| Smoking cessation (label). View labelExact | Label dosing is typically started before the target quit date with a short titration to reduce nausea, then continued for a defined course (often 12 weeks) with behavioral support (label/guideline). | Nicotinic acetylcholine receptor partial agonist (α4β2) used to support smoking cessation by reducing cravings and blunting nicotine reinforcement; often paired with behavioral support (label/guideline). | Minimal metabolism; primarily renal excretion (label) | Single-dose mean 24 h | No | — | - Track smoking status and document quit attempts, because medication doses for CYP1A2 substrates may need reassessment when smoking stops (clinical).
- Monitor nausea and sleep effects early; adjust the plan based on tolerability and functional impact (label/clinical).
- Monitor mood symptoms during cessation attempts, especially in people with active depression/anxiety or unstable psychiatric illness (clinical).
- Renal function assessment is commonly used when comorbidity is present or when severe impairment is suspected (label/clinical).
| No | 2025-12-30 |
|---|
bupropionAdjunctive therapyBrands: WELLBUTRIN | MDD; seasonal affective disorder; smoking cessation (SR). View labelExact | XL: start 150 mg qAM for 3–7 days, increase to 300 mg qAM; may increase to 450 mg qAM if needed. | Norepinephrine–dopamine reuptake inhibitor (NDRI). | CYP2B6 | Steady-state mean 21 h | No | — | - Blood pressure at baseline and after dose changes, especially when nicotine replacement is used.
- Seizure risk factors (eating disorder history, alcohol/benzodiazepine withdrawal, electrolyte disturbances) before initiation and at follow-up.
- Sleep and anxiety during early titration; dose timing and titration speed are common levers for tolerability.
- Mood elevation or agitation in bipolar-spectrum illness; coordinate prevention plans via the bipolar disorder hub.
- Medication list review to ensure only one bupropion-containing product is active (to reduce accidental dose escalation across brands).
| No | 2026-02-12 |
|---|
| Depression; use with caution in adolescents and patients with cardiac disease. View labelExact | Typical start is 25 mg HS with titration every 3–7 days as tolerated to 75–100 mg/day (single HS or divided). | Tricyclic antidepressant (TCA); predominantly norepinephrine reuptake inhibition. | CYP2D6 | Single-dose mean 36 h; Single-dose range 18–90 h | 50–150 ng/mL | | - Baseline ECG for patients >40 years, cardiac disease, electrolyte abnormalities, or higher target doses; repeat after major dose changes or when adding QT-active medications.
- TDM after steady state (about 7–10 days) and after dose adjustments; track both symptom response and adverse effects when interpreting levels.
- Orthostatic vitals, falls risk, and anticholinergic burden (bowel and bladder symptoms), especially in older adults or when adding anticholinergic co-medications.
- Mood activation and suicidality during initiation and titration, particularly in adolescents/young adults and in bipolar-spectrum illness.
- Medication reconciliation for CYP2D6 inhibitors/inducers, QT-active agents, and serotonergic combinations; include OTC antihistamines and decongestants.
| No | 2025-12-29 |
|---|
| Hypertension (label). Psychiatric uses are typically off-label (formulation- and population-dependent). View labelExact | Hypertension labeling commonly starts at 0.1 mg twice daily (morning and bedtime) (label). | Alpha-2 adrenergic agonist; reduces central sympathetic outflow (antihypertensive; also used off-label in psychiatry). | Hepatic metabolism (multiple pathways) | Single-dose range 12–16 h | No | | - Baseline and periodic blood pressure and heart rate, especially during titration or dose changes.
- Orthostasis, dizziness, and sedation; adjust dosing timing and review interacting medications if symptoms emerge.
- Renal impairment and medication adherence; missed doses can trigger rebound hypertension in some patients.
- Discontinuation plan documented in advance to reduce rebound hypertension and agitation risk.
| No | 2025-12-30 |
|---|