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Bupropion Sustained-Release Tablets (Smoking Deterrent) and Phlemex

Determining the interaction of Bupropion Sustained-Release Tablets (Smoking Deterrent) and Phlemex and the possibility of their joint administration.

Check result:
Bupropion Sustained-Release Tablets (Smoking Deterrent) <> Phlemex
Relevance: 28.09.2022 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

BuPROPion may increase the blood levels and effects of dextromethorphan. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience increased side effects or your condition changes. 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.

Professional:

ADJUST DOSE: Coadministration with bupropion may increase the plasma concentrations of drugs that are metabolized by CYP450 2D6 (e.g., selective serotonin reuptake inhibitors; tricyclic antidepressants; some beta blockers, antiarrhythmics, and antipsychotics). The mechanism is decreased clearance due to inhibition of CYP450 2D6 activity by bupropion. Approximately 93% of Caucasians and more than 98% of Asians and individuals of African descent are extensive metabolizers of CYP450 2D6 and may be affected by this interaction. In a study of 15 male volunteers who were extensive metabolizers of CYP450 2D6, administration of a single 50 mg dose of desipramine following treatment with bupropion 150 mg twice daily increased the desipramine peak plasma concentration (Cmax), systemic exposure (AUC) and half-life by an average of 2-, 5-, and 2-fold, respectively. The effect was present for at least 7 days after the last dose of bupropion. A case report describes a 4-fold increase in plasma levels of imipramine and its metabolite, desipramine, in a 64-year-old woman following the addition of bupropion 225 mg/day. Plasma levels of desipramine were increased twofold more than the imipramine levels, which is consistent with the fact that desipramine is primarily metabolized by CYP450 2D6 while imipramine is also metabolized by other CYP450 isoenzymes. In another report, an 83-year-old woman became unsteady, confused, and lethargic following the addition of bupropion SR 300 mg/day. Her nortriptyline level was found to have increased by 185%. A later rechallenge prompted recurrence of the interaction. Likewise, a 62-year-old woman with no history of seizures developed a generalized tonic-clonic seizure in association with toxic trimipramine plasma levels following the addition of bupropion 300 mg/day. No further seizures occurred following dosage reductions of both drugs.

MANAGEMENT: Caution is advised if bupropion must be used concomitantly with medications that undergo metabolism by CYP450 2D6, particularly those with a narrow therapeutic range. Concomitant medications should be initiated at the lower end of the dose range. Clinical and laboratory monitoring may be appropriate for some drugs whenever bupropion is added to or withdrawn from therapy.

References
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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

Phlemex

Generic Name: dextromethorphan / guaifenesin

Brand name: Aquatab DM, Broncotron, Coricidin HBP Chest Congestion & Cough, DayQuil Mucus Control DM, Delsym Cough Plus Chest Congestion DM, Fenesin DM IR, G-Zyncof, Mucinex DM, Phlemex, Robitussin Cough + Chest Congestion DM, Safetussin DM, Siltussin DM, TabTussin DM, Tussin DM, Zyncof, Bidex-A, Guaifenex DM, Biospec DMX, Robitussin DM, Mucinex Cough Mini-Melts, Tussi-Organidin DM-S NR, Tussi-Organidin DM NR, Gani-Tuss-DM NR, Guaibid DM, Muco-Fen DM, Guiadrine DM, Fenex-DM, Iobid DM, Q-Bid DM, Aquabid DM, Touro DM, Respa-DM, Mucobid DM, Fenesin DM, Humibid DM Pediatric, Iofen-DM NF, Phanatuss, Naldecon Senior DX, Guiatussin-DM, Halotussin DM, Guiatuss DM, Halotussin DM Sugar Free, Rhinosyn-DMX, Tuss-DM, Kolephrin GG/DM, Cheracol D Cough, Genatuss DM, Glycotuss-DM, Mytussin DM, Tolu-Sed DM, Benylin Expectorant, Vicks 44E Pediatric, Guiacough DM, Lotussin DM, Anti-Tuss DM, Biotuss DM, Cheracol-D, GG/DM, Mastussin DM, Recofen D, Recofen Plus, Ri-Tussin DM, Robafen DM, Robichem DM, T-Tussin DM, Tusscidin DM, Bidex-DM, Diabetic Suppressant, Duraganidin, G Bid DM, GG-DM SR, Humigen DM, Tussidin DM, Altarussin DM, Amibid DM, Guiat Clear DM, Cough Formula-DM, Double-Tussin DM, Guaiasorb Cough Medicine, Kita La Tos, Q-Tussin DM, Scot-Tussin DM, Nalspan Senior DX, Diabetic Tuss DM, Vicks 44E, Scot-Tussin Senior, Naldecon DX Liquigel, Safetussin 30 DM, Duratuss DM, Guiatuss Clear, Iophen DM NR, Allfen-DM, S-Pack DM, HT Tuss DM, Monafed DM, Hydro-Tuss DM, Drituss DM, Liquibid-D LA, Guaifen DM, Maxi-Tuss DM, Robitussin-SF, Su-Tuss DM, Muco-Fen 800 DM, Guai-Dex, GuaiFENesin DM, GuaiFENesin DM SR, Tussi-Bid, Sudal DM, Iophen DM, Ru-Tuss 800 DM, Mintab DM, Mindal DM, Atuss-12 DX, Z-Cof LA, Extuss LA, DuraDEX, Humibid CS, Diabetic Tuss DM Maximum Strength, Siltussin DM DAS Cough Formula, Simuc-DM, Cofex-DM, Mucus Relief DM, G-Bid DM, Relacon LAX, Ambi 1000/55, Z-Cof LAX, Robafen DM Clear, DuraDEX Forte, Robitussin DM Infant Drops, Zotex DMX, Mucinex Children's Cough, Duratuss DM 12, Robitussin Cough Sugar-Free DM, Dex-Tuss DM, Mucinex DM Maximum Strength, GuaiFENesin DM NR, Children's Mucus Relief Cough, Siltussin-DM DAS-NA, Siltussin-DM DAS-NA Maximum Strength, ExeFen-DM, Bidex-DMI, Mucinex Children's Cough Mini-Melts, Robitussin Cough & Cong, Coricidin HBP Congestion/Cough

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.