP IF
Seizure, severe hypertension, suicidality/psychiatric deterioration, severe hypersensitivity
WATCH
Mood/suicidality (esp. <25, early), BP (esp. with nicotine), seizure risk factors, sleep
CDSCO approvedSchedule HATC N06AX12
KDIGO 2024 + manufacturer label
- ONSET
- 5h · absorption (XL)
- PEAK
- 5h · Cmax (XL)
- t½
- 21h · plasma t½
- DURATION
- 1d · once-daily (XL)
EXCRETION
Hepatic CYP2B6; ~87% renal metabolites
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Use only if benefit outweighs risk — possible small cardiac malformation signal; individualise
FDA category + note
Top interactionssee all 12 →
- MaoisContraindicatedDatabaseKimi deep-research + Cla
- AldesleukinSevereDatabaseDDInter
- AlfentanilSevereDatabaseDDInter
- AlimemazineSevereDatabaseDDInter
Available in India
35 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Inhibits noradrenaline and dopamine reuptake (and is a nicotinic acetylcholine receptor antagonist); no significant serotonergic activity — antidepressant and smoking-cessation efficacy without sexual dysfunction/weight gain.
Indications
Major depressive disorderSeasonal affective disorder (prophylaxis)Smoking cessation (Zyban)ADHD; obesity (with naltrexone) — off-label/combination
Dosing
- Adult
- Depression: SR 150 mg AM, increase to 150 mg BID (max 400 mg/day); XL 150 mg AM → 300 mg/day (max 450 mg). Smoking cessation: 150 mg/day ×3 days then 150 mg BID for 7–12 weeks (start 1–2 weeks before quit date).
- Pediatric
- Not first-line; specialist only.
- Renal adjustment
- Reduce dose/frequency in renal impairment (active metabolites accumulate); eGFR <30 use lowest dose.
- Hepatic adjustment
- Mild–moderate: reduce dose/frequency. Severe (cirrhosis): max 150 mg every other day.
- Geriatric
- Lower starting dose; reduced clearance.
- Max dose
- 450 mg/day (XL); 400 mg/day (SR)
Pharmacokinetics
Onset
Antidepressant 2–4+ weeks
Peak effect
SR ~3 h; XL ~5 h
Duration
SR BID / XL once daily
Half-life
~21 h (parent); active metabolites longer (hydroxybupropion ~20 h)
Bioavailability
Low absolute (extensive first-pass)
Protein binding
~84%
Metabolism
Hepatic CYP2B6 → active hydroxybupropion; strong CYP2D6 inhibitor
Excretion
Renal (~87% as metabolites; <1% unchanged)
Contraindications
- Seizure disorder
- Current/prior bulimia or anorexia nervosa
- Abrupt discontinuation of alcohol/benzodiazepines/sedatives (seizure risk)
- MAOI within 14 days
- Hypersensitivity to bupropion
Side effects
Common
InsomniaDry mouthHeadacheAgitation/anxietyNausea, tremorReduced appetite
Serious
- Dose-related seizures
- Hypertension (esp. with nicotine patch)
- Neuropsychiatric: suicidality (boxed — young patients), psychosis/mania
- Severe hypersensitivity (serum sickness-like, SJS)
- Angle-closure glaucoma
Pregnancy & lactation
Pregnancy
Use only if benefit outweighs risk — possible small cardiac malformation signal; individualise
Lactation
Excreted in milk; monitor infant (seizure case reports) — use lowest dose, caution
Drug interactions
Aldesleukin
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Alfentanil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Alimemazine
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Amantadine
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Amifampridine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Aminophylline
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amitriptyline
Severe
Database
May increase plasma exposures of TCAs.
The possibility of drug interactions should be kept in mind until the safety of the combination is firmly established.
Source: DDInter
Amoxapine
Severe
Database
May increase plasma exposures of TCAs.
The possibility of drug interactions should be kept in mind until the safety of the combination is firmly established.
Source: DDInter
Amphetamine
Severe
Database
Drug interaction classified as: metabolism.
Source: DDInter
Apalutamide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Aripiprazole
Severe
Database
Increased AUC of parent drug (up to double AUC of parent drug).
Reduce aripiprazole dose by 50%.
Source: DDInter
Related guidelines
Ask House about Bupropion
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19