Does armodafinil interact with bupropion? (+5 interactions)
In this article, we will answer the question “Does armodafinil interact with bupropion?”. We will also explain how the interaction happens and what are the potential risks of this interaction between armodafinil and bupropion.
Does armodafinil interact with bupropion?
Yes, armodifinil interact with bupropion. Armodifinil, a medication used to improve wakefulness in individuals with sleep disorders, can interact with many other medications, including bupropion. Both medications work on certain neurotransmitters in the brain.
Combining armodafinil and bupropion can increase the risk of potential side effects associated with both medications or reduce the effectiveness of one or both drugs.(1)
It’s essential to inform your healthcare provider about all the medications you are taking to assess the potential risks and benefits of combining these medications. Interactions between medications can significantly impact their effectiveness and safety profile.
How does armodafinil interact with bupropion?
Armodafinil, a stimulant-like medication, promotes wakefulness and is often prescribed to individuals with excessive daytime drowsiness, narcolepsy and obstructive sleep apnea. Armodafinil works by interfering with the transporters of dopamine and norepinephrine.(1)
Bupropion is an antidepressant and a smoking cessation aid. Bupropion also works by inhibiting the reuptake of dopamine and norepinephrine causing an increase in the levels of these neurotransmitters in the brain (2). Because both medications work on the same neurotransmitters, combining them can cause seizures (3)
Clinical studies have shown that armodafinil is a moderate inducer of CYP3A4, an enzyme responsible for the metabolism of bupropion. Therefore, bupropion will be metabolized faster. This causes a decrease in the effectiveness of bupropion.(4)
What are the possible risks of combining armodafinil and bupropion?
Armodafinil has shown its effectiveness in the treatment of depression. It can be used as adjunctive therapy for depressed individuals who do not respond to antidepressants or mood stabilizers. It also can treat fatigue symptoms and drowsiness associated with depression(5). When used in combination with bupropion, potential effects can happen.
- Risk of seizures
Seizure is a side effect associated with both armodafinil and bupropion. Combining these two medications can lower the seizure threshold, making seizures more likely to occur. This interaction can increase the risk of experiencing seizures, which are serious and potentially life-threatening events.
- Cardiovascular adverse events
Because armodafinil and bupropion have stimulating-like effects, they can increase the risk of cardiovascular adverse events. This risk increases if the individual has high blood, a previous heart attack or an irregular heartbeat. (6)
- Increased nervous system stimulation
Armodafinil and bupropion are both stimulant agents. Combining them can lead to overstimulation of the central nervous system, causing symptoms such as restlessness, agitation and anxiety.
- Liver enzyme interaction
Bupropion is metabolized by the liver, and armodafinil affects the liver enzymes. This can alter the metabolism in the liver and cause potential liver-related complications.(4)
- Decreased effectiveness of bupropion
Armodafinil induces the metabolism of bupropion in the body. This causes bupropion to be metabolized and eliminated from the body faster than normal. As a result, bupropion’s therapeutic effect is decreased.
What does the research suggest?
Recent research suggests that armodafinil may interfere with the effectiveness of bupropion when combined. In addition, the interaction between bupropion and armodafinil can lead to exacerbation of side effects.
Among 122 individuals taking armodafinil and bupropion, reported drug interactions include a rise in blood pressure among females and tremors among males. (6)
What are the possible alternatives to combining armodafinil and bupropion?
When considering alternatives to combining armodafinil and bupropion, it’s crucial to consult with your healthcare provider to determine the most suitable option based on your specific medical condition, needs and any potential interactions. Alternatives that your healthcare provider might consider include:
- Behavioral interventions: Behavioral interventions such as cognitive behavioral therapy and sleep hygiene practices can improve daytime alertness.
- Consultation with a sleep specialist: If excessive sleepiness persists, a consultation with a sleep specialist can provide valuable insights and alternative approaches to managing sleep disorders.
- Caffeine: Caffeine, found in coffee, tea and certain medications, is a mild stimulant that can temporarily enhance wakefulness.
Alternative medications to armodafinil
Modafinil, methylphenidate and dexmethylphenidate are examples of stimulant medications used to promote wakefulness in individuals with sleep disorders and can be used to treat ADHD. (7)
However, there are reported cases of interaction between bupropion and stimulant medications. Potential interactions may cause an increase in blood pressure, tremors, insomnia, nervousness and anxiety.
Responses to medication interactions can vary widely among individuals. Your healthcare provider would make the necessary adjustments to your medication regimens and closely monitor your condition.
In summary, armodafinil interacts with bupropion. This interaction can cause potential risks that can be life-threatening. There are potential alternatives to combining armodafinil and bupropion that you can discuss with your healthcare provider. In my opinion, your healthcare provider should make a thorough evaluation before prescribing armodafinil and bupropion together or combining any two medications.
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Stahl SM, Pradko JF, Haight BR, Modell JG, Rockett CB, Learned-Coughlin S. A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. Prim Care Companion J Clin Psychiatry. 2004;6(4):159-166. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514842/
William D. Hedrich, Hazem E. Hassan, Hongbing Wang,Insights into CYP2B6-mediated drug–drug interactions,Acta Pharmaceutica Sinica B,Volume 6, Issue 52016,Pages 413-425,ISSN 2211-3835.
Darwish M, Kirby M, Robertson P Jr, Hellriegel ET. Interaction profile of armodafinil with medications metabolized by cytochrome P450 enzymes 1A2, 3A4 and 2C19 in healthy subjects. Clin Pharmacokinet. 2008;47(1):61-74.https://pubmed.ncbi.nlm.nih.gov/18076219/