1 What is Aplenzin?

Brand: Aplenzin, Budeprion SR, Budeprion XL, Buproban, Forfivo XL, Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban

Generic: Bupropion

Aplenzin is an atypical anti-depressant which is usually indicated for the treatment of the major depressive disorder (MDD).

It is often used to treat depression and to prevent depression in patients with seasonal affective disorder (SAD), which is sometimes called winter depression. It is also used as an aid to smoking cessation.

This drug is sold in the market under different trade names. If you are already taking any medicine for depression or to stop smoking, discuss this with your doctor before taking bupropion.

This medicine is available only with your doctor's prescription. This product is available in the following dosage forms:

  • Tablet
  • Tablet, Extended Release
  • Tablet, Extended Release, 12 HR
  • Tablet, Extended Release, 24 HR

2 What to Know Before Using

Before using Aplenzin, you must know all about the risks and complications associated with it. The suitable drug therapy is usually chosen by a doctor with the active participation of the patient.

There are some important factors such as drug interactions, the presence of any metabolic impairment, history of hypersensitivity reaction, pregnancy, lactation etc. which may alter the desired therapeutic effects of a medicine.

Sometimes the presence of other health disorders affects the beneficial effects of this medicine and even may cause serious toxic effects.

If you have had any allergic reactions to any medicine then you must tell your doctor about that. The use of bupropion is contraindicated in those who are hypersensitive to this drug or any of the ingredients of the formulation.

Make sure you inform your doctor if you have any medical problem and drug history, especially:

  • Seizure disorder
  • Current or prior diagnosis of eating disorders (bulimia or anorexia nervosa)
  • Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, antiepileptic drugs
  • Brain tumor or infection
  • Circulatory problems
  • Severe head injury
  • Stroke—should not be used in patients with these conditions.
  • Bipolar illness
  • Angle-closure glaucoma
  • Hypertension (high blood pressure)
  • History of mania or hypomania
  • Psychosis
  • Schizophrenia—caution should be exercised because this drug may make these conditions worse.
  • Kidney or liver disease

Because of drug-drug interactions, certain medicines should not be used along with this medicine. It is always recommended to consult with your doctor if you are in need of some other medications or even any over-the-counter medicine for another health problem in order to avoid unwanted toxic effects.

Besides, the following drug interactions should be kept in mind:

Bupropion inhibits CYP2D6 and can increase concentrations of antidepressants (e.g. venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, sertraline), antipsychotics (e.g. haloperidol, risperidone, thioridazine), beta-blockers (e.g. metoprolol), and Type 1C antiarrhythmics (e.g. propafenone, flecainide). Consider dose reduction when using with bupropion.

An increased dose may be necessary if concurrently administered with CYP2B6 inducers (e.g. ritonavir, lopinavir, efavirenz, carbamazepine, phenobarbital, and phenytoin) based on clinical response, but should not exceed the maximum recommended dose.

CNS toxicity can occur when dopaminergic drugs (levodopa and amantadine) are used concomitantly with bupropion.

Increased risk of hypertensive reactions can occur when monoamine oxidase inhibitors (MAOIs) are used concomitantly with bupropion.

Bupropion can cause false positive urine test results for amphetamines.

Animal reproduction studies have shown an adverse effect, and there are no adequate and well-controlled studies in pregnant women. Thus, this drug should be used during pregnancy only if clearly needed.

Besides, caution should be exercised when used in lactating women because there are no adequate studies in women for determining infant risk when using this medication during breastfeeding.

3 Proper Usage

To use Aplenzin properly, you must follow all instructions given by your doctor. The dosage schedule and the duration of drug therapy should be individualized and determined based on the doctor’s advice.

The therapeutic dose may also vary with the patient’s condition or requirement and the strength of the medicine as well. This medicine comes with patient information.

You should read and follow the instructions carefully before using this medicine. It is generally agreed that acute episodes of depression require several months or longer of antidepressant drug treatment beyond the response in the acute episode.

The recommended starting dose is 200 mg per day, given as 100 mg twice daily. After 3 days of dosing, the dose may be increased to 300 mg per day, given as 100 mg 3 times daily, with at least 6 hours between successive doses.

A maximum of 450 mg per day, given in divided doses of not more than 150 mg each, may be considered for patients who show no clinical improvement after several weeks of treatment at 300 mg per day. To minimize the risk of seizure, increase the dose gradually. Increases in dose should not exceed 100 mg per day in a 3-day period.

If you miss a dose of this medicine, take it as soon as possible. But, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use this drug in larger amounts, more often, or for a longer time than your doctor ordered.

Further, it is advised to store the medicine in a closed container at room temperature away from heat, moisture, and direct light. All kinds of medicines should be kept out of the reach of children. However, outdated medicines should be disposed of by an appropriate way.

4 Precautions to Take

Before using Aplenzin, there are some precautions you must take. Firstly, regular visits to your doctor are recommended to check that this medicine is working properly or not.

Additionally, the following guidelines should be followed to prevent unwanted complications as well as for the better prognosis of the patients: 

Aplenzin should not be taken with a monoamine oxidase (MAO) inhibitor (e.g. isocarboxazid, linezolid, methylene blue injection, phenelzine, selegiline, tranylcypromine). Further, it is advised to wait for at least 14 days after you stop a MAO inhibitor before taking bupropion.

Regular measurement of blood pressure is recommended during this drug therapy because this drug may cause your blood pressure high manifesting headaches, dizziness, or blurred vision. If you think your blood pressure is too high, call your doctor right away.

Aplenzin may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Monitoring is required for worsening and emergence of suicidal thoughts and behaviors.

This medicine may cause a serious type of allergic reaction called anaphylaxis that can be life-threatening and requires immediate medical attention. If you notice any symptom suggesting allergic reactions that may be rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth, check with your doctor immediately.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

The results of some tests may be affected by this medicine. Before having any medical tests, you should inform the healthcare professional in charge that you are taking this medicine.

Drinking alcoholic beverages should be limited or avoided while you are taking this drug. In addition, you should not take other prescription or nonprescription (over-the-counter) medicines and herbal or vitamin supplements unless they have been discussed with your doctor.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Aplenzin. These side effects usually go away during the treatment episode as your body adjusts to the medicine. Your healthcare professional may advise you about the ways how to prevent or reduce those unwanted side effects.

Sometimes you may need to consult with the doctor if you notice any of the following toxic effects:

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.