Antidepressant medicines may increase the risk of suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment.
Depression or other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a particularly high risk of having suicidal thoughts or actions. These include people who have (or have a family history of) bipolar illness (also called manic-depressive illness) or suicidal thoughts or actions.
How can I watch for and try to prevent suicidal thoughts and actions in myself or a family member?
Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant medicine is started or when the dose is changed.
Call your healthcare provider right away to report new or sudden changes in mood, behavior, thoughts, or feelings.
Keep all follow up visits with your healthcare provider as scheduled. Call the healthcare provider between visits as needed, especially if you have concerns about symptoms.
Call your healthcare provider right away if you or your family member has any of the following symptoms, especially if they are new, worse, or worry you:
thoughts about suicide or dying
attempts to commit suicide
new or worse depression
new or worse anxiety
feeling very agitated or restless
panic attacks
trouble sleeping (insomnia)
new or worse irritability
acting aggressive, being angry, or violent
acting on dangerous impulses
an extreme increase in activity and talking (mania)
other unusual changes in behavior or mood

Never stop an antidepressant medicine without first talking to a healthcare provider. Stopping an antidepressant medicine suddenly can cause other symptoms.
Antidepressants are medicines used to treat depression and other illnesses. It is important to discuss all the risks of treating depression and also the risks of not treating it. Patients and their families or other caregivers should discuss all treatment choices with the healthcare provider, not just the use of antidepressants.
Antidepressant medicines have other side effects. Talk to the healthcare provider about the side effects of the medicine prescribed for you or your family member.
Antidepressant medicines can interact with other medicines. Know all of the medicines that you or your family member takes. Keep a list of all medicines to show the healthcare provider. Do not start new medicines without first checking with your healthcare provider.
It is not known if bupropion hydrochloride extended-release tablets (XL) is safe and effective in children under the age of 18.
Quitting Smoking, Quit-Smoking Medications, Changes in Thinking and Behavior, Depression, and Suicidal Thoughts or Actions
This section of the Medication Guide is only about the risk of changes in thinking and behavior, depression and suicidal thoughts or actions with drugs used to quit smoking. Although bupropion hydrochloride extended-release tablets (XL) are not a treatment for quitting smoking, it contains the same active ingredient (bupropion hydrochloride) as ZYBAN® which is used to help patients quit smoking.Talk to your healthcare provider or your family member’s healthcare provider about:
all risks and benefits of quit-smoking medicines.
all treatment choices for quitting smoking.
When you try to quit smoking, with or without bupropion you may have symptoms that may be due to nicotine withdrawal, including:
urge to smoke
depressed mood
trouble sleeping
irritability
frustration
anger
feeling anxious
difficulty concentrating
restlessness
decreased heart rate
increased appetite
weight gain
Some people have even experienced suicidal thoughts when trying to quit smoking without medication. Sometimes quitting smoking can lead to worsening of mental health problems that you already have, such as depression. Some people have had serious side effects while taking bupropion to help them quit smoking, including:
New or worse mental health problems, such as changes in behavior or thinking, aggression, hostility, agitation, depression, or suicidal thoughts or actions. Some people had these symptoms when they began taking bupropion, and others developed them after several weeks of treatment, or after stopping bupropion. These symptoms happened more often in people who had a history of mental health problems before taking bupropion than in people without a history of mental health problems.
Stop taking bupropion hydrochloride extended-release tablets (XL) and call your healthcare provider right away if you, your family, or caregiver notice any of these symptoms. Work with your healthcare provider to decide whether you should continue to take bupropion hydrochloride extended-release tablets (XL). In many people, these symptoms went away after stopping bupropion hydrochloride extended-release tablets (XL), but in some people symptoms continued after stopping bupropion hydrochloride extended-release tablets (XL). It is important for you to follow-up with your healthcare provider until your symptoms go away. Before taking bupropion hydrochloride extended-release tablets (XL), tell your healthcare provider if you have ever had depression or other mental health problems. You should also tell your healthcare provider about any symptoms you had during other times you tried to quit smoking, with or without bupropion.

Seizures: There is a chance of having a seizure (convulsion, fit) with bupropion hydrochloride extended-release tablets (XL), especially in people:
with certain medical problems
who take certain medicines
The chance of having seizures increases with higher doses of bupropion hydrochloride extended-release tablets (XL). For more information, see the sections “Who should not take bupropion hydrochloride extended-release tablets (XL)?” and “What should I tell my healthcare provider before taking bupropion hydrochloride extended-release tablets (XL)?” Tell your healthcare provider about all of your medical conditions and all the medicines you take. Do not take any other medicines while you are taking bupropion hydrochloride extended-release tablets (XL) unless your healthcare provider has said it is okay to take them.
If you have a seizure while taking bupropion hydrochloride extended-release tablets (XL), stop taking the tablets and call your healthcare provider right away. Do not take bupropion hydrochloride extended-release tablets (XL) again if you have a seizure.
High blood pressure (hypertension): Some people get high blood pressure, that can be severe, while taking bupropion hydrochloride extended-release tablets (XL). The chance of high blood pressure may be higher if you also use nicotine replacement therapy (such as a nicotine patch) to help you stop smoking (see the section of this Medication Guide called “How should I take bupropion hydrochloride extended-release tablets (XL)?”).
Manic episodes:Some people may have periods of mania while taking bupropion hydrochloride extended-release tablets (XL), including:
Greatly increased energy
Severe trouble sleeping
Racing thoughts
Reckless behavior
Unusually grand ideas
Excessive happiness or irritability
Talking more or faster than usual
If you have any of the above symptoms of mania, call your healthcare provider.
Unusual thoughts or behaviors: Some patients have unusual thoughts or behaviors while taking bupropion hydrochloride extended-release tablets (XL), including delusions (believe you are someone else), hallucinations (seeing or hearing things that are not there), paranoia (feeling that people are against you), or feeling confused. If this happens to you, call your healthcare provider.
Visual problems:
eye pain
changes in vision
swelling or redness in or around the eye
Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.
Severe allergic reactions: Some people can have severe allergic reactions to bupropion hydrochloride extended-release tablets (XL). Stop taking bupropion hydrochloride extended-release tablets (XL) and call your healthcare provider right away if you get a rash, itching, hives, fever, swollen lymph glands, painful sores in the mouth or around the eyes, swelling of the lips or tongue, chest pain, or have trouble breathing. These could be signs of a serious allergic reaction.

Bupropion hydrochloride extended-release tablets (XL) should be used with a patient support program. It is important to participate in the behavioral program, counseling, or other support program your healthcare professional recommends.
Quitting smoking can lower your chances of having lung disease, heart disease, or getting certain types of cancer that are related to smoking.
Who should not take bupropion hydrochloride extended-release tablets (XL)?Do not take bupropion hydrochloride extended-release tablets (XL) if you:
have or had a seizure disorder or epilepsy.
have or had an eating disorder such as anorexia nervosa or bulimia.
are taking any other medicines that contain bupropion, including WELLBUTRIN®, WELLBUTRIN SR®, APLENZIN®, ZYBAN® or FORFIVO XL®. Bupropion is the same active ingredient that is in bupropion hydrochloride extended-release tablets (XL).
drink a lot of alcohol and abruptly stop drinking, or take medicines called sedatives (these make you sleepy), benzodiazepines, or anti-seizure medicines, and you stop taking them all of a sudden.
take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid.
do not take an MAOI within 2 weeks of stopping bupropion hydrochloride extended-release tablets (XL) unless directed to do so by your healthcare provider.
do not start bupropion hydrochloride extended-release tablets (XL) if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your healthcare provider.
are allergic to the active ingredient in bupropion hydrochloride extended-release tablets (XL), bupropion hydrochloride, or to any of the inactive ingredients. See the end of this Medication Guide for a complete list of ingredients in bupropion hydrochloride extended-release tablets (XL).
What should I tell my healthcare provider before taking bupropion hydrochloride extended-release tablets (XL)?Tell your healthcare provider if you have ever had depression, suicidal thoughts or actions, or other mental health problems. You should also tell your healthcare provider about any symptoms you had during other times you tried to quit smoking, with or without bupropion hydrochloride extended-release tablets (XL). See “Quitting Smoking, Quit-Smoking Medications, Changes in Thinking and Behavior, Depression, and Suicidal Thoughts or Actions.”

have liver problems, especially cirrhosis of the liver.
have kidney problems.
have, or have had, an eating disorder such as anorexia nervosa or bulimia.
have had a head injury.
have had a seizure (convulsion, fit).
have a tumor in your nervous system (brain or spine).
have had a heart attack, heart problems, or high blood pressure.
are a diabetic taking insulin or other medicines to control your blood sugar.
drink alcohol.
abuse prescription medicines or street drugs.
are pregnant or plan to become pregnant.
are breastfeeding. Bupropion passes into your milk in small amounts.
Tell your healthcare provider about all the medicines you take, including prescription, over-the-counter medicines, vitamins, and herbal supplements. Many medicines increase your chances of having seizures or other serious side effects if you take them while you are taking bupropion hydrochloride extended-release tablets (XL).

Start bupropion hydrochloride extended-release tablets (XL) before you stop smoking to give bupropion hydrochloride extended-release tablets (XL) time to build up in your body. It takes about 1 week for bupropion hydrochloride extended-release tablets (XL) to start working.
Pick a date to stop smoking that is during the second week you are taking bupropion hydrochloride extended-release tablets (XL).
Take bupropion hydrochloride extended-release tablets (XL) exactly as prescribed by your healthcare provider. Do not change your dose or stop taking bupropion hydrochloride extended-release tablets (XL) without talking with your healthcare provider first.
Bupropion hydrochloride extended-release tablets (XL) are usually taken for 7 to 12 weeks. Your healthcare provider may decide to prescribe bupropion hydrochloride extended-release tablets (XL) for longer than 12 weeks to help you stop smoking. Follow your healthcare provider’s instructions.
Swallow bupropion hydrochloride extended-release tablets (XL) whole. Do not chew, cut, or crush bupropion hydrochloride extended-release tablets (XL). If you do, the medicine will be released into your body too quickly. If this happens you may be more likely to get side effects including seizures. Tell your healthcare provider if you cannot swallow tablets.
Bupropion hydrochloride extended-release tablets (XL) may have an odor. This is normal.
Take your doses of bupropion hydrochloride extended-release tablets (XL) at least 8 hours apart.
You may take bupropion hydrochloride extended-release tablets (XL) with or without food.
It is not dangerous to smoke and take bupropion hydrochloride extended-release tablets (XL) at the same time. But, you will lower your chance of breaking your smoking habit if you smoke after the date you set to stop smoking.
You may use bupropion hydrochloride extended-release tablets (XL) and nicotine patches (a type of nicotine replacement therapy) at the same time, following the precautions below.
You should only use bupropion hydrochloride extended-release tablets (XL) and nicotine patches together under the care of your healthcare provider. Using bupropion hydrochloride extended-release tablets (XL) and nicotine patches together may raise your blood pressure, and sometimes this can be severe.
Tell your healthcare provider if you plan to use nicotine patches. Your healthcare provider should check your blood pressure regularly if you use nicotine patches with bupropion hydrochloride extended-release tablets (XL) to help you quit smoking.
If you miss a dose, do not take an extra dose to make up for the dose you missed. Wait and take your next dose at the regular time. This is very important.Too much bupropion hydrochloride extended-release tablets (XL) can increase your chance of having a seizure.
If you take too much bupropion hydrochloride extended-release tablets (XL), or overdose, call your local emergency room or poison control center right away.
Do not take any other medicines while taking bupropion hydrochloride extended-release tablets (XL) unless your healthcare provider has told you it is okay.

Limit or avoid using alcohol during treatment with bupropion hydrochloride extended-release tablets (XL). If you usually drink a lot of alcohol, talk with your healthcare provider before suddenly stopping. If you suddenly stop drinking alcohol, you may increase your chance of having seizures.
Do not drive a car or use heavy machinery until you know how bupropion hydrochloride extended-release tablets (XL) affects you. Bupropion hydrochloride extended-release tablets (XL) can affect your ability to do these things safely.
What are possible side effects of bupropion hydrochloride extended-release tablets (XL)?Bupropion hydrochloride extended-release tablets (XL) can cause serious side effects. See the sections at the beginning of this Medication Guide for information about serious side effects of bupropion hydrochloride extended-release tablets (XL).

trouble sleeping
stuffy nose
dry mouth
dizziness
feeling anxious
nausea
constipation
joint aches
If you have trouble sleeping, do not take bupropion hydrochloride extended-release tablets (XL) too close to bedtime.
Tell your healthcare provider right away about any side effects that bother you.
These are not all the possible side effects of bupropion hydrochloride extended-release tablets (XL). For more information, ask your healthcare provider or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
You may also report side effects to Epic Pharma, LLC at 1-888-374-2791.

Store bupropion hydrochloride extended-release tablets (XL) at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature].
Keep bupropion hydrochloride extended-release tablets (XL) and all medicines out of the reach of children.

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use bupropion hydrochloride extended-release tablets (XL) for a condition for which it was not prescribed. Do not give bupropion hydrochloride extended-release tablets (XL) to other people, even if they have the same symptoms you have. It may harm them.
If you take a urine drug screening test, bupropion hydrochloride extended-release tablets (XL), may make the test result positive for amphetamines. If you tell the person giving you the drug screening test that you are taking bupropion hydrochloride extended-release tablets (XL), they can do a more specific drug screening test that should not have this problem.
This Medication Guide summarizes important information about bupropion hydrochloride extended-release tablets (XL). If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for information about bupropion hydrochloride extended-release tablets (XL) that is written for health professionals.
For more information about bupropion hydrochloride extended-release tablets (XL), call 1-888-374-2791.