Dextromethorphan Hydrobromide 45mg, Bupropion Hydrochloride 105mg, Oral tablet, extended release
Alcohol
· Severity: Major
· Notes for Consumers: Do not drink alcohol while taking this medication. Drinking alcohol may alter the effects of your medication. Serious side effects may occur. Contact your care team if you experience new or worsening side effects.
· Notes for Professionals: Advise patients to avoid alcohol consumption while taking bupropion. Bupropion is associated with a dose-related risk of seizures. Alcohol abuse and abrupt discontinuation of alcohol have also been associated with seizures. Neuropsychiatric events and reduced alcohol tolerance have also been described in postmarketing reports.
Dextromethorphan Hydrobromide 45mg, Bupropion Hydrochloride 105mg, Oral tablet, extended release
Caffeine-containing Foods/Beverages
· Severity: Moderate
· Notes for Consumers: Side effects from Bupropion may get worse if you consume large quantities of caffeine. Side effects such as nervousness, irritability, difficulty with sleep, increased blood pressure, tremor, or seizures may get worse if you take Bupropion and an excessive amount of caffeine. Try to limit Caffeine intake during Bupropion use. Many non-prescription medicines and weight loss aids may contain caffeine, so read labels carefully. Examples of foods and beverages containing caffeine include coffee, teas, colas, energy drinks, chocolate, and some herbal or dietary supplements.
· Notes for Professionals: Bupropion is associated with a dose-related risk of seizures. Excessive use of psychostimulants, including caffeine, is associated with an increased seizure risk and may increase this risk during the concurrent use of bupropion. Carefully consider a patient's caffeine intake from all sources, including medicines. Monitor for irritability, tremor, increased blood pressure, insomnia and seizures. Many non-prescription medicines and weight loss aids may contain caffeine and patients should read labels carefully. Examples of foods and beverages containing caffeine include coffee, teas, colas, energy drinks, chocolate, and some herbal or dietary supplements. Patients should be advised to limit excessive caffeine intake during bupropion therapy.
Dextromethorphan Hydrobromide 45mg, Bupropion Hydrochloride 105mg, Oral tablet, extended release
Grapefruit juice
· Severity: Mild
· Notes for Consumers: Grapefruit juice may increase the actions of Dextromethorphan, which may make some people feel drowsiness or other side effects (dizziness, nervousness or restlessness, nausea, vomiting, stomach upset) of Dextromethorphan that do not usually occur with prescribed or nonprescription product doses. It may be best to limit intake of grapefruit juice while you are taking Dextromethorphan-containing products.
· Notes for Professionals: Intake of grapefruit juice or seville orange juice increased dextromethorphan bioavailability in one study. Patients with increased concentrations of dextromethorphan may experience drowsiness or serotonergic side effects (dizziness, nervousness or restlessness, nausea, vomiting, stomach upset) not usually noted with prescribed or nonprescription product doses. Grapefruit juice and seville orange juice contain compounds that can inhibit P-glycoprotein in the intestinal wall, and dextromethorphan absorption may be affected by P-glycoprotein activity. Dextromethorphan is largely metabolized by CYP2D6, so this particular interaction with grapefruit juice may be more relevant in patients who are poor CYP2D6 metabolizers.