Health
Contraindications and side effects of Bupropion

Discover the contraindications and side effects of Bupropion.
This psychotropic drug is used both to treat depressive symptoms and in tobacco addiction.
A drug belonging to the IRND.
Tobacco is one of the substances with psychoactive effects that have been used the most legally since its discovery.
Even though today smoking is prohibited in establishments and closed public spaces and its price has risen based on taxes, millions of people still have the habit of smoking.
But many of these people, at some point, need to stop. Although it is possible to do it voluntarily, in some cases they may require psychological and even pharmacological help.
In the latter case, one of the existing drugs used to quit smoking is bupropion, a drug that originated as an antidepressant.
What is bupropion?
Bupropion is a well-known antidepressant drug, although more than in its application for depression it is more common and distinctive due to its efficacy in the treatment of tobacco addiction.
In this sense, it is a treatment that does not include nicotine and that is recommended together with some type of therapy or psychological treatment.
This shows that psychotropic drugs are not designed following a plan from scratch, but rather that there is a certain process of trial and error in their development, and that sometimes there are benefits for the drug that were not even taken into account at first.
Bupropion is a specific dopamine and norepinephrine reuptake inhibitor, or NRDI , that works by increasing the levels of these neurotransmitters in the brain.
Compared with other drugs in the group of antidepressants, bupropion has the advantage of not causing sexual dysfunctions, although, on the other hand, its effectiveness alone seems less compared to other drugs on the market.
Thus, bupropion is an example that molecules related to other substances used for a certain class of disorder may be more useful in different health conditions, no matter how similar their structure is.
Mechanism of action
The function of bupropion and its mechanism of action is based on its role as a selective inhibitor of dopamine and norepinephrine reuptake.
This implies that bupropion works by preventing these two transmitters (associated with gratification and energy) from being re-uploaded by the presynaptic neuron, in such a way that they are available to postsynaptic neurons for a longer time.
Furthermore, it appears to stimulate the secretion of these neurotransmitters.
Thus, dopamine and norepinephrine levels and their transport increase at the brain level, something that can alter the mood.
Likewise, it has also been observed that it has an effect at the level of acetylcholine, binding to nicotinic receptors and exerting a non-competitive antagonistic effect.
Although there is no total security for this, this element is one of the possible explanations for its role in smoking cessation.
However, it must be taken into account that the exact way in which the mechanism of action of bupropion and psychotropic drugs in general works is still unknown.
Its use does not guarantee that it will work to alleviate the symptoms of the disorder to be treated, and its efficacy is only slightly better than that of a placebo.
That does not mean that in many cases it is very useful, simply that the percentage of patients who try this treatment and do not obtain any benefit is relatively high.
Indications: uses in disorders
Bupropion is a drug that has had various uses throughout its history. Although it was born as an antidepressant and today it is still used to treat this condition both as monotherapy (single therapy) and combined therapy (more common, to enhance some specific antidepressants when first-line drugs are not effective), the truth is is that by itself it is generally considered less effective than other antidepressants.
Where this drug stands out and has the greatest use is in smoking cessation, being effective in reducing the consumption habit and the urge to smoke.
In this sense, its mechanism of action seems to contribute to stopping craving (possibly due, on the one hand, to its antagonism of nicotinic receptors and its interaction with brain dopamine, although the exact mechanism is not fully known).
Another disorder in which it is used is seasonal affective disorder, in which depressive episodes appear associated with certain times of the year.
In addition to the above, it has sometimes been used in the treatment of bipolar disorder, especially during the depressive episodes that can occur in this disorder (although this use requires caution since there is a risk of turning the disorder into a manic crisis).
Also in ADHD. But in any case, further research is required and possible risks must be taken into account.
Side effects of Bupropion
Bupropion is a drug that is very useful in smoking cessation and is used in cases of depression, but as with other drugs, its clinical utility is not free of risks and possible side effects.
This occurs because the active substance in bupropion affects many areas of the body, not just the areas that could produce an improvement in symptoms.
This unwanted interaction generates a chain reaction of consequences to some extent unpredictable, which can lead to new health disorders (although they tend to disappear as the substance leaves the body). Therefore, its use should always be supervised and indicated by doctors.
In this sense, among the main side effects of bupropion, we can find the cause of insomnia (being one of the most frequent), dry mouth and dizziness, headaches, nausea, constipation, rapid heartbeat, tremors, skin rashes, agitation, and nervousness. It can also cause a decrease in appetite.
In more serious cases it can generate seizures (this being one of the most well-known serious risks), arrhythmias, hallucinations, panic or difficulties in breathing or feeding, or inflammations being necessary to see a doctor. In some cases, it can cause irritability, hostility, depression, suicidal thoughts.
Contraindications of Bupropion
In addition to these side effects, this drug is contraindicated in some sections of the population.
People who are allergic to it or any of its components (something obvious on the other hand), those who consume certain medications (especially MAOS), dependence on substances other than tobacco (such as alcohol, drugs, and pharmaceuticals), and those who suffer from epilepsy, brain tumors and anorexia nervosa or bulimia (since it reduces the appetite).
It is also not recommended, although it can sometimes be used if the benefits are considered greater than the risks, in cases of people with kidney or liver failure, head trauma, insomnia, or the use of other medications that may interact with bupropion.
Diabetics, alcoholics, hypertensive or people with psychiatric disorders (since it can contribute to the appearance of mania in bipolar or psychotic crisis in schizophrenia, among others) also have it contraindicated (or at least the treatment should be done with a high level of control of the patient’s condition and the doses administered) due to the risk of seizures and other side effects.
Finally, it is not recommended for pregnant and lactating women either
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Health
Serious side effects of metoprolol

- Discover the serious side effects of metoprolol.
- How does this medication work? What are its effects?
- Metoprolol belongs to the class of medications called beta-blockers. Metoprolol is used to treat high blood pressure and prevent symptoms of certain types of angina ( chest pain). It is also used to reduce the risk of death immediately after a heart attack. It works by reducing the needs of the heart during exercise.
- People who have had a heart attack take metoprolol to avoid having another heart attack. Metoprolol is often used in combination with other drugs that lower high blood pressure, such as diuretics (pills that increase urine output), when just one agent is not enough to control blood pressure.
- This medicine is available under various brand names or in different formulations, or both. A specific brand of this medication may not be available in all forms and may not have been approved for all of the conditions discussed here. Also, some forms of this medicine may not be used for all of the conditions mentioned in this article.
- Your doctor may have suggested this medication for a condition that is not listed in this Medication Information article. If you have not yet discussed this with your doctor, or if you are not sure why you are taking this medicine, consult your doctor. Do not stop taking this medicine without consulting your doctor first.
- Do not give this medicine to anyone, even someone who has the same symptoms as yours. This medicine could harm people for whom it was not prescribed.
- What forms does this medication come in?
- Apo-Metoprolol
- 25 mg
- Each white, oval, scored tablet, engraved “ME” over “25” on one side and “APO” on the other, contains 25 mg of metoprolol tartrate. Nonmedicinal ingredients: colloidal silica dioxide, croscarmellose sodium, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.
- 50 mg
- Each white, round, scored tablet, engraved “APO” over “M50”, contains 50 mg of metoprolol tartrate. Nonmedicinal ingredients: colloidal silica dioxide, croscarmellose sodium, lactose, magnesium stearate, and microcrystalline cellulose.
- 100 mg
- Each white, round, scored tablet, debossed with “APO” over “M100”, contains 100 mg of metoprolol tartrate. Nonmedicinal ingredients: colloidal silica dioxide, croscarmellose sodium, lactose, magnesium stearate, and microcrystalline cellulose.
- Apo-Metoprolol (Type L)
- 50 mg
- Each pink, capsule-shaped, coated tablet, scored on one side and engraved “50” on the other, contains 50 mg of metoprolol. Nonmedicinal ingredients: carnauba wax, colloidal silica dioxide, croscarmellose sodium, D&C aluminum lake red No. 30, sun yellow aluminum lake, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350, and sodium dioxide. titanium.
- 100 mg
- Each blue, capsule-shaped, coated tablet, scored on one side and engraved “100” on the other, contains 100 mg of metoprolol. Nonmedicinal ingredients: carnauba wax, colloidal silica dioxide, croscarmellose sodium, hydroxypropylmethylcellulose, indigotin aluminum lake (AD & C blue # 2), lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol 3350, and titanium dioxide.
- How should this medication be used?
- The usual maintenance dose of metoprolol ranges from 100 mg to 200 mg per day, however, this dose may be increased to 400 mg per day as needed to achieve symptom control. Immediate-release tablets are taken in 2 divided doses while slow-release tablets are taken once a day.
- This medication should be taken soon after a meal, but try to take it at the same time every day.
- Several factors can be taken into account in determining the dose a person needs: their weight, their health, and whether they are taking other medications. If your doctor has recommended a dose other than those listed here, do not change the way you are taking the medicine without consulting your doctor.
- This medicine must be taken exactly as your doctor has told you. If you miss a dose, take the medicine as soon as you notice the missed dose and resume treatment as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your usual dosing schedule. Do not use a double dose to make up for a missed dose. If you are unsure of what to do after missing a dose, ask your doctor or pharmacist for advice.
- Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
- Do not dispose of medicines in the wastewater (eg not in the sink or in the toilet bowl) or with the household garbage. Ask your pharmacist how to dispose of unused or expired medicines.
- In which cases is this medication not recommended?
- Do not use this medicine under the following circumstances:
- a condition such as right ventricular failure caused by high blood pressure in the lungs;
- is allergic to metoprolol or any of the ingredients of the medication
- are allergic to other beta-blockers;
- anesthesia caused by an agent having a depressant effect on the myocardium (eg ether);
- a history of heart attack accompanied by:
- a heart rate of fewer than 45 beats per minute,
- severe heart block
- very low blood pressure
- moderate or severe heart failure.
- slow heartbeat caused by problems with the heart rhythm;
- severe heart block;
- cardiogenic shock;
- significant circulatory disorders;
- proven heart failure;
- the presence of asthma or other obstructive airway conditions (only when it comes to metoprolol in intravenous form);
- a disorder referred to as “sinus dysfunction syndrome”;
- have untreated pheochromocytoma (a tumor of the adrenal glands).
- What are the possible side effects of metoprolol
- Many medications can cause side effects. A side effect is an unwanted response to a drug when taken in normal doses. It can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
- At least 1% of people taking this medicine reported the following side effects. Many of these side effects can be managed and a few may go away on their own over time.
- Consult your doctor if you experience these side effects and if they are serious or bothersome. Your pharmacist may be able to give you advice on what to do if these side effects appear:
- changes in libido or sexual ability;
- constipation;
- diarrhea;
- pain or discomfort in the abdomen;
- dizziness or light-headedness when changing from sitting or lying down to standin
- fatigue or unusual weakness brought on by activity;
- fatigue;
- headaches;
- nausea;
- hair loss;
- weight gain;
- dreams giving a powerful sensation;
- dry mouth;
- increased sensitivity of the skin to solar radiation;
- increased sweating;
- sleep disturbances;
- vomitings.
- Most of the side effects listed below do not happen very often, but they could cause serious problems if you do not see your doctor or receive medical attention.
- Check with your doctor as soon as possible if any of the following side effects occur:
- slow heartbeat (especially less than 40 beats per minute);
- hearing changes;
- confusion;
- difficulty breathing or wheezing;
- back or joint pain;
- chest pain;
- hallucinations (the perception of phenomena that do not exist);
- tingling in the arms and legs.
- a feeling of coldness in the hands and feet;
- signs of depression (eg, lack of concentration, weight fluctuations, trouble sleeping, indifference to many activities, thoughts of suicide);
- signs of certain heart problems (e.g., increased or irregular heartbeat or pulse, chest pain, difficulty breathing, excessive fatigue, swelling of the feet, ankles, or part lower legs);
- signs of certain kidney problems (eg increased or reduced urine production, itching, nausea, vomiting, rash);
- signs of a bleeding disorder (e.g. unusual nosebleeds, bruising, blood in urine, cough with bloody sputum, bleeding gums, cuts that keep bleeding) ;
- signs of liver problems (eg, nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools );
- a flare-up of psoriasis (eg, red spots the size of a pinhead on the skin; red, scaly, or crusty skin);
- a feeling of numbness or tingling in the extremities;
- symptoms of low blood pressure (eg, dizziness, fatigue);
- vision changes (eg blurred vision, dry eye, eye pain).
- Stop taking the drug and seek immediate medical attention if there is a response such as :
- coldness, discoloration, or pain in the fingers or toes;
- symptoms of a serious allergic reaction (such as swelling of the face or swelling of the throat, hives, or difficulty breathing).
- Some people may experience side effects other than those listed. See your doctor if you notice any symptom that worries you while you are using this medicine.
- Are there other precautions or warnings?
- Before using any medication, be sure to tell your doctor about any medical conditions or allergies you may have, the medications you are using, and any other important facts about your health. Women should mention if they are pregnant or breastfeeding. These factors could influence how you should use this medicine.
- Respiratory disorders: In general, people with asthma, and certain other lung problems, should generally avoid taking beta-blockers such as metoprolol, as they can cause breathing difficulties. If you have breathing problems, and your doctor has prescribed metoprolol for you, it is probably in lower doses, and they will monitor you regularly while you are using this medicine. If you have breathing problems, talk to your doctor about how this medicine may affect your condition, how your condition affects the administration and effectiveness of this medicine, and whether medical supervision is needed. specific.
- Severe allergies: If you have allergies severe enough to cause anaphylaxis (a severe allergic reaction in which swelling of the face, lips, and throat makes it very difficult to breathe), talk to your doctor about what to do next. take if you have an allergic reaction. the use of metoprolol may make it more difficult to treat severe allergic reactions with epinephrine.
- Stopping the drug: People with heart disease who suddenly stop taking this drug may experience chest pain, irregular heartbeat, or a heart attack. If you have heart disease, do not stop taking this medication without consulting your doctor first. When this medication is to be stopped, it should be done gradually, under the supervision of your doctor.
- Diabetes: The signs associated with low blood sugar may be more difficult to see while you are taking metoprolol. People with diabetes may have a harder time regulating their blood sugar levels when taking this medicine. If you have diabetes, discuss with your doctor how this medication may affect your condition, how your condition affects the administration and effectiveness of this medicine, and whether medical supervision is needed. specific. You will be kept under medical supervision while taking this medicine and your doctor may need to adjust your doses of diabetes medicine.
- Dizziness or syncope: Metoprolol may cause side effects, including dizziness or fainting, soon after starting treatment. Do not drive a vehicle or do other potentially dangerous tasks until you know how this medicine works for you.
- Hyperthyroidism (high level of thyroid hormones): Metoprolol may mask the symptoms of a person with hyperthyroidism (high level of thyroid hormones).
- If you have hyperthyroidism, discuss with your doctor how this medication may affect your condition, how your condition affects the administration and effectiveness of this medicine, and whether it is appropriate to have it. specific medical surveillance. Stopping the medication suddenly could make this condition worse.
- Liver function: Liver disease or reduced liver function can cause this drug to build up in the body, causing side effects. If you have liver problems, talk to your doctor about how this medicine may affect your condition, how your condition affects the administration and effectiveness of this medicine, and whether medical supervision is needed. specific. Your doctor will monitor your liver function with regular blood tests while you are taking this medicine.
- If you notice symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain, or swelling and itching of the skin, contact your doctor immediately.
- Kidney function: Taking metoprolol may affect kidney function. Your doctor will take this into account in his monitoring and will adjust your dose as needed. If you have reduced kidney function or kidney disease, talk to your doctor about how this medicine may affect your condition, how your condition affects the administration, and how well this medicine works. , and the relevance of specific medical surveillance. If you notice swelling in your hands, feet, or face, an increase in your blood pressure, unusual muscle cramps, or a dark appearance of your urine, this medicine may be interfering with the proper function of your blood. kidneys.
- If you notice any of these symptoms, contact your doctor as soon as possible.
- Heart disease: Beta-blockers like metoprolol can worsen already present heart failure. It is essential to use metoprolol as prescribed by your doctor to reduce this risk. If you have a history of heart disease, discuss with your doctor how this medication may affect your condition, how your condition affects the administration and effectiveness of this medicine, and whether it is appropriate to use it. specific medical surveillance.
- Pheochromocytoma: This medicine may worsen the symptoms of pheochromocytoma (a tumor of the adrenal gland) if taken alone Talk to your doctor about how this medicine might affect your condition, how your condition affects your condition. administration and efficacy of this medicinal product, and the relevance of specific medical supervision.
- Surgery: If you are about to have surgery, tell all healthcare professionals who treat you that you are using metoprolol.
- Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If pregnancy occurs while you are using this medicine, contact your doctor immediately.
- Breast-feeding: This medicine passes into breast milk. If you use metoprolol while you are breastfeeding your baby may feel the effects. Check with your doctor to see if you should continue breastfeeding.
- Children: The safety and effectiveness of this medicine have not been established in children
- Seniors: Normal doses of metoprolol for adults may lower blood pressure more than expected. Lower doses may be necessary for the elderly.
- Can other agents interact with this medication?
- There may be an interaction between metoprolol and any of the following:
- abiraterone acetate;
- acetylcholine;
- anesthetic agents;
- alpha agonists (eg, clonidine, methyldopa);
- alcohol;
- aldesleukin;
- aliskiren;
- alpha1-blockers (eg doxazosin, prazosin, tamsulosin);
- amifostine;
- amiodarone;
- amphetamines (eg, dextroamphetamine, lisdexamfetamine);
- serotonin antagonists (antiemetic drugs; eg dolasetron, granisetron, ondansetron);
- tricyclic antidepressants (eg amitriptyline, clomipramine, desipramine, trimipramine);
- antihistamines (eg, cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine, diphenhydramine);
- nonsteroidal anti-inflammatory drugs (NSAIDs) eg. ibuprofen, indomethacin, naproxen);
- antimalarials (e.g. chloroquine, hydroxychloroquine, mefloquine, quinine);
- antipsychotics (eg, chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone);
- asunaprevir;
- atomoxetine;
- other beta-blockers (eg, atenolol, pindolol, propranolol);
- azelastine;
- barbiturates (eg, butalbital, pentobarbital, phenobarbital);
- beta-agonists (anti-asthma medicines, eg salbutamol, salmeterol, formoterol);
- calcium channel blockers (eg, verapamil, diltiazem, nifedipine, amlodipine);
- angiotensin II receptor blockers (ARBs) eg. irbesartan, losartan);
- bortezomib;
- brimonidine;
- buprenorphine;
- bupropion;
- celecoxib;
- ceritinib;
- milk thistle;
- cholecalciferol;
- cimetidine;
- cinacalcet;
- clobazam;
- clotrimazole;
- cobicistat;
- cocaine;
- cyproterone;
- darifenacin;
- delavirdine;
- rye ergot derivatives (eg bromocriptine, ergotamine, methylergonovine);
- nitro derivatives (eg nitroglycerin, isosorbide dinitrate, isosorbide mononitrate);
- dextromethorphan;
- digoxin;
- dipyridamole;
- disopyramide;
- disulfiram;
- diuretics (pills to remove water; eg furosemide, hydrochlorothiazide);
- donepezil;
- doxorubicin;
- dronedarone;
- entacapone;
- epinephrine;
- grass pollen allergen extract;
- fentanyl;
- fingolimod;
- flecainide;
- floctafenine;
- galantamine;
- ginger;
- ginseng;
- guanfacine;
- imatinib;
- phosphodiesterase type 5 inhibitors (eg, sildenafil, tadalafil);
- proton pump inhibitors (eg, lansoprazole, omeprazole, rabeprazole);
- Angiotensin-Converting Enzyme Inhibitors (ACEIs) eg. captopril, ramipril);
- selective serotonin reuptake inhibitors (eg fluoxetine, paroxetine, sertraline);
- selective serotonin-norepinephrine reuptake inhibitors or SNRIs (eg, desvenlafaxine, duloxetine, venlafaxine);
- insulin;
- isoniazid;
- ketoconazole;
- lacosamide;
- lanreotide;
- levodopa;
- lidocaine;
- lomustine;
- cholesterol “statin” drugs (eg pravastatin, simvastatin);
- methacholine;
- methadone;
- methimazole;
- methoxsalen;
- methylphenidate;
- metoclopramide;
- midodrine;
- mifepristone;
- mirabegron;
- moclobemide;
- nefazodone;
- nevirapine;
- nilotinib;
- noradrenaline;
- octreotide;
- orphenadrine;
- oxybutynin;
- pasireotide;
- pazopanib;
- peginterferon alfa-2b;
- pentoxifylline;
- sodium phenylbutyrate;
- pilocarpine;
- pimozide;
- praziquantel;
- propafenone;
- quinidine;
- quinine;
- ranitidine;
- regorafenib;
- rifabutin;
- rifampin;
- rituximab;
- rivastigmine;
- ropinirole;
- sulfonylureas (eg gliclazide, glyburide, tolbutamide);
- temsirolimus;
- terbinafine;
- theophyllines (eg aminophylline, oxtriphylline, theophylline);
- ticagrelor;
- ticlopidine;
- tizanidine;
- tofacitinib;
- tolcapone;
- tranylcypromine;
- yohimbine.
- If you are taking any of the above medicines, please tell your doctor or pharmacist. In your case, your doctor may ask you to:
- stop taking any of the medications;
- replace one of the drugs with another;
- change the way you take one or both of the medicines.
- do not change anything at all.
- Interference of one medicine with another does not always mean that you stop taking one of them. Ask your doctor what to do with drug interactions.
- Drugs other than those listed above may interact with this drug. Tell your doctor everything you take, whether it is prescription or over-the-counter drugs and herbal remedies. Do not forget to mention any supplements you take. If you consume caffeine, alcohol, nicotine, or street drugs, you should tell your prescribing doctor since these substances can affect the way many drugs work
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