Bupropion with Aripiprazole Lauroxil Interaction Details

Brand Names Associated with Bupropion

Brand Names Associated with Aripiprazole Lauroxil

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Mar 06, 2024

Interaction Effect

Increase aripiprazole exposure

Interaction Summary

Aripiprazole lauroxil is a prodrug of aripiprazole and aripiprazole is a CYP2D6 substrate. Coadministration of aripiprazole lauroxil and a strong CYP2D6 inhibitor for longer than 2 weeks may result in increased aripiprazole exposure and increased risk of toxicity. If coadministration with Aristada(R) is required, reduce Aristada(R) to next lower strength (882 mg every 6 weeks or 1064 mg every 2 months is reduced to 441 mg monthly); a 441 mg monthly dosage may be continued if tolerated. In poor CYP2D6 metabolizers, no dose adjustment of Aristada(R) is required[1]. Avoid the use of Aristada Initio(TM) concomitantly with strong CYP2D6 inhibitors or in poor metabolizers of CYP2D6 because the Aristada Initio(TM) dose cannot be modified [2].

Severity

Moderate

Onset

Unspecified

Evidence

Probable

How To Manage Interaction

Coadministration of aripiprazole lauroxil and a strong CYP2D6 inhibitor for longer than 2 weeks may result in increased aripiprazole exposure and increased risk of toxicity. If coadministration with Aristada(R) is required, reduce Aristada(R) to the next lower strength (882 mg every 6 weeks or 1064 mg every 2 months is reduced to 441 mg monthly); a 441 mg monthly dosage may be continued if tolerated. In poor CYP2D6 metabolizers, no dose adjustment of Aristada(R) is required[1]. Avoid the use of Aristada Initio(TM) concomitantly with strong CYP2D6 inhibitors or in poor metabolizers of CYP2D6 because the Aristada Initio(TM) dose cannot be modified [2].

Mechanism Of Interaction

Inhibition of CYP2D6-mediated metabolism of aripiprazole

Literature Reports

A) During drug interaction studies, coadministration of quinidine 166 mg/day for 13 days with a single dose of aripiprazole 10 mg resulted in a 112% increase in aripiprazole AUC. The AUC of dehydro-aripiprazole, the active metabolite of aripiprazole, was decreased by 35% [3]

References

1 ) Product Information: ARISTADA(R) intramuscular extended-release injection, aripiprazole lauroxil intramuscular extended-release injection. Alkermes, Inc (per manufacturer), Waltham, MA, 2017.

2 ) Product Information: ARISTADA INITIO (TM) intramuscular extended-release injection, aripiprazole lauroxil intramuscular extended-release injection. Alkermes, Inc (per manufacturer), Waltham, MA, 2018.

3 ) Product Information: ABILIFY(R) oral tablets, oral solution, intramuscular injection, aripiprazole oral tablets, oral solution, intramuscular injection. Otsuka America Pharmaceutical, Inc. (per FDA), Rockville, MD, 2014.

Bupropion Overview

• Bupropion (Aplenzin, Wellbutrin, Wellbutrin SR, Wellbutrin XL) is used to treat depression. Bupropion (Aplenzin, Wellbutrin XL) is also used to treat seasonal affective disorder (SAD; episodes of depression that occur at the same time each year [usually in the fall and winter but rarely may occur in the spring or summer months]). Bupropion (Zyban) is used to help people stop smoking. Bupropion is in a class of medications called antidepressants. It works by increasing certain types of activity in the brain.

Aripiprazole Lauroxil Overview

• Aripiprazole is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) in adults and teenagers 13 years of age and older. It is also used alone or with other medications to treat episodes of mania or mixed episodes (symptoms of mania and depression that happen together) in adults, teenagers, and children 10 years of age and older with bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Aripiprazole is also used with an antidepressant to treat depression when symptoms cannot be controlled by the antidepressant alone. Aripiprazole is also used to treat children 6 to 17 years of age who have autistic disorder (a developmental problem that causes difficulty communicating and interacting with others). Aripiprazole may help control irritable behavior such as aggression, temper tantrums, and frequent mood changes in these children. Aripiprazole is also used to treat children 6 to 18 years of age who have Tourette's disorder (a condition characterized by the need to perform repeated motions or to repeat sounds or words). Aripiprazole is in a class of medications called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain.

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.

Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.

Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.

Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.