Zybex SR
Generic Name
Bupropion Hydrochloride
Manufacturer
ACI Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zybex sr 150 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Zybex SR (Bupropion Hydrochloride) is an antidepressant primarily used to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). It is also used as an aid to smoking cessation.
Uses & Indications
Dosage
Adults
For MDD: Initially 150 mg once daily. After 4 days, may increase to 300 mg once daily. Max 450 mg/day. For smoking cessation: Initially 150 mg once daily for 3 days, then 150 mg twice daily.
Elderly
Consider lower starting doses and slower titration due to potential age-related decrease in renal or hepatic function.
Renal_impairment
Reduced dose and/or frequency may be necessary. For severe impairment, consider 75 mg once daily.
How to Take
Take orally, swallowed whole, with or without food. Do not crush, cut, or chew the tablet.
Mechanism of Action
Bupropion is a relatively weak inhibitor of the neuronal reuptake of norepinephrine and dopamine. It does not inhibit monoamine oxidase or serotonin reuptake. Its antidepressant and smoking cessation effects are thought to be mediated by noradrenergic and dopaminergic mechanisms.
Pharmacokinetics
Onset
Antidepressant effects typically observed within 1 to 4 weeks. Smoking cessation effects may be seen within the first week.
Excretion
Approximately 87% of the dose is excreted in the urine and 10% in the feces.
Half life
Bupropion has an elimination half-life of approximately 21 hours. Its active metabolites have half-lives ranging from 20 to 37 hours.
Absorption
Well absorbed after oral administration; peak plasma levels achieved in about 5 hours for SR formulation.
Metabolism
Extensively metabolized in the liver, primarily by the CYP2B6 isoenzyme, to three active metabolites (hydroxybupropion, threohydrobupropion, and erythrohydrobupropion).
Side Effects
Contraindications
- Seizure disorder or history of seizures
- History of bulimia or anorexia nervosa
- Abrupt discontinuation of alcohol or sedatives
- Concomitant use with monoamine oxidase inhibitors (MAOIs)
Drug Interactions
MAOIs
Concomitant use is contraindicated. A washout period of at least 14 days is required between discontinuing an MAOI and starting bupropion, and vice versa.
CYP2B6 inhibitors/inducers
Dose adjustment may be necessary if co-administered with strong CYP2B6 inhibitors (e.g., ticlopidine, clopidogrel) or inducers (e.g., ritonavir, efavirenz).
Drugs lowering seizure threshold
Use with caution with other medications that may lower the seizure threshold (e.g., antipsychotics, other antidepressants, systemic corticosteroids).
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include seizures, hallucinations, loss of consciousness, sinus tachycardia, and cardiac arrhythmias. Management involves supportive care, gastric lavage, and activated charcoal. Benzodiazepines may be used to control seizures.
Pregnancy & Lactation
Pregnancy category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Bupropion and its metabolites are excreted in human milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Seizure disorder or history of seizures
- History of bulimia or anorexia nervosa
- Abrupt discontinuation of alcohol or sedatives
- Concomitant use with monoamine oxidase inhibitors (MAOIs)
Drug Interactions
MAOIs
Concomitant use is contraindicated. A washout period of at least 14 days is required between discontinuing an MAOI and starting bupropion, and vice versa.
CYP2B6 inhibitors/inducers
Dose adjustment may be necessary if co-administered with strong CYP2B6 inhibitors (e.g., ticlopidine, clopidogrel) or inducers (e.g., ritonavir, efavirenz).
Drugs lowering seizure threshold
Use with caution with other medications that may lower the seizure threshold (e.g., antipsychotics, other antidepressants, systemic corticosteroids).
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include seizures, hallucinations, loss of consciousness, sinus tachycardia, and cardiac arrhythmias. Management involves supportive care, gastric lavage, and activated charcoal. Benzodiazepines may be used to control seizures.
Pregnancy & Lactation
Pregnancy category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Bupropion and its metabolites are excreted in human milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved by FDA (US), DGDA (Bangladesh)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of bupropion for its approved indications.
Lab Monitoring
- Routine monitoring not generally required. Monitor blood pressure, especially in patients with pre-existing hypertension. Consider liver and renal function tests in patients with impairment.
Doctor Notes
- Counsel patients on the risk of seizures and neuropsychiatric events, especially when used for smoking cessation.
- Monitor blood pressure regularly, particularly in patients with a history of hypertension.
Patient Guidelines
- Take Zybex SR exactly as prescribed. Do not crush, chew, or divide the tablet.
- Take doses at least 8 hours apart (if prescribed twice daily) to minimize seizure risk.
- Do not stop taking the medication suddenly without consulting your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next scheduled dose. Do not take two doses at the same time to make up for a missed dose.
Driving Precautions
Zybex SR may cause dizziness, drowsiness, or impaired judgment. Patients should be cautious when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Avoid or minimize alcohol consumption, as it may increase the risk of seizures and other side effects.
- Inform your doctor about any new or worsening mood symptoms, anxiety, or suicidal thoughts.
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