1. Where’s my Chiral Carbon?

2. My IPPE site

3. Brand Names and Strengths

4. Aplenzin Budeprion SR Budeprion XL Buproban Forfivo XL Wellbutrin Wellbutrin SR Wellbutrin XL Zyban As of October 2013, the US Federal Drug Administration asked for the withdrawal of one brand and strength. Who was pulled of the shelf? Bonus: What was the dosage strength? 300mg

6. Indications Therapeutic class?

7. Indications Major depressive disorder Seasonal affective disorder Depression associated with bipolar disorder Panic disorder Adjunct for smoking cessation ADHD

8. Mechanism of Action

9. Metabolised in liver to hydroxybupropion Inhibits neuronal uptake/reuptake of norepinephrine, dopamine, and serotonin Does not inhibit monoamine oxidase Pharmacology Question: What kind of activity is this?

10. Side and Adverse Effects Lowered mood Suicidal ideation Fast heartrate Headache Nervousness Seizures Inability to sleep Agitation

11. Counseling Points Storage: Room temperature Protect from light Dry Use: Avoid missing dose Can be taken without food Take early to avoid sleeping problems Adherence: Take as soon as you think it If close to next dose, skipped missed dose and return to usual dosing schedule

12. Bioequivalence FDA determined in a review that Budeprion XL 300mg from TEVA and generic Bupropion XL 300mg from Watson were not equivalent to Wellbutrin XL 300mg

14. Bioequivalence

15. What should the patient do? If currently taking… If a new prescription comes in… Available substitutions: Actavis Mylan Par Pharmaceutical (Actvavis and Watson recently merged)

16. References BuPROPion. In: Lexi-Drugs [database on the internet]. Hudson (OH): Lexicomp; 2013 [cited 28 Oct 2013]. BuPROPion. In: Drugdex Evaluations [database on the internet]. Greenwood Village (CO): Thompson Micromedex; 2013 [28 Oct 2013]. Questions and Answers Regarding Market Withdrawal of Budeprion XL 300 mg Manufactured by Impax and Marketd by Teva [Internet]. Silver Spring (MD): US Food an Drug Administration; 2013 [cited 28 Oct 2013]. Available from http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders /ucm322160.htm Update: Bupropion Hydrochloride Extended-Release 300 mg Bioequivalence Studies [Internet]. Silver Spring (MD): US Food an Drug Administration; 2013 [cited 28 Oct 2013]. Available from http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders /ucm322161.htm Review of Therapeutic Equivalence Generic Bupropion XL 300 mg and Wellbutrin XL 300 mg [Internet]. http://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/ucm 153270.htm Bupropion. In: DynaMed [database on the internet]. Ipswich (MA): EBSCO; 2013 [28 Oct 2013] Katzung BG. Chapter 6. Introduction to Autonomic Pharmacology. In: Basic & Clinical Pharmacology,. 12 th ed. New York: McGraw-Hill; 2012 Bupropion [Internet]. Bethesda, MA: AHFS; 2013 [cited 28 Oct 2013]. Available from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a695033.html

17. Other interesting drugs at IPPE