Bupropion Contraindications and Precautions

Contraindications

The American College of Cardiology and other guideline societies recommend that patients with a history of seizure disorders or epilepsy should not use bupropion due to the significant risk of reduced seizure threshold 1
Patients with a current or previous diagnosis of bulimia or anorexia nervosa are at higher risk of seizures when treated with bupropion, according to the National Comprehensive Cancer Network 1
The use of bupropion with monoamine oxidase inhibitors (MAOIs) is contraindicated due to the increased risk of hypertensive reactions, as stated by the American Diabetes Association and the National Comprehensive Cancer Network 2, 3

The risk of seizures is dose-dependent, with an incidence of approximately 0.1% (1/1000 patients) at doses up to 300 mg per day, according to the National Comprehensive Cancer Network 1
Patients with brain metastases are at increased risk of seizures and should avoid using bupropion, as recommended by the National Comprehensive Cancer Network 1, 2

The American Academy of Ophthalmology and the American Diabetes Association recommend that patients with glaucoma of the closed angle should avoid using bupropion, as it may worsen this condition 2, 3, 4
The American Heart Association recommends that patients with uncontrolled hypertension should not use bupropion, as it may increase blood pressure, according to the American Diabetes Association 3
The use of bupropion is contraindicated in patients with chronic opioid use due to opioid antagonism when used in combination with naltrexone, as stated by the American Gastroenterological Association and the American Diabetes Association 3, 5
The use of bupropion is contraindicated in pregnancy and lactation, especially when used in combination with naltrexone for the treatment of obesity, according to the Obesity Society and the American Diabetes Association 3, 6