Bupropion Sustained-Release Tablets (Smoking Deterrent) and Neoral

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using cycloSPORINE together with buPROPion may increase your risk of seizures. This may be more likely to occur in older adults or those with a debilitating condition. Talk to your doctor before using these medications together. You may need a dose adjustment or special tests to safely take these medications together. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: The use of bupropion is associated with a dose-related risk of seizures. The estimated incidence of seizures is approximately 0.1% at dosages up to 300 mg/day and 0.4% at dosages between 300 to 450 mg/day, but increases almost tenfold between 450 mg and 600 mg/day. The risk may also be increased during coadministration of bupropion with other potentially epileptogenic agents such as cyclosporine.

A case report suggests that bupropion may decrease the blood concentrations of cyclosporine. The mechanism of interaction and a causal relationship have not been established. In the report, a 10-year-old heart transplant patient developed a significant and potentially life-threatening reduction in cyclosporine blood levels shortly after initiation of bupropion therapy. The dosage of cyclosporine was subsequently increased but blood levels continued to decline, leading to the withdrawal of bupropion. Four days later cyclosporine levels returned to near previous levels. A drug interaction was suspected, although patient noncompliance could not be ruled out.

MANAGEMENT: Caution is advised if bupropion is administered with cyclosporine, particularly in the elderly and in patients with a history of seizures or other risk factors for seizures (e.g., head trauma; brain tumor; severe hepatic cirrhosis; metabolic disorders; CNS infections; excessive use of alcohol or sedatives; addiction to opiates, cocaine, or stimulants; diabetes treated with oral hypoglycemic agents or insulin). A lower initial dosage of bupropion and gradual dosage increments should be considered in patients receiving the drugs concurrently. The total dose of bupropion should generally not exceed 450 mg/day (or 150 mg every other day in patients with severe hepatic cirrhosis). Bupropion should be discontinued and not restarted in patients who experience a seizure during treatment.

Bupropion Sustained-Release Tablets (Smoking Deterrent)

Generic Name: bupropion

Brand name: Aplenzin, Buproban, Forfivo XL, Wellbutrin SR, Wellbutrin XL, Zyban, Zyban Advantage Pack, Budeprion XL

Synonyms: Bupropion, BuPROPion

What is Bupropion Sustained-Release Tablets (Smoking Deterrent)?

Neoral

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Neoral (Capsules, Modified)

What is Neoral?