Bupropion hydrobromide ER
APLENZIN
What it isNorepinephrine and dopamine reuptake inhibitor with nicotinic antagonism; major depression.
Why this oneIt is the only HBr salt; 522 mg = 450 mg HCl XL, once daily.
What limits itSeizures, insomnia, hypertension, and CYP2D6 inhibition matter; avoid in eating disorders and abrupt sedative withdrawal.
FDA-approved for
- depression (2008)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Major depressive disorder | Adults | 174 mg QAM | 348 mg QD | 522 mg QD |
| Seasonal affective disorder (prevention) | Adults | 174 mg QD | 348 mg QD | 348 mg QD |
Titration MDD: may increase after 4 days; SAD: may increase after 7 days
Renal GFR <90 mL/min: consider reduced dose and/or frequency
Hepatic Moderate–severe (Child-Pugh 7–15): max 174 mg every other day; mild (5–6): consider reduced dose/frequency
Do not exceed 522 mg once daily (dose-related seizure risk)
Instructions
- Swallow whole; do not crush, divide, or chew
- Take in the morning, with or without food
- Discontinue by tapering: reduce 348 mg → 174 mg QD before stopping
- Allow ≥14 days between an MAOI and APLENZIN in either direction
Contraindications
- Seizure disorder
- Current or prior bulimia or anorexia nervosa
- Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs
- MAOIs (for psychiatric disorders) concurrently or within 14 days; do not start in patients on linezolid or IV methylene blue
Cautions
- Dose-related seizure risk
- Hypertension (can increase blood pressure)
- Activation of mania/hypomania
- Psychosis and other neuropsychiatric reactions
- Angle-closure glaucoma
- Neuropsychiatric events with smoking-cessation use
Adverse reactions
- Dry mouth
- Nausea
- Insomnia
- Dizziness
- Pharyngitis
- Agitation/anxiety
- Tremor
- Palpitation
- Sweating
- Tinnitus
Pregnancy First-trimester epidemiologic data do not show increased overall malformation risk; registry available.
Lactation Bupropion and active metabolites present in human milk (~2% of maternal weight-adjusted dose); seizures reported in breastfed infants.
⚠ BOXED WARNING
- Suicidal thoughts and behaviors in patients under 25
Classes and tags
Clinical profile
Active metabolites
Mechanism of action: Bupropion hydrobromide ER ballicule
Open Bupropion hydrobromide ER in the interactive console ↗
Memory aids: mascots and interaction avatars
Strong CYP2D6 inHibitor
Skinny → weight loss possible
