Key takeaways:
Bupropion (Wellbutrin SR, Wellbutrin XL, Aplenzin, Forfivo XL) can interact with several medications and substances. You shouldn’t take bupropion within 2 weeks of a monoamine oxidase inhibitor. It’s also best to avoid alcohol while taking bupropion.
Other bupropion interactions may be OK with additional monitoring or dosage changes. These include certain antiplatelet, antiseizure, and antiviral medications. It also includes other antidepressant and antipsychotic medications.
Medications that raise dopamine levels, increase seizure risk, or raise blood pressure — including stimulant ADHD medications — may also require extra caution.
Give your prescriber and pharmacist an updated medication list so they can check for bupropion interactions before you start treatment.
Save on related medications
Bupropion (Wellbutrin SR, Wellbutrin XL, Aplenzin, Forfivo XL) is an atypical antidepressant medication. It works by raising the amount of dopamine and norepinephrine in the brain. These are both chemicals involved in regulating your mood.
Bupropion treats mental health conditions such as depression and seasonal affective disorder. It can also help you quit smoking. But bupropion can also interact with other medications and substances. Knowing more about bupropion interactions can help protect your safety and avoid unwanted issues during treatment.
Bupropion interactions at a glance
Below are lists of bupropion interactions to be aware of. Keep in mind that this isn’t a comprehensive list. The best way to avoid interactions is to review your medication list with your healthcare team before starting bupropion or making any changes to your regimen.
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Medications and substances to avoid while taking bupropion include:
Monoamine oxidase inhibitors (MAOIs), such as selegiline (Zelapar, Emsam)
Alcohol
Medications that may require additional monitoring or dose adjustments if taken with bupropion include:
Antiplatelet medications, such as clopidogrel (Plavix)
Some antiseizure medications, such as phenytoin (Dilantin, Phenytek)
Some antiviral medications, such as ritonavir (Norvir)
Some serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor)
Some selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac)
Some tricyclic antidepressants (TCAs), such as imipramine
Other atypical antidepressants
Other medications that can raise the risk of seizures, such as stimulants and antipsychotic medications
Other medications that can increase dopamine levels, such as amantadine (Gocovri)
Beta-blockers, such as metoprolol (Toprol XL)
Some antiarrhythmic medications, such as flecainide
Stimulant attention deficit-hyperactivity disorder (ADHD) medications
Let’s take a closer look at nine bupropion interactions and how they may affect your treatment.
1. Monoamine oxidase inhibitors, such as linezolid and selegiline
MAOIs treat depression and Parkinson’s disease. Examples include linezolid (Zyvox), phenelzine (Nardil), and selegiline.
Taking MAOIs and bupropion together can lead to a hypertensive crisis (dangerously high blood pressure). This interaction is likely due to the fact that both bupropion and MAOIs raise norepinephrine levels, which can in turn increase blood pressure.
You shouldn’t take bupropion and MAOIs at the same time or within 2 weeks of one another. If you’re taking an MAOI, let your prescriber know. They can choose a bupropion alternative that’s safer for you.
2. Alcohol
It’s best to avoid alcohol while taking bupropion for several reasons:
Alcohol can increase the risk of bupropion side effects, such as dizziness, mood changes, and suicidal thoughts or behaviors.
Combining alcohol and bupropion can raise your risk of seizures.
Bupropion can lower your tolerance for alcohol, which can raise the risk of unintended intoxication or alcohol poisoning.
Alcohol can contribute to depression, which can make it harder for bupropion to work.
It’s best to avoid drinking while taking bupropion. Talk to your prescriber about whether an occasional drink or two is OK for you based on your personal history. You can also talk to your prescriber about ways to help you stop drinking if you’re having trouble cutting back on your own.
3. Antiplatelet medications, such as Plavix
Clopidogrel and ticlopidine are antiplatelet medications that help prevent unwanted blood clots. These medications can block the breakdown of bupropion in the body. In turn, this can raise bupropion levels and increase the chance of side effects.
In most cases, it’s fine to take bupropion with an antiplatelet medication. But your prescriber may need to adjust your bupropion dosage if this interaction leads to bothersome side effects. So be sure to let them know about any issues that arise while taking these medications.
4. Antiseizure medications, such as carbamazepine
Bupropion can interact with antiseizure medications in several ways.
First, bupropion can increase the risk of seizures. This may make it harder for antiseizure medications to work. If you’re taking medication for a seizure-related condition, it’s best to discuss this risk with your prescriber before starting bupropion.
Some antiseizure medications may also lower bupropion levels in the body. Examples include:
Carbamazepine (Tegretol, Tegretol XR)
You may need a higher bupropion dose if you take it with one of these antiseizure medications. Your prescriber will likely keep an eye on your progress and adjust your dosage if needed. Don’t make any changes to your bupropion dose on your own.
5. Antiviral medications, such as ritonavir
Some antiviral medications may also lower bupropion levels in the body. Examples include:
Ritonavir and any medications that contain it, such as Kaletra (lopinavir / ritonavir)
Efavirenz (Sustiva) and any medications that contain it, such as Atripla (efavirenz / emtricitabine / tenofovir)
If you take one of these medications, you may need a higher bupropion dose. Your prescriber will monitor your progress and adjust your dose if needed.
6. Some antidepressant and antipsychotic medications
Bupropion can block the breakdown of several other mental health medications in the body. This can raise their levels in the body and increase the risk of side effects. Examples include:
Nortriptyline (Pamelor)
Imipramine (Tofranil)
Desipramine (Norpramin)
Paroxetine (Paxil)
Sertraline (Zoloft)
Haloperidol (Haldol)
Risperidone (Risperdal)
Thioridazine (Mellaril)
You may need a lower dose of these medications if you take them along with bupropion. But keep in mind that you should only take more than one mental health medication if your prescriber recommends it. In most cases, if bupropion isn’t working well on its own, your prescriber will recommend trying a different treatment before combining it with other medications.
7. Medications that increase your risk of seizures, including Adderall, Abilify, and tramadol
Some medications can make it more likely for you to have a seizure. This is known as lowering the seizure threshold.
Bupropion is one medication that lowers the seizure threshold. If you take it along with other medications that carry this side effect, the risk of seizures is even higher. Examples include:
TCAs, such as amitriptyline
Antipsychotic medications, such as aripiprazole (Abilify) and clozapine (Clozaril)
Opioids, such as tramadol (ConZip, Qdolo)
ADHD stimulant medications, such as Adderall (mixed amphetamine salts)
Cyclobenzaprine (Amrix)
Diphenhydramine (Benadryl)
If you take other medications that lower the seizure threshold, let your prescriber know. They may recommend a lower dose of bupropion or a different treatment altogether.
8. Medications that raise dopamine levels
Medications that increase dopamine levels are used to treat Parkinson’s disease and restless leg syndrome. Examples include:
Sinemet (carbidopa / levodopa)
Levodopa (Inbrija)
Bupropion also increases dopamine levels. Combining it with another medication that has this effect could lead to excess dopamine in your system. This can cause symptoms such as:
In some cases, your prescriber may recommend taking bupropion with another medication that increases dopamine levels. But be sure to let them know if you experience any of the side effects listed above.
9. Stimulant ADHD medications, such as Adderall and Vyvanse
Common stimulant ADHD medications include Adderall and Vyvanse (lisdexamfetamine). Bupropion and stimulant ADHD medications can both increase your blood pressure. The risk is low when you take these medications on their own. But combining them can make high blood pressure more likely.
It’s a good idea to avoid this combination if you’re living with high blood pressure or have a history of heart problems. If your prescriber OKs taking bupropion along with a stimulant ADHD medication, they may want you to check your blood pressure at home to make sure it stays within a safe level. But if you develop chest pain or trouble breathing at any time during treatment, seek emergency care right away.
Frequently asked questions
Yes, bupropion is one of several medications that may cause a false positive on a urine drug test. Taking bupropion can lead to false positive results for amphetamines or methamphetamine. It’s best to let the testing facility know about any prescription medication you take in advance to avoid any issues.
Yes, it’s typically fine to eat grapefruit while taking bupropion. While grapefruit and grapefruit juice can interact with many other medications, bupropion isn’t considered one of them. But it’s a good idea to review your entire medication list with a healthcare professional to make sure grapefruit isn’t an issue with anything else you’re taking.
Coffee doesn’t interact directly with bupropion. So there isn’t a specific amount of time you should wait after taking it to have coffee. Just keep in mind that bupropion and caffeine can both increase your blood pressure. So it’s best to limit caffeine intake to 400 mg or less per day — about 2 to 4 cups of coffee.
Yes, bupropion is one of several medications that may cause a false positive on a urine drug test. Taking bupropion can lead to false positive results for amphetamines or methamphetamine. It’s best to let the testing facility know about any prescription medication you take in advance to avoid any issues.
Yes, it’s typically fine to eat grapefruit while taking bupropion. While grapefruit and grapefruit juice can interact with many other medications, bupropion isn’t considered one of them. But it’s a good idea to review your entire medication list with a healthcare professional to make sure grapefruit isn’t an issue with anything else you’re taking.
Coffee doesn’t interact directly with bupropion. So there isn’t a specific amount of time you should wait after taking it to have coffee. Just keep in mind that bupropion and caffeine can both increase your blood pressure. So it’s best to limit caffeine intake to 400 mg or less per day — about 2 to 4 cups of coffee.
The bottom line
Bupropion (Wellbutrin SR, Wellbutrin XL, Aplenzin, Forfivo XL) can interact with several medications and substances. You shouldn’t take bupropion within 2 weeks of a monoamine oxidase inhibitor due to the risk of dangerously high blood pressure. It’s also best to avoid alcohol while taking bupropion because the combination can increase the risk of side effects, seizures, and alcohol poisoning.
Other bupropion interactions may be OK with additional monitoring or dosage changes. These include certain antiplatelet, antiseizure, and antiviral medications. It also includes other antidepressant and antipsychotic medications. Medications that raise dopamine levels, increase seizure risk, or raise blood pressure — including stimulant ADHD medications — may also require extra caution. Give your prescriber and pharmacist an updated medication list so they can check for bupropion interactions before you start treatment.
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References
Edinoff, A. N., et al. (2022). Clinically relevant drug interactions with monoamine oxidase inhibitors. Health Psychology Research.
Huecker, M. R., et al. (2024). Bupropion. StatPearls.
O’Donnell, J., et al. (2013). Norepinephrine: A neuromodulator that boosts the function of multiple cell types to optimize CNS performance. Neurochemical Research.
Remedyrepack Inc. (2026). Bupropion hydrochloride- bupropion hydrochloride tablet [package insert].
Smith, M. D., et al. (2024). Norepinephrine. StatPearls.
U.S. Food and Drug Administration. (2024). Spilling the beans: How much caffeine is too much?
