Drug interactions
Bupropion + Flecainide
Severity: Major
Bupropion and Flecainide: major interaction.
Last updated Sources: US FDA label
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
Flecainide is metabolized by CYP2D6, and bupropion can raise its concentrations. Higher levels increase the risk of conduction slowing and proarrhythmia.
What this interaction means in plain words
Bupropion and Flecainide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Bupropion belongs to Central Nervous System; Flecainide belongs to Cardiovascular.
Why it happens
Bupropion inhibits CYP2D6-mediated flecainide metabolism.
What to do
Start flecainide at the low end of the dose range or reduce the dose when bupropion is added. Monitor ECG and flecainide plasma levels.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir Contraindicated
Frequently asked questions
Can I take Bupropion with Flecainide?
MediHelp rates the interaction as major. Bupropion and Flecainide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Flecainide is metabolized by CYP2D6, and bupropion can raise its concentrations. Higher levels increase the risk of conduction slowing and proarrhythmia.
How serious is the interaction between Bupropion and Flecainide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start flecainide at the low end of the dose range or reduce the dose when bupropion is added. Monitor ECG and flecainide plasma levels.
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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