Bupropion hydrobromide ER

APLENZIN

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Pronunciation: byoo-PROE-pee-on (a-PLEN-zin)

Bupropion hydrobromide ER ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Bupropion hydrobromide ER ballicule

Bupropion hydrobromide ER WELLBUTRIN mascot mnemonic cartoon — Visual mnemonic: Bupropion hydrobromide ER mascot
**“Boop ropin’ Well booty”**
Strong CYP2D6 inHibitor
Skinny → weight loss possible

What it isNorepinephrine and dopamine reuptake inhibitor with nicotinic antagonism; major depression.

Why this oneIt is the only HBr salt; 522 mg = 450 mg HCl XL, once daily.

What limits itSeizures, insomnia, hypertension, and CYP2D6 inhibition matter; avoid in eating disorders and abrupt sedative withdrawal.

Bupropion hydrobromide ER molecular structure (skeletal formula) — Molecular structure: Bupropion hydrobromide ER

FDA-approved for

depression (2008)

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Suicidal thoughts and behaviors: increased risk in children, adolescents, and young adults taking antidepressants; monitor closely.

FDA dosing	Population	Start	Target	Max
Major depressive disorder	Adults	174 mg QAM	348 mg QD	522 mg QD
Seasonal affective disorder (prevention)	Adults	174 mg QD	348 mg QD	348 mg QD

Titration MDD: may increase after 4 days; SAD: may increase after 7 days

Renal GFR <90 mL/min: consider reduced dose and/or frequency

Hepatic Moderate–severe (Child-Pugh 7–15): max 174 mg every other day; mild (5–6): consider reduced dose/frequency

Do not exceed 522 mg once daily (dose-related seizure risk)

Instructions

Swallow whole; do not crush, divide, or chew
Take in the morning, with or without food
Discontinue by tapering: reduce 348 mg → 174 mg QD before stopping
Allow ≥14 days between an MAOI and APLENZIN in either direction

Available strengths

ER tab 174, 348, 522 mg
tab 75, 100 mg

Contraindications

Seizure disorder
Current or prior bulimia or anorexia nervosa
Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs
MAOIs (for psychiatric disorders) concurrently or within 14 days; do not start in patients on linezolid or IV methylene blue

Cautions

Dose-related seizure risk
Hypertension (can increase blood pressure)
Activation of mania/hypomania
Psychosis and other neuropsychiatric reactions
Angle-closure glaucoma
Neuropsychiatric events with smoking-cessation use

Adverse reactions

Dry mouth
Nausea
Insomnia
Dizziness
Pharyngitis
Agitation/anxiety
Tremor
Palpitation
Sweating
Tinnitus

Pregnancy First-trimester epidemiologic data do not show increased overall malformation risk; registry available.

Lactation Bupropion and active metabolites present in human milk (~2% of maternal weight-adjusted dose); seizures reported in breastfed infants.

Cost

Bupropion hydrobromide ER (APLENZIN)

Strength		#/mo	CostPlus
174 mg	ER tab	30 qd	not offered
348 mg	ER tab	30 qd	not offered
522 mg	ER tab	30 qd	not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Bupropion hydrobromide ER is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Other forms: Bupropion (WELLBUTRIN) · Bupropion SR (WELLBUTRIN SR) · Bupropion XL (WELLBUTRIN XL) · Bupropion XL 450 mg (FORFIVO XL)

Available combined with: dextromethorphan / bupropion · naltrexone / bupropion

⚠ BOXED WARNING

Suicidal thoughts and behaviors in patients under 25

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger4 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryC

Defining liabilityDose-related seizures and delayed cardiotoxicity are prominent in overdose, especially with extended-release products.

Active metabolites

Hydroxybupropion

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Memory aids: interaction avatars

CYP2B6 substrate

CYP2D6 inhibitor (strong)

Open Bupropion hydrobromide ER in the interactive console ↗