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Smoking cessation - Management
Who should avoid taking bupropion?

  • Pregnancy: bupropion should not be used during pregnancy, as information is limited on its safety during pregnancy [ABPI Medicines Compendium, 2006].
  • Breastfeeding: bupropion should not be used during breastfeeding, as its safety has not been established [ABPI Medicines Compendium, 2006].
  • Children and adolescents: bupropion should not be used in smokers younger than 18 years of age, as its safety and efficacy have not been evaluated and it is not licensed for use in this age group.
  • Epilepsy (or increased risk of seizures): bupropion is associated with a dose-related risk of seizure. The Committee on Safety of Medicines reminds prescribers that:
    • Bupropion is contraindicated in people with:
      • A current seizure disorder or any history of seizures.
      • A current or previous diagnosis of bulimia or anorexia nervosa.
      • A central nervous system tumour.
      • Abrupt withdrawal from alcohol or benzodiazepines.
      • Severe hepatic cirrhosis.
      • Bipolar disorder.
    • Do not prescribe bupropion to people with other risk factors for seizures unless there is compelling clinical justification for which the potential benefit outweighs the increased risk of seizure. If bupropion is prescribed, consider using the lower dose of 150 mg daily throughout the entire treatment period. Risk factors for seizures include:
      • Concomitant use of any drug known to lower the seizure threshold (including antipsychotics; antidepressants; some antimalarials, such as mefloquine; theophylline; systemic corticosteroids; tramadol; quinolones; and sedating antihistamines).
      • Alcohol abuse.
      • A history of head trauma.
      • Diabetes treated with hypoglycaemic drugs or insulin.
      • Use of stimulants or anorectic products.
    • Stop bupropion if an individual has a seizure while taking it.

[CSM, 2001a]

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