Bupropion and Nevirapine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Nevirapine
Bupropion
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced buPROPion and hydroxybuPROPion exposure
Interaction Deep Dive
Avoid coadministration of buPROPion (CYP2B6 substrate) and CYP2B6 inducers, as it may reduce efficacy1 and may decrease exposure of buPROPion and hydroxybuPROPion 234. In a series of studies in healthy volunteers, coadministration of buPROPion with CYP2B6 inducers decreased buPROPion exposure by as much as 66% in a dose-dependent manner. If coadministration is necessary, consider increasing the buPROPion dose if necessary (avoiding exceeding the maximum recommended dose) 534.
Why it happens (mechanism)
Induction of CYP2B6-mediated buPROPion metabolism
Literature reports
4 reports — tap to read
a) Concomitant administration of buPROPion and ritonavir resulted in decreased buPROPion AUC and Cmax. When buPROPion was administered concurrently with ritonavir 600 mg twice daily for 8 days in healthy volunteers, decreases in AUC and Cmax were observed for both buPROPion (66% and 62%, respectively) and the hydroxybuPROPion metabolite (78% and 42%, respectively). In a second study, concomitant administration of buPROPion and ritonavir 100 mg twice daily in healthy volunteers reduced AUC and Cmax for both buPROPion (22% and 21%, respectively) and the hydroxybuPROPion metabolite exposure was reduced by 23% 15234.
b) Short-term ritonavir administration had minimal effect on buPROPion pharmacokinetics in healthy males in a randomized, crossover study (N=7, age 18 to 45 years). Subjects received either oral ritonavir 200 mg twice daily for 2 consecutive days or placebo. BuPROPion was given to all subjects as a single, oral 75 mg dose concurrently with the morning ritonavir or placebo dose on day 2. Following a 1-week washout period, subjects were crossed over to the opposite treatment arm and the procedure was repeated. Results showed a less than 20% change in pharmacokinetic parameters for buPROPion and its metabolites (hydroxybuPROPion, threohydrobuPROPion, and erythrohydrobuPROPion) when coadministered with ritonavir. Significant changes occurred in threohydrobuPROPion AUC, which decreased by 14%, and erythrohydrobuPROPion Tmax, which increased by 161%, from 2.6 to 5.2 hours 6.
c) In 13 healthy volunteers, the administration of a single dose of buPROPion 150 mg sustained-release before and after a 2-week regimen of efavirenz 600 mg once daily resulted in significant 34% and 55% decreases in buPROPion Cmax and AUC values, respectively, and a 50% increase in the Cmax of hydroxybuPROPion (active metabolite of buPROPion). While the ratio of hydroxybuPROPion to buPROPion increased significantly (2.3-fold) with the concomitant use of efavirenz, the AUC of hydroxybuPROPion was not affected 7.
d) In an open-label, sequential, 3-phase study in healthy participants, coadministration of buPROPion and lopinavir/ritonavir significantly decreased buPROPion and hydroxybuPROPion exposure. Subjects aged 20 to 44 years (N=12) were given a single 100-mg dose of sustained-release buPROPion (day 1) and following a 2-week washout period received lopinavir 400 mg/ritonavir 100 mg twice daily for 14 days. On day 30, a second 100-mg dose of sustained-release buPROPion was given simultaneously with lopinavir/ritonavir. Results showed that, when given in combination with lopinavir/ritonavir, both mean buPROPion Cmax and AUC significantly decreased by 57% compared to when buPROPion was given alone. The mean Cmax and AUC of buPROPion's active metabolite, hydroxybuPROPion, also significantly decreased by 31% and 50%, respectively. The AUC ratio of hydroxybuPROPion to buPROPion increased from 12.2 when buPROPion was given alone to 14.5 when given concurrently with lopinavir/ritonavir. No significant alterations occurred in lopinavir/ritonavir pharmacokinetic parameters 8.
Common questions
Can I take Bupropion and Nevirapine together?
Reduced buPROPion and hydroxybuPROPion exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Bupropion and Nevirapine interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Bupropion or Nevirapine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (8)
- Product Information: CONTRAVE(R) oral extended-release tablets, naltrexone HCl bupropion HCl oral extended-release tablets. Currax Pharmaceuticals LLC (per FDA), Brentwood, TN, 2024. DailyMed
- Product Information: WELLBUTRIN(R) SR oral sustained-release tablets, bupropion hydrochloride oral sustained-release tablets. GlaxoSmithKline (per FDA), Durham, NC, 2024. DailyMed
- Product Information: WELLBUTRIN(R) oral tablets, bupropion hydrochloride oral tablets. GlaxoSmithKline (per FDA), Durham, NC, 2024. DailyMed
- Product Information: FORFIVO XL(R) oral extended-release tablets, bupropion hydrochloride oral extended-release tablets. TWi Pharmaceuticals USA, Inc (per FDA), Paramus, NJ, 2024. DailyMed
- Product Information: WELLBUTRIN XL(R) oral extended-release tablets, bupropion hydrochloride oral extended-release tablets. Bausch Health US, LLC (per FDA), Bridgewater, NJ, 2024. DailyMed
- Hesse LM, Greenblatt DJ, vonMoltke LL, et al: Ritonavir has minimal impact on the pharmacokinetic disposition of a single dose of bupropion administered to human volunteers. J Clin Pharmacol 2006; 46(5):567-576. PubMed
- Robertson SM, Maldarelli F, Natarajan V, et al: Efavirenz induces CYP2B6-mediated hydroxylation of bupropion in healthy subjects. J Acquir Immune Defic Syndr 2008; 49(5):513-519. DOI
- Hogeland GW, Swindells S, McNabb JC, et al: Lopinavir/ritonavir reduces bupropion plasma concentrations in healthy subjects. Clin Pharmacol Ther 2007; 81(1):69-75. PubMed
Keep reading about Nevirapine
Keep reading about Bupropion
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist