Bupropion: risk of serotonin syndrome
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Bupropion: risk of serotonin syndrome The UK Medicines and Healthcare products Regulatory Authority (MHRA) is warning that the smoking cessation aid bupropion [Zyban] is associated with a risk of serotonin syndrome if an overdose is taken or when administered in combination with other serotonergic drugs such as selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). Healthcare professionals are advised that if bupropion is prescribed along with other serotonergic drugs, the recommended dosage should not be exceeded, and they should remind patients that they may experience mild symptoms of serotonergic syndrome when bupropion is initiated or the dosage is changed. If serotonin syndrome is suspected, the dosage of bupropion should be reduced or treatment withdrawn, depending on the serverity of symptoms. Patients should contact their prescriber if they develop signs or symptoms of serotonin syndrome including nausea, vomiting, diarrhoea, unstable blood pressure, tachycardia, agitation, hallucinations, muscular rigidity or lack of coordination. They should be advised to never exceed the prescribed dosage, and to read the side effects section of the patient information leaflet so that they are aware of when to seek medical advice. A European review of safety data for Zyban identified at least eight cases of serotonin syndrome possibly due to an interaction between bupropion and a serotonergic drug. It also identified six cases of serotonin syndrome with evidence of bupropion overdose; in most these cases the patients had intentionally exceeded the prescribed dose. The summary of product characteristics and patient information leaflet have been updated to include postmarketing reports of serotonin syndrome when bupropion is coadministered with a serotonergic agent such as a SSRI or SNRI, and advice that serotonin syndrome has been reported after bupropion overdoses. Up to October 2020, three reports of serotonin syndrome after overdose or concomitant use of antidepressants were reported to the UK Yellow Card scheme. MHRA. Bupropion (Zyban): risk of serotonin syndrome with use with other serotonergic drugs. Internet Document : 16 Nov 2020. Available from: URL: https://www.gov.uk/ 803517757 drug-safety-update/bupropion-zyban-risk-of-serotonin-syndrome-with-use-with-other-serotonergic-drugs
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Reactions 28 Nov 2020 No. 1832
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