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Drug Interactions between Strattera and Wellbutrin XL

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

buPROPion atomoxetine

Applies to: Wellbutrin XL (bupropion) and Strattera (atomoxetine)

Consumer information for this interaction is not currently available.

ADJUST DOSE: Coadministration with potent inhibitors of CYP450 2D6 may significantly increase the plasma concentrations of atomoxetine, which is primarily metabolized by the isoenzyme. In patients who are extensive metabolizers of CYP450 2D6 (approximately 93% of Caucasians and more than 98% of Asians and individuals of African descent), potent inhibitors of the isoenzyme such as fluoxetine and paroxetine have been shown to increase atomoxetine systemic exposure (AUC) by 6- to 8-fold and peak plasma concentration (Cmax) by 3- to 4-fold. These higher concentrations are similar to those observed in CYP450 2D6 poor metabolizers given the drug alone. In vitro studies suggest that coadministration of CYP450 2D6 inhibitors to poor metabolizers will not further increase atomoxetine plasma concentrations.

MANAGEMENT: Pharmacologic response to atomoxetine should be monitored more closely whenever a potent CYP450 2D6 inhibitor such as fluoxetine, paroxetine, or quinidine is added to or withdrawn from therapy, as dosage adjustment of atomoxetine may be necessary in extensive metabolizers. The initial recommended dose should only be increased up to the usual target dose if symptoms fail to improve after 4 weeks and the initial dose is well tolerated. During coadministration, patients should be advised to contact their physician if they experience excessive adverse effects of atomoxetine such as dizziness, dry mouth, anorexia, sleep disturbances, and palpitations.

Drug and food interactions

Moderate

buPROPion food

Applies to: Wellbutrin XL (bupropion)

Using buPROPion with alcohol may increase the risk of uncommon side effects such as seizures, hallucinations, delusions, paranoia, mood and behavioral changes, depression, suicidal thoughts, anxiety, and panic attacks. On the other hand, sudden withdrawal from alcohol following regular or chronic use can also increase your risk of seizures during treatment with buPROPion. If you are prone to frequent or excessive alcohol use, talk to your doctor before starting buPROPion. In general, you should avoid or limit the use of alcohol while being treated with buPROPion. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

buPROPion food

Applies to: Wellbutrin XL (bupropion)

Both buPROPion and caffeine can increase blood pressure. And using them together may have additive effects. Talk to your doctor if you have any questions or concerns, particularly if you have a history of high blood pressure or heart disease. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

buPROPion food

Applies to: Wellbutrin XL (bupropion)

Using buPROPion and nicotine together can cause an increase in blood pressure. This can cause dizziness, confusion, uneven heartbeats, and chest pain. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or need your blood pressure checked more often if you take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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