Bupropion-Associated Skin Rash Management

Assessment and Immediate Action

The American College of Clinical Oncology recommends assessing for severe features immediately, including blistering, skin sloughing, mucosal involvement, facial or tongue swelling, or respiratory symptoms, which indicate Stevens-Johnson syndrome, toxic epidermal necrolysis, or anaphylaxis and require immediate emergency care 1, 2
Evaluate body surface area affected and presence of systemic symptoms such as fever, malaise, joint pain, or muscle aches 1, 2

Apply topical corticosteroids, such as 1-2.5% hydrocortisone or moderate-potency topical steroids, to affected areas for mild rashes 3
Use oral antihistamines, such as non-sedating agents like cetirizine, loratadine, or fexofenadine for daytime, and sedating antihistamines like diphenhydramine for nighttime pruritus 3
Apply emollients at least once daily to prevent xerosis 3
Administer acetaminophen or ibuprofen for associated fever or discomfort 3
For severe reactions, immediate hospitalization is required, with IV methylprednisolone 1-2 mg/kg for severe cutaneous reactions, and burn unit admission may be necessary for extensive skin sloughing 1, 2

Avoid hot showers and excessive soap, which worsen skin irritation 3
Do not apply topical acne medications or retinoids, as they cause further irritation 3