Drug interactions
Bupropion + Methylenedioxymethamphetamine
Severity: Major
Bupropion and Methylenedioxymethamphetamine: major interaction.
Last updated Sources: UK SmPC
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
MDMA is a potent monoamine releaser and has pro-convulsant and cardiovascular effects, which combined with bupropion's seizure-threshold lowering increase seizure risk. Bupropion also inhibits CYP2D6, which participates in MDMA metabolism, and may increase MDMA toxicity.
What this interaction means in plain words
Bupropion and Methylenedioxymethamphetamine 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.
Why it happens
Additive pro-convulsant and sympathomimetic effects, with CYP2D6 inhibition by bupropion potentially raising MDMA levels.
What to do
Advise against recreational MDMA use during bupropion therapy. Treat seizures, hyperthermia or hypertension as emergencies if exposure occurs.
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
- Zyban 150 mg prolonged release tablets - SmPC sections 4.3/4.5 (class statement: serotonergic agent; "There have been post-marketing reports of serotonin syndrome, a potentially life-threatening condition, when Zyban is co-administered with a serotonergic agent,") — electronic medicines compendium (UK SmPC)
Other interactions of Bupropion
- Bupropion + Isocarboxazid Contraindicated
- Bupropion + Linezolid Contraindicated
- Bupropion + Phenelzine Contraindicated
- Bupropion + Rasagiline Contraindicated
- Bupropion + Selegiline Contraindicated
- Bupropion + Selegiline transdermal Contraindicated
Frequently asked questions
Can I take Bupropion with Methylenedioxymethamphetamine?
MediHelp rates the interaction as major. Bupropion and Methylenedioxymethamphetamine 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. MDMA is a potent monoamine releaser and has pro-convulsant and cardiovascular effects, which combined with bupropion's seizure-threshold lowering increase seizure risk. Bupropion also inhibits CYP2D6, which participates in MDMA metabolism, and may increase MDMA toxicity.
How serious is the interaction between Bupropion and Methylenedioxymethamphetamine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise against recreational MDMA use during bupropion therapy. Treat seizures, hyperthermia or hypertension as emergencies if exposure occurs.
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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