Aplenzin
Aplenzin, the brand name for extended-release bupropion hydrobromide, is an atypical antidepressant. It's used to treat depression and seasonal affective disorder (SAD) in adults. This medication is a tablet that's taken by mouth once per day. The dosage generally depends on how well the medication improves your mood. Side effects include headache, dry mouth, and nausea. Aplenzin (bupropion) isn't yet available as a generic.
What is Aplenzin (bupropion)?
What is Aplenzin (bupropion) used for?
How Aplenzin (bupropion) works
Aplenzin (bupropion) is an atypical antidepressant. It's not fully known how the medication works, but it's thought to boost norepinephrine and dopamine levels in the brain. This can help to improve mood.
Drug facts
Side effects of Aplenzin (bupropion)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (26%)
- Dry mouth (17%)
- Nausea (13%)
- Trouble sleeping (11%)
- Constipation (10%)
- Dizziness (7%)
Less Common Side Effects
- Diarrhea
- Stomach pain
- Low appetite
- Anxiety
- Tremor (shaking)
- Nervousness
- Fast heartbeat
- Sweating
- Ringing in the ears
- Muscle pain
- Rash
- Sore throat
- Infection
Note: Side effects are reported from people taking bupropion (Wellbutrin) for depression at the target dose.
Aplenzin (bupropion) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts or behaviors
- Serious allergic reaction or skin reaction: sore throat, fever, fatigue, rash, hives, painful blisters, skin reddening, skin peeling, swollen lymph nodes, swelling of the face, trouble breathing
- Seizures
More on Aplenzin (bupropion) side effects
The following Aplenzin (bupropion) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
hyperventilation
irregular heartbeats
irritability
restlessness
shaking
trouble sleeping
Rare
Confusion
fainting
false beliefs that cannot be changed by facts
having extreme distrust of people
seeing, hearing, or feeling things that are not there
seizures
trouble concentrating
Incidence not known
Actions that are out of control
anger
assaulting or attacking others
being aggressive or impulsive
chest pain or discomfort
fast or pounding heartbeat
force
inability to sit still
need to keep moving
sweating
talking, feeling, or acting with excitement
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Lightheadedness, dizziness, or fainting
loss of consciousness
slow or irregular heartbeat
unusual tiredness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Blurred vision
change in sense of taste
drowsiness
unusual feeling of well-being
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Aplenzin (bupropion)
Pros
- First-choice option for mild-to-moderate depression
- Taken by mouth once per day
- Lower risk of sexual side effects and weight gain than other antidepressants
Cons
- Only available as an extended-release tablet that's swallowed whole
- Can cause trouble sleeping if you take it too late in the day
- Can raise the risk of seizures and high blood pressure
Pharmacist tips for Aplenzin (bupropion)
- You can take Aplenzin (bupropion) with or without food. If it's hurting your stomach, taking the medication with food might help.
- Swallow the Aplenzin (bupropion) tablet whole. Don't chew, cut, or crush it because the tablet can get damaged and the medication can get released into your body too fast. This raises your risk for serious side effects, like seizures.
- It's recommended to take Aplenzin (bupropion) in the morning. It helps you avoid having trouble sleeping at night, which is one of the medication's side effects.
- It can take several weeks or months to feel the full effects of Aplenzin (bupropion). It's also possible to have side effects before you see an improvement in your mood, though these can go away with time. Talk to your prescriber if any side effects you have are too bothersome.
- Aplenzin (bupropion) can cause dry mouth. To help with dry mouth, try staying hydrated and chewing sugar-free gum.
- Aplenzin (bupropion) can lower your appetite. Make sure that you're still getting enough nutrition by planning healthy and well-balanced meals while you're taking the medication.
- It's best to avoid drinking alcohol while you're taking Aplenzin (bupropion). This keeps your risk for side effects, like dizziness, nausea, and seizures, low.
- Make sure to tell your care team about all of the medications you're taking and planning to take. Bupropion, the active ingredient of Aplenzin, can interact with a lot of common medications, including clopidogrel (Plavix) and other antidepressants. Your care team can check that all your medications are safe to take together.
- Don't change your dose or stop taking Aplenzin (bupropion) without talking to your prescriber first. Otherwise, it might lead to bothersome withdrawal symptoms like nausea, headache, and sleeping problems. Follow your prescriber's instructions to lower your dose slowly over a period of time to safely stop the medication.
- Speak with your prescriber if you become pregnant while you're taking Aplenzin (bupropion). It's not clear whether the medication is safe to take while pregnant, but there's some data about a possible higher risk for problems with the unborn baby's heart. If you're pregnant and you're taking Aplenzin (bupropion), it's recommended to enroll in the National Pregnancy Registry for Antidepressants so researchers can closely monitor you.
- Let your prescriber know if you're breastfeeding. Aplenzin (bupropion) can get into breast milk, which might be harmful for nursing babies. Your care team can discuss the risks and benefits of continuing Aplenzin (bupropion).
Common questions about Aplenzin (bupropion)
No, Aplenzin (bupropion) isn't a monoamine oxidase inhibitor (MAOI). Instead, Aplenzin (bupropion) is classified as an atypical antidepressant. These two types of medications work differently in the brain to raise the levels of norepinephrine and dopamine. MAOIs also raise the levels of serotonin. Treatment with Aplenzin (bupropion) doesn't require certain food limitations like MAOI treatment does. Additionally, treatment guidelines include bupropion as a recommended antidepressant, but not MAOIs.
A typical dose of Aplenzin (bupropion) is either 174 mg or 348 mg by mouth once per day. There's also an even higher dose (522 mg once per day), but it isn't typically recommended. Your prescriber will work closely with you to find a dose that works as best as possible to treat your symptoms while also limiting your risk for side effects. Don't change your dose or stop taking the medication without talking to your prescriber first.
In studies, people who took extended-release bupropion, a similar active ingredient as in Aplenzin, had higher blood pressure. Their systolic blood pressure (the top number) went up by an average of 1.3 mmHg, and their diastolic blood pressure (the bottom number) also went up by an average of 0.8 mmHg. Let your prescriber know if you have a history of high blood pressure or if you take blood pressure medications.
No, don't cut Aplenzin (bupropion) tablets in half. Cutting the tablet can damage its coating that makes it possible for the medication to release into the body throughout the day. When the coating gets damaged, the medication can get released into your body too quickly. This can raise your risk for side effects. Talk to your prescriber if you're having trouble swallowing the tablets whole.
It's best to ask your prescriber if you can have coffee with Aplenzin (bupropion). Caffeinated beverages, like coffee, can cause dry mouth. In addition, they can raise your blood pressure and also make it hard for you to fall asleep. These are all possible side effects of Aplenzin (bupropion). So, drinking coffee (or other caffeinated drinks) with the medication can raise the risk for these side effects even more. What's more, Aplenzin (bupropion) can make you more sensitive to the effects of alcohol. Follow your prescriber's recommendations about how much coffee you can drink each day if they say it's okay. Keep in mind that different types of coffee have different amounts of caffeine.
Studies show that up to 11% of people taking Wellbutrin XL, which has a similar active ingredient as Aplenzin, gained at least 5 pounds. But weight loss is more common. Although there haven't been specific studies looking at Aplenzin, it's expected to have similar effects as Wellbutrin XL. Talk to your prescriber or primary care provider if you notice unexplained weight changes while you're taking Aplenzin (bupropion).
Not quite. Both Aplenzin and Wellbutrin XL are once-daily, extended-release tablets that contain bupropion as the active ingredient. The main difference is the salt form of the bupropion in each medication. Aplenzin contains bupropion hydrobromide and Wellbutrin contains bupropion hydrochloride. Both medications also have different inactive ingredients. Aplenzin is the only form of bupropion available in a high dose and it doesn't have a generic version. On the other hand, Wellbutrin XL is available as a generic. Speak with your prescriber to learn more about comparisons between the two medications.
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Risks and warnings for Aplenzin (bupropion)
Aplenzin (bupropion) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Worsening depression and suicidal thoughts and behavior
- Risk factors: Age under 24 years old | History of depression or other mental health conditions
Taking antidepressants like Aplenzin (bupropion) can make your depression worse. It can also lead to thoughts of suicide or harming yourself. The risk is highest if you're 24 years of age or younger, during the first few weeks of taking the medication, and when your dose changes. Get medical help right away if you or anyone around you notices that you have signs of worsening depression or any unusual behavior (e.g., anxiety, panic attacks, feeling angry or irritated, restlessness) while you're taking Aplenzin (bupropion). Call 911 if you have suicidal thoughts or behaviors.
Changes in mental health
- Risk factors: Personal or family history of depression, bipolar disorder, or suicide
Some people who’ve taken bupropion have had serious changes in their mental health as side effects. These changes can include depression, hallucinations, getting lost from reality (psychosis), paranoia, and delusions.
It's important that you, your caregiver, and the people around you watch for depressed mood, feelings of uneasiness, and any changes of behavior, thoughts, or feelings while you're taking Aplenzin (bupropion). Stop taking the medication right away and talk to your prescriber if you have any concerning changes to your mental health.
Not for use alone in bipolar disorder
Before you start Aplenzin (bupropion), your prescriber will check whether you have or are at risk for bipolar disorder. Aplenzin (bupropion) isn't approved to treat bipolar depression. Taking antidepressants can sometimes cause a manic episode to happen. The risk is higher for those with or at risk for bipolar disorder. Talk to your care team right away if you or your loved ones notice symptoms of a bipolar manic episode, such as racing thoughts, restlessness, getting easily distracted, or unusual talkativeness.
Seizures
- Risk factors: Taking a higher dose than recommended | History of seizures or eating disorder | History of head injury or medical conditions that can raise the risk for seizures | Taking other medications that raise the risk for seizures Taking insulin or diabetes medications | Recently quitting alcohol or stopping treatment with certain medications | Frequent alcohol, sedative, stimulant, or illicit drug use
Aplenzin (bupropion) can raise your risk of having a seizure. Be sure to take the medication exactly as prescribed. Stop taking Aplenzin (bupropion) and tell your prescriber right away if you think you've had a seizure during treatment.
Don't take Aplenzin (bupropion) if you have a history of seizures or medical conditions that raise your risk for seizures, like head injury, stroke, or eating disorder. Also don't take Aplenzin (bupropion) if you've recently stopped drinking alcohol regularly or recently stopped taking benzodiazepines, barbiturates, or seizure medications.
High blood pressure
- Risk factors: History of high blood pressure | Taking other medications that can raise blood pressure
Aplenzin (bupropion) can cause high blood pressure, especially in people who have or are at risk for high blood pressure. Your prescriber will check your blood pressure before you start this medication and also during your follow-up visits. Your prescriber might recommend that you check your blood pressure at home often. Tell your prescriber if your blood pressure rises more than usual or if you feel dizzy or lightheaded.
Glaucoma
- Risk factors: History of angle-closure glaucoma
Aplenzin (bupropion) can cause or worsen angle-closure glaucoma in some people. Tell your prescriber about your full medical history before you start this medication to make sure it's safe for you to take. Visit your optometrist or ophthalmologist right away if you have sudden symptoms of angle-closure glaucoma like severe headache, eye pain, nausea, and seeing halos around lights.
Severe allergic reaction and skin reaction
Severe allergic reactions to Aplenzin (bupropion) are possible, including life-threatening reactions like facial swelling and anaphylaxis (e.g., closing of the throat). Aplenzin (bupropion) can also cause rare but serious skin reactions, like Stevens-Johnson syndrome.
Stop taking Aplenzin (bupropion) and get medical attention right away. if you notice unusual changes in your skin, like rash, painful blisters, skin reddening, or skin peeling, that can happen with or without sore throat, fever, and fatigue. Call 911 if you experience swelling in your face or if you have trouble breathing.
Aplenzin (bupropion) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 174mg | 30 tablets | $2,351.71 | $78.39 |
| 348mg | 30 tablets | $3,098.15 | $103.27 |
| 522mg | 30 tablets | $7,042.50 | $234.75 |
Typical dosage for Aplenzin (bupropion)
-
Depression: The typical starting dose is 174 mg by mouth once daily in the morning. After 4 days, your prescriber might raise your dose to the target of 348 mg once daily in the morning.
-
Seasonal affective disorder (SAD): The typical starting dose is 174 mg by mouth once daily. After 1 week, your prescriber might raise your dose to the target of 348 mg once daily in the morning. To prevent depressive symptoms related to SAD, you usually start treatment with Aplenzin (bupropion) during the fall season and stop in the early spring.
Your dose might differ if you have kidney or liver problems.
More on Aplenzin (bupropion) dosage
Interactions between Aplenzin (bupropion) and other drugs
More on Aplenzin (bupropion) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bromopride
- Eliglustat
- Furazolidone
- Iproniazid
- Isocarboxazid
- Linezolid
- Methylene Blue
- Moclobemide
- Nialamide
- Phenelzine
- Procarbazine
- Rasagiline
- Selegiline
- Tranylcypromine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acetophenazine
- Aclidinium
- Acrivastine
- Alcaftadine
- Amantadine
- Ambenonium
- Amdinocillin
- Amdinocillin Pivoxil
- Amiloride
- Amineptine
- Aminophylline
- Amitriptyline
- Amitriptylinoxide
- Amoxapine
- Amphetamine
- Ampicillin
- Anisotropine
- Antazoline
- Aripiprazole
- Astemizole
- Atomoxetine
- Atropine
- Azatadine
- Azelastine
- Azlocillin
- Bacampicillin
- Belladonna Alkaloids
- Benperidol
- Benzphetamine
- Bepotastine
- Betamethasone
- Brexpiprazole
- Bromodiphenhydramine
- Bromperidol
- Brompheniramine
- Buclizine
- Budesonide
- Bupivacaine
- Butriptyline
- Butylscopolamine
- Carbamazepine
- Carbenicillin
- Carbimazole
- Carbinoxamine
- Carvedilol
- Chlorambucil
- Chlorotrianisene
- Chlorpheniramine
- Chlorphenoxamine
- Cimetidine
- Cimetropium
- Cinnarizine
- Citalopram
- Clemastine
- Clemizole
- Clidinium
- Clobetasone
- Clomipramine
- Clopidogrel
- Cloxacillin
- Clozapine
- Codeine
- Conjugated Estrogens
- Corticotropin
- Cortisone
- Cosyntropin
- Cyclacillin
- Cyclizine
- Cyclosporine
- Cyproheptadine
- Danazol
- Darifenacin
- Deflazacort
- Delavirdine
- Demecarium
- Desipramine
- Desonide
- Desvenlafaxine
- Deutetrabenazine
- Dexamethasone
- Dexbrompheniramine
- Dexchlorpheniramine
- Dextroamphetamine
- Dextromethorphan
- Dibenzepin
- Dicloxacillin
- Dicyclomine
- Dienestrol
- Diethylstilbestrol
- Dihydrocodeine
- Dimenhydrinate
- Diphenhydramine
- Diphenylpyraline
- Distigmine
- Donepezil
- Dopamine
- Dothiepin
- Doxepin
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Doxylamine
- Droperidol
- Duloxetine
- Ebastine
- Echothiophate
- Edrophonium
- Efavirenz
- Emedastine
- Enflurane
- Epinastine
- Escitalopram
- Esterified Estrogens
- Estradiol
- Estramustine
- Estriol
- Estrone
- Estropipate
- Ethinyl Estradiol
- Famotidine
- Fesoterodine
- Flavoxate
- Flecainide
- Floxacillin
- Fludrocortisone
- Flunarizine
- Flunisolide
- Fluoxetine
- Fluticasone
- Fluvoxamine
- Fosphenytoin
- Galantamine
- Glycopyrrolate
- Guanidine
- Haloperidol
- Hetacillin
- Homatropine
- Hydrocortisone
- Hydroxyzine
- Hyoscyamine
- Imipramine
- Indalpine
- Iobenguane I 123
- Iobenguane I 131
- Isoflurophate
- Isoniazid
- Isopropamide
- Ketamine
- Ketotifen
- Lemborexant
- Levocabastine
- Levodopa
- Levomilnacipran
- Lidocaine
- Lindane
- Lisdexamfetamine
- Lofepramine
- Lopinavir
- Loxapine
- Mebeverine
- Mebhydrolin
- Meclizine
- Memantine
- Mepenzolate
- Mestranol
- Metformin
- Methamphetamine
- Methantheline
- Methdilazine
- Methenolone
- Methicillin
- Methimazole
- Methixene
- Methylphenidate
- Methylprednisolone
- Methyltestosterone
- Metoclopramide
- Metronidazole
- Mexiletine
- Mezlocillin
- Milnacipran
- Mizolastine
- Nafcillin
- Nalidixic Acid
- Nandrolone
- Nebivolol
- Nefazodone
- Neostigmine
- Niaprazine
- Nortriptyline
- Olopatadine
- Ondansetron
- Opipramol
- Oxacillin
- Oxaliplatin
- Oxandrolone
- Oxatomide
- Oxybutynin
- Oxymetholone
- Paramethasone
- Paroxetine
- Penicillin G
- Penicillin V
- Phenindamine
- Pheniramine
- Phenobarbital
- Phenyltoloxamine
- Phenytoin
- Physostigmine
- Pimozide
- Pinaverium
- Pindolol
- Piperacillin
- Pirenzepine
- Pitolisant
- Pivampicillin
- Pizotyline
- Polyestradiol Phosphate
- Prednisolone
- Prednisone
- Procainamide
- Procaine
- Promestriene
- Promethazine
- Propafenone
- Propantheline
- Propicillin
- Propiverine
- Propizepine
- Propranolol
- Protriptyline
- Pyrilamine
- Quinestrol
- Ranitidine
- Rimexolone
- Risperidone
- Ritonavir
- Rivastigmine
- Scopolamine
- Sertraline
- Sibutramine
- Solifenacin
- Stanozolol
- Sultamicillin
- Tacrine
- Terfenadine
- Testosterone
- Theophylline
- Thioridazine
- Thiotepa
- Thonzylamine
- Tibolone
- Ticarcillin
- Ticlopidine
- Timiperone
- Tolterodine
- Tramadol
- Trimeprazine
- Trimipramine
- Tripelennamine
- Triprolidine
- Tropicamide
- Trospium
- Umeclidinium
- Valbenazine
- Valethamate
- Varenicline
- Venlafaxine
- Vortioxetine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aripiprazole Lauroxil
- Digoxin
- Isavuconazonium Sulfate
- Lofexidine
- St John's Wort
- Tipranavir
- Zolpidem
How much does Aplenzin (bupropion) cost?
$2,351.71
Aplenzin (bupropion) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Aplenzin (bupropion) will not be safe for you to take.
- Have a medical condition that causes seizures
- Currently have or have had a eating disorder (e.g., bulimia, anorexia)
- Suddenly stopping alcohol, benzodiazepine, barbiturate, or antiepileptic medications
- Currently take, have recently taken within the last 14 days, or plan to take within the next 14 days medications called monoamine oxidase inhibitors (MAOIs). Examples include phenelzine, linezolid (Zyvox), and methylene blue (ProvayBlue).
What are alternatives to Aplenzin (bupropion)?
News about Aplenzin (bupropion)
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