Drug interactions
Bupropion + Doxepin
Severity: Moderate
Bupropion and Doxepin: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Bupropion strongly inhibits CYP2D6 and can raise doxepin concentrations, increasing anticholinergic, sedative and cardiac adverse effects. Both drugs also lower the seizure threshold, so the risk of seizures is additive.
What this interaction means in plain words
Bupropion and Doxepin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Bupropion belongs to Central Nervous System; Doxepin belongs to Dermatology.
Why it happens
Bupropion and its metabolites inhibit CYP2D6-mediated doxepin metabolism, and both drugs have additive pro-convulsant effects.
What to do
Start doxepin at a low dose and titrate slowly, monitoring for tricyclic toxicity such as sedation, tachycardia and ECG changes. Keep the bupropion dose as low as effective and avoid in patients with seizure risk factors.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Bupropion
- Bupropion + Isocarboxazid Contraindicated
- Bupropion + Linezolid Contraindicated
- Bupropion + Phenelzine Contraindicated
- Bupropion + Rasagiline Contraindicated
- Bupropion + Selegiline Contraindicated
- Bupropion + Selegiline transdermal Contraindicated
Other interactions of Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Bupropion with Doxepin?
MediHelp rates the interaction as moderate. Bupropion and Doxepin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Bupropion strongly inhibits CYP2D6 and can raise doxepin concentrations, increasing anticholinergic, sedative and cardiac adverse effects. Both drugs also lower the seizure threshold, so the risk of seizures is additive.
How serious is the interaction between Bupropion and Doxepin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start doxepin at a low dose and titrate slowly, monitoring for tricyclic toxicity such as sedation, tachycardia and ECG changes. Keep the bupropion dose as low as effective and avoid in patients with seizure risk factors.
What other medicines interact with Bupropion?
MediHelp also lists interactions of Bupropion with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Bupropion page.
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