7 Interactions found for:
- 5 Major
- 2 Moderate
- 0 Minor
Drug Interactions
Major
Wellbutrin Xl
+ Trazodone
The following applies to the ingredients: Bupropion (found in Wellbutrin Xl) and Trazodone
Talk to your doctor before using buPROPion together with traZODone. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of traZODone, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Drug and Food Interactions
Moderate
Wellbutrin Xl
+ Food
The following applies to the ingredients: Bupropion (found in Wellbutrin Xl)
Using buPROPion with alcohol may increase the risk of uncommon side effects such as seizures, hallucinations, delusions, paranoia, mood and behavioral changes, depression, suicidal thoughts, anxiety, and panic attacks. On the other hand, sudden withdrawal from alcohol following regular or chronic use can also increase your risk of seizures during treatment with buPROPion. If you are prone to frequent or excessive alcohol use, talk to your doctor before starting buPROPion. In general, you should avoid or limit the use of alcohol while being treated with buPROPion. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
The following applies to the ingredients: Bupropion (found in Wellbutrin Xl)
Both buPROPion and caffeine can increase blood pressure. And using them together may have additive effects. Talk to your doctor if you have any questions or concerns, particularly if you have a history of high blood pressure or heart disease. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
The following applies to the ingredients: Bupropion (found in Wellbutrin Xl)
Using buPROPion and nicotine together can cause an increase in blood pressure. This can cause dizziness, confusion, uneven heartbeats, and chest pain. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or need your blood pressure checked more often if you take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate
Trazodone
+ Food
The following applies to the ingredients: Trazodone
Alcohol can increase the nervous system side effects of traZODone such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with traZODone. Do not use more than the recommended dose of traZODone, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.
Drug and Pregnancy Interactions
Major
Wellbutrin Xl
+ Pregnancy
The following applies to the ingredients: Bupropion (found in Wellbutrin Xl)
Professional Content
This drug should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Smoking cessation without the use of medications is advisable during pregnancy.
AU TGA pregnancy category: B2
US FDA pregnancy category: C
Comments:
-A pregnancy exposure registry is available.
-Neonates exposed to this drug late in the third trimester may require respiratory support, tube feeding, and/or prolonged hospitalization.
-Exposed neonates should be monitored after delivery for direct toxic effects of this drug, drug discontinuation syndrome, and serotonin syndrome (e.g.,. respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypo/hypertonia, hyperreflexia, tremor, jitteriness, irritability, constant crying).
High dose animal studies have failed to reveal evidence of specific teratogenic effects. Low dose animal studies in rabbits have reported a slightly increased incidence of fetal malformations and skeletal variations. Epidemiological studies of pregnant women exposed to bupropion in the first trimester show no increased risk of congenital malformations overall.
Data from the international bupropion pregnancy register (675 trimester exposures) and a retrospective cohort study using the United Healthcare database (1,213 first trimester exposures) and a case-control study from the National Birth Defects Prevention Study (6,853 infants with cardiovascular malformations and 5,763 with non-cardiovascular malformations) did not show an increased risk for malformations overall after bupropion exposure during the first trimester. A retrospective database of infants (n=7005) whose mothers were exposed to bupropion in the first trimester and outside of the first trimester also failed to reveal an increased risk for congenital malformation, especially cardiovascular malformation. Study findings on the risk for left ventricular outflow tract obstruction and ventricular septal defect after first trimester exposure to bupropion are inconclusive.
To monitor maternal-fetal outcomes of pregnant women exposed to antidepressant therapy, a National Pregnancy Registry for Antidepressants has been established. Healthcare providers are encouraged to prospectively register patients. For additional information: https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/antidepressants/
AU TGA pregnancy category B2: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals are inadequate or may be lacking, but available data show no evidence of an increased occurrence of fetal damage.
US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
References
- "Product Information. Wellbutrin (bupropion)." Glaxo Wellcome PROD (2001):
- "Product Information. Wellbutrin SR (bupropion)." Glaxo Wellcome PROD (2001):
- "Product Information. Zyban (bupropion)." Glaxo Wellcome PROD (2001):
- "Product Information. Wellbutrin XL (bupropion)." GlaxoSmithKline (2003):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Aplenzin (bupropion)." sanofi-aventis (2009):
Major
Trazodone
+ Pregnancy
The following applies to the ingredients: Trazodone
Professional Content
This drug should be used during pregnancy only if the benefit outweighs the risk to the fetus.
-Some experts recommend: Use with caution; use should be avoided during the first trimester of pregnancy.
US FDA pregnancy category: C
Comment: When this drug is used until delivery, newborns should be monitored for the occurrence of withdrawal symptoms.
Animal studies have revealed evidence of increased fetal resorption and congenital anomalies in adolescents. Other animal models have failed to reveal evidence of adverse effects on embryofetal development, parturition, or postnatal development when given at therapeutic doses. There are no controlled data in human pregnancy.
US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
References
- "Product Information. Desyrel (trazodone)." Bristol-Myers Squibb PROD (2001):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Drug and Breastfeeding Interactions
Major
Wellbutrin Xl
+ Breastfeeding
The following applies to the ingredients: Bupropion (found in Wellbutrin Xl)
Professional Content
A decision should be made to discontinue nursing or discontinue the drug, taking into account the benefit of breast-feeding to the infant and the importance of the drug to the mother.
-Some experts recommend: Use with caution.
Excreted into human milk: Yes
Comment: Another drug may be preferred, particularly when breastfeeding a newborn or preterm infant.
There is limited information that maternal bupropion at oral doses up to 300 mg daily produces low levels in breastmilk. It is not generally expected to cause adverse effects in breastfed infants; however, there are case reports of possible seizure in partially breastfed 6-month-olds. Alternate drugs that may be considered in place of bupropion include nortriptyline, paroxetine, and sertraline.
One case report has suggested that bupropion accumulates in human breast milk in concentrations much greater than in maternal plasma. At least two metabolites of bupropion are also detectable in human milk. However, in the plasma of one nursing infant whose mother took bupropion, neither bupropion nor its metabolites could be detected.
Data from a lactation study in 10 women showed breastmilk levels of 45.2 mcg/L for bupropion, and 104.6 mcg/mL, 72.1 mcg/mL, and 459 mcg/mL for it metabolites hydroxybupropion, erythrohydroxybupropion, and threohydroxybupropion, respectively. The authors of this study estimated that an exclusively breastfed infant would receive an average of 0.2% of the maternal weight-adjusted dose of bupropion and an average of 2% of the maternal weight-adjusted dosage of bupropion plus metabolites.
References
- "Product Information. Wellbutrin (bupropion)." Glaxo Wellcome PROD (2001):
- "Product Information. Wellbutrin SR (bupropion)." Glaxo Wellcome PROD (2001):
- "Product Information. Zyban (bupropion)." Glaxo Wellcome PROD (2001):
- "Product Information. Wellbutrin XL (bupropion)." GlaxoSmithKline (2003):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Aplenzin (bupropion)." sanofi-aventis (2009):
- United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
Major
Trazodone
+ Breastfeeding
The following applies to the ingredients: Trazodone
Professional Content
A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.
-Some experts recommend: Caution is recommended.
Excreted into human milk: Yes
Comments:
-The effects in the nursing infant are unknown.
-The American Academy of Pediatrics considers this agent a drug for which the effect on nursing infants is unknown but may be of concern.
References
- "Product Information. Desyrel (trazodone)." Bristol-Myers Squibb PROD (2001):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Briggs GG, Freeman RK. "Drugs in Pregnancy and Lactation." Philadelphia, PA: Wolters Kluwer Health (2015):
Therapeutic Duplication Warnings
Warning
Antidepressants
The following applies to: Wellbutrin Xl (bupropion), Trazodone
Professional Content
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one. Your list includes two medicines.
Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.
Switch to: Professional Interactions
| Drug Interaction Classification | |
|---|---|
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
| Unknown | No interaction information available. |
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