Dextromethorphan and Bupropion Application Scope

Dextromethorphan / Bupropion is primarily used for the treatment of Major Depressive Disorder (MDD), particularly in adults. It may be used when other antidepressants have not been effective.

Dextromethorphan and Bupropion Characteristics

Ingredients:
- Dextromethorphan (45 mg)
- Bupropion (105 mg)
Properties:
- Mechanism of Action: Dextromethorphan modulates glutamate and serotonin, while Bupropion works as a norepinephrine-dopamine reuptake inhibitor (NDRI). Together, they work to alleviate depressive symptoms.
- Therapeutic Effects: Effective for the management of major depressive disorder (MDD), helping improve mood, energy, and overall well-being.
Packaging Specification:
- Tablets containing 45 mg of dextromethorphan and 105 mg of bupropion.
- Available in blister packs or bottles, depending on packaging standards.
Storage:
- Store at room temperature (15–30°C / 59–86°F).
- Keep in a dry place, away from moisture and heat.
Expiry Date: Typically 24 to 36 months from the manufacturing date. Always check the packaging for the specific expiration date.
Executive Standard:
- Complies with FDA standards in the U.S. and EMA standards in Europe.
- Must adhere to Good Manufacturing Practices (GMP) and local regulatory bodies.
Approval Number: FDA NDA approval number (or corresponding approval number in other countries, e.g., EMA or NMPA)..
Date of Revision: Revision date will vary depending on the most recent update provided by the manufacturer (usually mentioned in official documents).
Manufacturer:
- Axsome Therapeutics (in the U.S.).
- Different manufacturers may exist depending on the region.

Guidelines for the Use of Dextromethorphan and Bupropion

Dosage and Administration:
- Initial Dose: Start with 45 mg dextromethorphan and 105 mg bupropion once daily in the morning.
- Maintenance Dose: After at least 1 week, increase to 90 mg dextromethorphan and 210 mg bupropion per day, taken once daily.
- Do not exceed the recommended dose.
- Can be taken with or without food.
Adverse Reactions:
- Common: Insomnia, headache, dry mouth, dizziness, nausea.
- Serious: Risk of suicidal thoughts or behaviors, especially in younger patients; serotonin syndrome, seizures (due to bupropion), elevated blood pressure.
Contraindications:
- Seizure Disorders: Not for patients with a history of seizures.
- Eating Disorders: Caution in patients with bulimia or anorexia nervosa.
- MAOIs: Do not take within 14 days of using MAO inhibitors.
- Alcohol or Drug Use: Avoid alcohol use to reduce seizure risk.
Precautions:
- Use cautiously in liver or kidney impairment.
- Monitor blood pressure regularly, as bupropion can increase it.
- Pregnancy: Use only if the potential benefit outweighs the risk.

Dextromethorphan and Bupropion Interactions

Drug Interactions:
- Serotonergic Drugs: Risk of serotonin syndrome when combined with SSRIs, SNRIs, or triptans.
- CYP2D6 Inhibitors: These can affect dextromethorphan metabolism, increasing side effects.
- Alcohol: Increases risk of seizures; alcohol should be limited.
- Other Antidepressants: Combining with other antidepressants should be carefully monitored to prevent additive effects.

Note:

If there is a new packaging for the drug, the new packaging shall prevail. The above information is sourced from DengYue Medicine.
It is only for internal discussion among medical staff and does not serve as a basis for medication. For specific medication guidelines, please consult the attending physician.