Dronabinol Oral Solution and Forfivo XL
Determining the interaction of Dronabinol Oral Solution and Forfivo XL and the possibility of their joint administration.
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:Consumer information for this interaction is not currently available.MONITOR CLOSELY: The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics), monoamine oxidase inhibitors, neuroleptic agents, central nervous system stimulants, opioids, tricyclic antidepressants, other tricyclic compounds (e.g., cyclobenzaprine, phenothiazines), systemic steroids, or any substance that can reduce the seizure threshold (e.g., carbapenems, cholinergic agents, fluoroquinolones, interferons, chloroquine, mefloquine, lindane, theophylline). These agents are often individually epileptogenic and may have additive effects when combined. The estimated incidence of seizures is approximately 0.4% for immediate-release bupropion hydrochloride at dosages between 300 to 450 mg/day (equivalent to 348 to 522 mg/day of bupropion hydrobromide), but increases almost tenfold between 450 mg and 600 mg/day (equivalent to 522 and 696 mg/day of bupropion hydrobromide). Data for sustained-release (SR) bupropion hydrochloride revealed a seizure incidence of approximately 0.1% at dosages up to 300 mg/day and 0.4% at 400 mg/day. Likewise, in clinical trials, an overall seizure incidence of approximately 0.1% has been reported with extended-release (XL) bupropion hydrochloride at dosages up to 450 mg/day and approximately 0.39% at 450 mg/day. The 0.4% seizure incidence may exceed that of other marketed antidepressants by as much as 4-fold. MANAGEMENT: Extreme caution is advised if bupropion is administered with any substance that can reduce the seizure threshold, 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). Bupropion as well as concomitant medications should be initiated at the lower end of the dosage range and titrated gradually as needed and as tolerated. The maximum recommended dosage for the specific bupropion formulation should not be exceeded. Bupropion should be discontinued and not restarted in patients who experience a seizure during treatment. References "Product Information. Wellbutrin XL (buPROPion)." GlaxoSmithKline, Philadelphia, PA. Masco HL, Kiev A, Holloman LC, Batey SR, Johnston JA, Lineberry CG "Safety and efficacy of bupropion and nortriptyline in outpatients with depression." Curr Ther Res Clin Exp 55 (1994): 851-63 Sheehan DV, Welch JB, Fishman SM "A case of bupropion-induced seizure." J Nerv Ment Dis 174 (1986): 496-8 "Product Information. Wellbutrin (bupropion)." Glaxo Wellcome, Research Triangle Park, NC. Gittelman DK, Kirby MG "A seizure following bupropion overdose." J Clin Psychiatry 54 (1993): 162 Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink." Pisani F, Spina E, Oteri G "Antidepressant drugs and seizure susceptibility: from in vitro data to clinical practice." Epilepsia 40(Suppl 10) (1999): S48-56 "Product Information. Aplenzin (buPROPion)." sanofi-aventis , Bridgewater, NJ. Dufresne RL, Weber SS, Becker RE "Bupropion hydrochloride." Drug Intell Clin Pharm 18 (1984): 957-64 Johnston JA, Lineberry CG, Ascher JA, et al. "A 102-center prospective study of seizure in association with bupropion." J Clin Psychiatry 52 (1991): 450-6 "Product Information. Zyban (bupropion)." Glaxo Wellcome, Research Triangle Park, NC. "Product Information. Wellbutrin SR (bupropion)." Glaxo Wellcome, Research Triangle Park, NC. James WA, Lippmann S "Bupropion: overview and prescribing guidelines in depression." South Med J 84 (1991): 222-4 Storrow AB "Bupropion overdose and seizure." Am J Emerg Med 12 (1994): 183-4 Rosenstein DL, Nelson JC, Jacobs SC "Seizures associated with antidepressants: a review." J Clin Psychiatry 54 (1993): 289-99 View all 15 references
Professional:MONITOR CLOSELY: The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics), monoamine oxidase inhibitors, neuroleptic agents, central nervous system stimulants, opioids, tricyclic antidepressants, other tricyclic compounds (e.g., cyclobenzaprine, phenothiazines), systemic steroids, or any substance that can reduce the seizure threshold (e.g., carbapenems, cholinergic agents, fluoroquinolones, interferons, chloroquine, mefloquine, lindane, theophylline). These agents are often individually epileptogenic and may have additive effects when combined. The estimated incidence of seizures is approximately 0.4% for immediate-release bupropion hydrochloride at dosages between 300 to 450 mg/day (equivalent to 348 to 522 mg/day of bupropion hydrobromide), but increases almost tenfold between 450 mg and 600 mg/day (equivalent to 522 and 696 mg/day of bupropion hydrobromide). Data for sustained-release (SR) bupropion hydrochloride revealed a seizure incidence of approximately 0.1% at dosages up to 300 mg/day and 0.4% at 400 mg/day. Likewise, in clinical trials, an overall seizure incidence of approximately 0.1% has been reported with extended-release (XL) bupropion hydrochloride at dosages up to 450 mg/day and approximately 0.39% at 450 mg/day. The 0.4% seizure incidence may exceed that of other marketed antidepressants by as much as 4-fold.
MANAGEMENT: Extreme caution is advised if bupropion is administered with any substance that can reduce the seizure threshold, 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). Bupropion as well as concomitant medications should be initiated at the lower end of the dosage range and titrated gradually as needed and as tolerated. The maximum recommended dosage for the specific bupropion formulation should not be exceeded. Bupropion should be discontinued and not restarted in patients who experience a seizure during treatment.
- "Product Information. Wellbutrin XL (buPROPion)." GlaxoSmithKline, Philadelphia, PA.
- Masco HL, Kiev A, Holloman LC, Batey SR, Johnston JA, Lineberry CG "Safety and efficacy of bupropion and nortriptyline in outpatients with depression." Curr Ther Res Clin Exp 55 (1994): 851-63
- Sheehan DV, Welch JB, Fishman SM "A case of bupropion-induced seizure." J Nerv Ment Dis 174 (1986): 496-8
- "Product Information. Wellbutrin (bupropion)." Glaxo Wellcome, Research Triangle Park, NC.
- Gittelman DK, Kirby MG "A seizure following bupropion overdose." J Clin Psychiatry 54 (1993): 162
- Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink."
- Pisani F, Spina E, Oteri G "Antidepressant drugs and seizure susceptibility: from in vitro data to clinical practice." Epilepsia 40(Suppl 10) (1999): S48-56
- "Product Information. Aplenzin (buPROPion)." sanofi-aventis , Bridgewater, NJ.
- Dufresne RL, Weber SS, Becker RE "Bupropion hydrochloride." Drug Intell Clin Pharm 18 (1984): 957-64
- Johnston JA, Lineberry CG, Ascher JA, et al. "A 102-center prospective study of seizure in association with bupropion." J Clin Psychiatry 52 (1991): 450-6
- "Product Information. Zyban (bupropion)." Glaxo Wellcome, Research Triangle Park, NC.
- "Product Information. Wellbutrin SR (bupropion)." Glaxo Wellcome, Research Triangle Park, NC.
- James WA, Lippmann S "Bupropion: overview and prescribing guidelines in depression." South Med J 84 (1991): 222-4
- Storrow AB "Bupropion overdose and seizure." Am J Emerg Med 12 (1994): 183-4
- Rosenstein DL, Nelson JC, Jacobs SC "Seizures associated with antidepressants: a review." J Clin Psychiatry 54 (1993): 289-99
Generic Name: dronabinol
Brand name: Marinol, Syndros
Synonyms: Dronabinol
Generic Name: bupropion
Brand name: Aplenzin, Budeprion XL, Forfivo XL, Wellbutrin XL, Buproban, Wellbutrin SR, Zyban, Zyban Advantage Pack
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.
- Dronabinol Oral Solution-Formerly available as Dalmane
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- Dronabinol Oral Solution-Formoterol
- Dronabinol Oral Solution-Formoterol and glycopyrrolate
- Dronabinol Oral Solution-Formoterol and mometasone
- Dronabinol Oral Solution-Formoterol Capsules for Inhalation
- Forfivo XL-Dronedarone
- Forfivo XL-Dronedarone Hydrochloride
- Forfivo XL-Droperidol
- Forfivo XL-Droperidol Injection
- Forfivo XL-Drospirenone
- Forfivo XL-Drospirenone and estradiol