Bupropion with Dexamethasone Interaction Details

Brand Names Associated with Bupropion

Brand Names Associated with Dexamethasone

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

Interaction Effect

Lowering of the seizure threshold

Interaction Summary

Concomitant administration of buPROPion and agents that lower seizure threshold, such as systemic steroids, should be undertaken with caution. In addition to using small initial doses and gradual dose increases, follow the dosing regimen recommendation according to each product labeling as xaximum daily dose varies by product formulation and indication[1][2][3][4][5].

Severity

Major

Onset

Rapid

Evidence

Theoretical

How To Manage Interaction

The concurrent administration of buPROPion and systemic steroids should be used with caution. Maximum daily dose varies by product formulation and indication: 1) When coadministration of buPROPion immediate-release (Wellbutrin(R)) is required, do not exceed the total daily dose of 450 mg. Minimize the risk of seizure by giving the daily dose three times daily, and limit each single dose to 150 mg or less[1]. 2) When coadministered with buPROPion extended-release tablets (Wellbutrin XL(R)), do not exceed the total daily dose of 450 mg [2]. 3) Coadministration of sustained-release buPROPion (Wellbutrin SR(R)) should not exceed the total daily maximum of 400 mg, and should be given twice daily. Each single dose should not be higher than 200 mg to minimize high peak concentration of buPROPion [3]. 4) When administration of buPROPion extended-release or sustained-release buPROPion (Zyban(R)) is indicated for smoking cessation, the total daily dose should not exceed more than 300 mg. Give the daily dose twice daily, and limit each single dose to 150 mg or less [4][5]. Furthermore, consider using small initial doses and gradual dose increases.

Mechanism Of Interaction

Unknown

References

1 ) Product Information: WELLBUTRIN(R) oral tablets, bupropion hcl oral tablets. GlaxoSmithKline, Research Triangle Park, NC, 2007.

2 ) Product Information: WELLBUTRIN XL(R) extended-release oral tablets, bupropion hcl extended-release oral tablets. GlaxoSmithKline, Research Triangle Park, NC, 2007.

3 ) Product Information: WELLBUTRIN SR(R) sustained-release oral tablets, bupropion hcl sustained-release oral tablets. GlaxoSmithKline, Research Triangle Park, NC, 2006.

4 ) Product Information: bupropion hcl extended release oral tablets, bupropion hcl extended release oral tablets. Sandoz,Inc, Princeton, NJ, 2006.

5 ) Product Information: ZYBAN(R) sustained-release oral tablets, bupropion hcl sustained-release oral tablets. GlaxoSmithKline, Research Triangle Park, NC, 2007.

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.

Dexamethasone Overview

• Dexamethasone, a corticosteroid, is similar to a natural hormone produced by your adrenal glands. It often is used to replace this chemical when your body does not make enough of it. It relieves inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders (e.g., colitis); severe allergies; and asthma. Dexamethasone is also used to treat certain types of cancer.

• This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

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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.