| Clinical use of bupropion SR 150 (FDA approved) | |
|---|---|
| Patient selection | Appropriate as a first-line medication for treating tobacco use |
| Precautions, warnings, contraindications, and side effects (see FDA package insert for complete list) | Pregnancy - Pregnant smokers should be encouraged to quit
without medication. Bupropion has not been shown to be effective for tobacco dependence
treatment in pregnant smokers. (Bupropion is an FDA pregnancy Class C agent.) Bupropion
has not been evaluated in breastfeeding patients. Cardiovascular diseases - Generally well-tolerated; occasional reports of hypertension. Side effects - The most common reported side effects were insomnia (35–40%) and dry mouth (10%). Contraindications - Bupropion SR is contraindicated in individuals who have a history of seizures or eating disorders, who are taking another form of bupropion, or who have used an MAO inhibitor in the past 14 days. |
| Dosage | Patients should begin bupropion SR treatment 1–2 weeks before they quit smoking. Patients should begin with a dose of 150 mg every morning for 3 days, then increase to 150 mg twice daily. Dosage should not exceed 300 mg per day. Dosing at 150 mg twice daily should continue for 7–12 weeks. For long-term therapy, consider use of bupropion SR 150 mg for up to 6 months postquit. |
| Availability | Prescription only |
| Prescribing instructions | Stopping smoking prior to quit date - Recognize that some
patients may lose their desire to smoke prior to their quit date or will spontaneously
reduce the amount they smoke. Dosing information - If insomnia is marked, taking the PM dose earlier (in the afternoon, at least 8 hours after the first dose) may provide some relief. Alcohol - Use alcohol only in moderation. |
| Costa | 1 box of 60 tablets, 150 mg = $97 per month (generic); $197 to $210 (Brand name) |
Cost data were established by averaging the retail price of the medication at national chain pharmacies in Atlanta, GA, Los Angeles, CA, Milwaukee, WI, Sunnyside, NY, and listed online during January 2008 and may not reflect discounts available to health plans and others.
From: 6, Evidence and Recommendations
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