Bupropion interaction with other drugs

Hesse LM, Venkatakrishnan K, Court MH, et al. CYP2B6 mediates the in vitro hydroxyla-tion of bupropion potential drug interactions with other antidepressants. Drug Metab Dispos... 

Bupropion Hydrochloride Bupropion interacts with levodopa, nicotine, alcohol, and drugs that affect hepatic metabolic enzymes. It lowers the seizure threshold and potentiates the seizure threshold-lowering effect of other antidepressants.135... 

Hesse, L. M., Venkatakrishnan, K., Court, M. H., von Moltke, L. L., Duan, S. X., Shader, R. I., and Greenblatt, D. J. (2000) CYP2B6 mediates the in vitro hydroxylation of bupropion potential drug interactions with other antidepressants. Drug Metab. Dispos. 28, 1176-1183. 

Three randomized clinical trials support the efficacy of bupropion in ADHD. The first used doses up to 6 mg/kg (98) the other two used doses of 100 to 300 mg per day in equally divided daily doses spaced at least 6 hours apart ( 99, 100). The concern with bupropion is its seizure risk, which requires that its daily dose stay below 450 mg per day in adults (i.e., approximately 6.5 mg/kg). Virtually no work has been done to determine the plasma concentrations of bupropion and its three active metabolites in children and adolescents. Hence, it is unknown whether a limit of 6.5 mg per kg is also appropriate for children. No data exist as to whether children are more or less sensitive to bupropion in terms of seizure risk at the same drug concentration. Also, little is known about pharmacokinetic drug-drug interactions that could reduce the clearance of bupropion. For these reasons, cautious dosing is advised when prescribing bupropion for children on other medications that can reduce oxidative drug metabolism (see Chapter 3 and Chapter 7 for more details). 

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