Bupropion SR

NDRI·Addiction Medicine

TGA/PBS — Short-term adjunctive therapy for nicotine dependence in patients committed to quitting, used with counselling

PBSSMOKINGZyban SR, Prexaton150 mg tabletS4+1

Max Dose

300 mg/day

Half-life

21 h

Seizure Risk

CRITICAL

Sexual Dys.

NONE

Rapid Summary

Overview

A noradrenaline-dopamine reuptake inhibitor approved in Australia as short-term adjunctive therapy for smoking cessation in patients committed to quitting with counselling.

Maximum Dose

Max 300 mg/day (150 mg BD).

Clinical Focus

Seizure risk is dose-related and patient-factor dependent. Avoid in seizure history, eating disorders, abrupt alcohol/benzodiazepine withdrawal, CNS tumour, and MAOI exposure; keep single doses at 150 mg and daily dose at 300 mg.

Bottom Line

Bupropion SR can help smoking cessation when combined with counselling, but it is a poor fit when seizure threshold is low, eating disorder history is present, alcohol/benzodiazepine withdrawal is likely, or CYP2D6 interactions are clinically important.

Formulation & Access

Brand Names

Zyban SR, Prexaton

Oral Routes

Do not crush

Modified-release tablet; swallow whole. Do not crush, divide, or chew.

Prescribing & PBS

PBS-listed bupropion hydrochloride 150 mg modified-release tablet items exist for smoking-cessation access; confirm the current item/restriction details before prescribing.

Indications & Use

Primary

PBSTGA

TGA/PBS — Short-term adjunctive therapy for nicotine dependence in patients committed to quitting, used with counselling.

Off-Label

OFF

Off-label note: antidepressant use or antidepressant augmentation is outside the checked Australian PI indication and needs separate source review before being presented as Australian-approved use.

Clinical Place

Excellent for smokers who also have underlying depression or those who fear weight gain upon quitting.

Quick reference

Class & Role

NDRI — Noradrenaline-Dopamine Reuptake Inhibitor (NDRI).

Route / Formulation

Modified-release tablets (150 mg). Swallow whole; do not crush, divide, or chew because altered release increases adverse-event/seizure risk.

Usual Dose & Max

Start while still smoking: 150 mg daily for 3 days, then 150 mg twice daily. Separate doses by at least 8 hours. Max single dose 150 mg; max daily dose 300 mg.

Key Indication Doses

Smoking cessation: set quit date within the first 2 weeks, preferably week 2. Treat at least 7 weeks; discontinue if no significant abstinence progress by week 7.

Best Uses

Bupropion SR is a dual-purpose antidepressant and smoking cessation aid with no sexual dysfunction or weight gain, but lowers the seizure threshold and is contraindicated in eating disorders.

Avoid / Cautions

Contraindicated with seizure disorder/history, CNS tumour, current/previous bulimia or anorexia, abrupt alcohol or benzodiazepine withdrawal, MAOI use within 14 days, or hypersensitivity. Reduce dose/frequency in renal or hepatic impairment; severe hepatic cirrhosis max 150 mg every other day.

Key Risks

Dose-related seizure risk (~0.1% up to 300 mg/day SR). Insomnia, agitation, tremor, hypertension/tachycardia, neuropsychiatric symptoms, and anorexia/weight loss can occur.

Key Interactions

Strong CYP2D6 inhibition: start CYP2D6 substrates at low dose or consider dose reduction. Avoid/minimise alcohol. Use caution with medicines that lower seizure threshold, levodopa/amantadine, and nicotine patches because BP can rise.

Monitoring

Check seizure risk factors, BP (especially with nicotine patches), renal/hepatic impairment, alcohol/benzodiazepine withdrawal risk, mood/neuropsychiatric symptoms, and adherence to dose spacing.

Clinical Pearl

Psychiatrists frequently add a low dose of Bupropion to a patient's SSRI regimen. The dopamine boost from Bupropion brilliantly reverses the emotional blunting and sexual dysfunction caused by the SSRI.

Access

Zyban SR, PrexatonModified-release tablet; swa…

Brand: Zyban SR, Prexaton
Formulation: Modified-release tablet; swallow whole