Stevens-Johnson Syndrome Risk Associated with Bupropion

Clinical Evidence and Recommendations

• The British Journal of Dermatology documents erythema multiforme as a severe hypersensitivity reaction associated with bupropion use 1
• Bupropion is not listed among the most notorious SJS-causing medications in major dermatology guidelines, with higher-risk medications including sulfonamide antibiotics, anticonvulsants, oxicam NSAIDs, and allopurinol 1, 2
• The Centers for Disease Control and Prevention recommends immediately discontinuing bupropion if any signs of hypersensitivity reaction develop, including chest pain and edema 3
• Patients with a history of drug hypersensitivity reactions are at higher risk of severe skin reactions, and should be exercised with particular caution when prescribing bupropion 1
• Drug-induced SJS/TEN typically occurs 5-28 days following drug initiation, and patients should be monitored most closely during the first month of therapy 1, 2