BUPROPION SANDOZ 150 mg EXTENDED-RELEASE TABLETS

2. What you need to know before you take Bupropion Sandoz

Do not take Bupropion Sandoz:

• if you are allergicto bupropion or any of the other ingredients of this medicine (listed in section 6),
• if you are takingother medicines that contain bupropion,
• if you have been diagnosed with epilepsyor have a history of seizures,
• if you have a brain tumor,
• if you have undergone sudden withdrawal from alcoholor any medicine associated with a risk of withdrawal, in particular,
• sedatives, to calm, induce sleep or relax muscles with active ingredient names ending in "azepam",
• or similar sedatives,
• if you have a severe long-term liver diseasemarked by degeneration and thickening of liver tissue,
• if you have an eating disorderor have had one, such as bulimiaor anorexia nervosa,
• if you have takenor have been taking other medicines for treating depression called monoamine oxidase inhibitors,

There must be at least 14 days between the interruption of the administration of certain monoamine oxidase inhibitors (called irreversible monoamine oxidase inhibitors) and treatment with bupropion. For some monoamine oxidase inhibitors (called reversible monoamine oxidase inhibitors), a period of 24 hours is considered sufficient. In case of doubt, consult your doctor.

Warnings and precautions

Consult your doctor before starting to take bupropion if:

• you regularly drink a lot of alcohol.

See previous section "Do not take Bupropion Sandoz" if you have undergone sudden withdrawal from alcohol,

• you have diabetes that is being treated with insulin or oral tablets,
• you have suffered a severe head injury,
• you suffer from mood changes or mental problems. Before treatment, patients must be supervised due to the risk of disorders with episodes of elation or agitation of mood,
• if you are taking other medicines for depression, the use of these medicines together with Bupropion Sandoz may cause serotonin syndrome, a potentially fatal disease (see "Other medicines and Bupropion Sandoz" in this section),
• you have mild to moderate kidney or liver dysfunction.

Patients with liver or kidney dysfunction will be supervised by the doctor for possible side effects. Do not use bupropion if you have the severe liver disease that appears in the sixth point of "Do not take Bupropion Sandoz",

• you need a urine test. Inform your doctor that you are taking bupropion as it may interfere with urine tests to detect other medicines,
• Brugada syndrome. If you have a condition called Brugada syndrome (a rare hereditary syndrome that affects heart rhythm) or if there has been a cardiac arrest or sudden death in your family

Bupropion has been observed to cause seizures. This side effect is more likely to occur in people:

• affected by a disease that appears in the first three points "Warnings and precautions" in section 2, or
• who take a medicine that appears in the second of the twelve points "Other medicines and Bupropion Sandoz" in section 2.

All patients must be evaluated for the existence of risk factors. Stop taking Bupropion Sandoz and inform your doctorif you suffer seizures during treatment.

Thoughts of self-harmor suicide are related to depression. These can increase at the start of treatment with medicines for depression, as they take time to work. Normally it is about two weeks, but sometimes it can be longer.

It is likely to happen to you if:

• you have previously had these thoughts,
• you are a young adult.

There is information from studies that shows an increased risk of suicidal behavior in adults under 25 with psychiatric disorders who were being treated with some antidepressant.

If you have thoughts of self-harm or suicide at any time, consult your doctor or go to the hospital immediately. Talk to a close family member or friend about your depression and ask them to read this leaflet. Ask them to tell you if they think your depression is getting worse or if there are changes in your behavior.

Children under 18 years

Bupropion is not recommended for this age group.

In children, there is a higher risk of thoughts and attempts of suicide when they are being treated with antidepressants.

Other medicines and Bupropion Sandoz

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

The following medicines may affect or may be affected by bupropion, although the list is not complete. Inform your doctor if you are taking any of these medicines so that your treatment can be modified if necessary:

• certain medicines for the treatment of depression or Parkinson's disease called monoamine oxidase inhibitors. Consider the last point of the section "Do not take Bupropion Sandoz" in section 2.
• medicines for the treatment of depression, such as amitriptyline, fluoxetine, paroxetine, dosulepin, desipramine, imipramine, citalopram, escitalopram, venlafaxine or medicines for the treatment of mental illnessessuch as clozapine, risperidone, thioridazine, olanzapine may interact with medicines used for the treatment of depression and may experience changes in mental state (e.g., agitation, hallucinations, coma) and other effects, such as body temperature above 38 °C, increased heart rate, unstable blood pressure and exaggerated reflexes, muscle stiffness, lack of coordination and / or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).
• theophylline: a medicine for the treatment of asthma and other respiratory diseases,
• tramadol: a medicine for the treatment of pain,
• sedatives. Consider the fifth point of "Do not take Bupropion Sandoz" in section 2 if you intend to stop taking sedatives,
• medicines for the prevention and treatment of malaria, such as mefloquine, chloroquine,
• stimulantsor other medicines for weight control or appetite,
• corticosteroids, administered orally or by injection,
• medicines for the treatment of bacterial infectionswith active ingredient names ending in "oxacin",
• antihistaminesthat can cause drowsiness: used for the treatment of allergies, sleep disorders or colds; or to prevent and treat nausea and vomiting,
• medicines for the treatment of diabetes,
• levodopa, amantadine: medicines for the treatment of Parkinson's disease,
• orphenadrine: a medicine for the treatment of painful muscle tension,
• carbamazepine, phenytoin, valproate: medicines for the treatment of epilepsy and certain pain conditions,
• certain medicines for the treatment of cancer, such as cyclophosphamide, ifosfamide,
• ticlopidine, clopidogrel: medicines for inhibiting blood coagulation,
• medicines for the treatment of high blood pressure, heart or other diseases, with active ingredient names ending in "lol", such as metoprolol,
• propafenone, flecainide: medicines for the treatment of heart rhythm disorders,
• nicotine patches: medicines for quitting smoking,
• ritonavir, efavirenz: medicines for the treatment of HIV infection,
• tamoxifen: a medicine for the treatment of breast cancer,

Tell your doctor if you are taking tamoxifen, as it may be necessary to change to another treatment for depression.

• digoxin, a medicine for the heart.

Tell your doctor if you are taking digoxin.He may consider adjusting the dose.

• metamizole, a medicine for fever, severe and acute pain and chronic pain.

Taking Bupropion Sandoz with alcohol

It is not recommendedto consume bupropion together with alcohol. If you currently drink a lot of alcohol, do not stop it abruptly, as you may be at risk of having a seizure.

Talk to your doctor about alcohol consumption and abstinence before taking bupropion.

Pregnancy and breastfeeding

Do not take bupropionif you are pregnant, think you may be pregnant or plan to become pregnant unless your doctor prescribes it. Some studies have reported an increased risk of birth defects, particularly heart defects, in babies whose mothers were taking bupropion. It is not known if this is due to the use of bupropion.

The components of bupropion may pass into breast milk. Consult your doctor or pharmacist if you are breastfeeding before taking bupropion.

Driving and using machines

Do not drive or usetools or machines if bupropion makes you feel dizzy or drowsy.

Bupropion Sandoz contains sodium

This medicine contains less than 1 mmol of sodium (23 mg) per modified release tablet; this is, essentially "sodium-free".

3. How to take Bupropion Sandoz

Follow exactly the administration instructions of this medicine indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

The recommended dose is

1 tablet of 150 mg once a day.

Your doctor may increase the dose to300 mg once a day if your depression does not improve after several weeks.

Patients with kidney or liver impairment

The recommended dose is 1 tablet of 150 mg once a day if you have mild to moderate kidney or liver impairment.

Do not use bupropion if you have the severe liver disease that appears in the sixth point "Do not take Bupropion Sandoz" in section 2.

Method of administration

Take the tablets whole, in the morning with a glass of water. The tablets can be taken with or without food.

The tablet is covered by a film that releases the medicine slowly in your body. Sometimes you may notice that a kind of tablet appears in the stool. This is the empty coating that has passed through your body.

Do not chew, crush or divide the tablets, because if you do this, there is a risk of overdose due to the medicine being released very quickly in your body. This increases the likelihood of having side effects, including seizures.

Duration of treatment

Your doctor will indicate the duration of treatment with bupropion.

It may take several weeks or months before you start to feel better or have the full effect.

Although you may start to feel better, your doctor may recommend continuing treatment with bupropion to prevent the symptoms of depression from returning.

If you take more Bupropion Sandoz than you should

In case of overdose or accidental ingestion, consult your doctor, pharmacist or call the Toxicology Information Service, phone: 91 562 04 20, indicating the medicine and the amount used.

If you take more tablets than indicated, consult your doctor or go to the nearest hospital, this can increase the risk of having seizures or convulsions.

If you forget to take Bupropion Sandoz

If you forget to take a dose, wait and take the next dose at the usual time. Do not take a double dose to make up for the forgotten doses.

If you stop taking Bupropion Sandoz

Do not stop taking bupropion or reduce the dose without having consulted your doctor first.

If you have any other questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible Adverse Effects

Like all medicines, this medicine can cause adverse effects, although not all people suffer from them.

Severe Adverse Effects

Inform your doctor immediately if you experience any of the following adverse effects.

Epileptic Seizures or Convulsions

Approximately 1 in every 1,000 people taking bupropion are at risk of suffering an epileptic seizure (a seizure or convulsion). This risk is higher if you take more tablets than you should, if you are taking certain medications, or if you have a higher than usual risk of suffering seizures. If you have any doubts, ask your doctor.

Consult your doctor if you suffer an epileptic seizure.Do not take any more tablets.

Allergic Reactions

Some people may have allergic reactions to bupropion. These include:

• redness or skin rash (urticaria), blisters, or hives on the skin. Some skin rashes may require hospitalization, especially if they are accompanied by swelling of the mouth and eyes,
• abnormal appearance of "wheezing" in the chest or difficulty breathing,
• swelling of eyelids, lips, or tongue,
• muscle or joint pain,
• fainting or loss of consciousness.

Consult your doctor immediately if you suffer an allergic reaction.Do not take any more tablets.

Allergic reactions can last for a long time. If your doctor prescribes any medication for this, make sure to complete the treatment.

Lupus Skin Rash or Worsening of Lupus Symptoms

Frequency not known: cannot be estimated from the available data in people taking bupropion.

Lupus is a disorder of the immune system that affects the skin and other organs. If you experience lupus outbreaks, skin rash, or lesions (especially in sun-exposed areas) while taking Bupropion Sandoz, contact your doctor immediately, as it may be necessary to interrupt treatment.

Other Adverse Effects

Very Common Adverse Effects:may affect more than 1 in 10 people:

• difficulty sleeping. Make sure to take bupropion in the morning,
• headache,
• dry mouth,
• dizziness and vomiting.

Common Adverse Effects:may affect up to 1 in 10 people:

• fever, dizziness, itching, sweating, and skin rash (sometimes due to allergic reactions),
• instability, tremors, weakness, fatigue, chest pain,
• feeling anxious or agitated,
• stomach pain or digestive discomfort (constipation), alterations in taste, loss of appetite (anorexia),
• increased blood pressure (sometimes severe), flushing,
• ringing in the ears, vision disturbances.

Uncommon Adverse Effects:may affect up to 1 in 100 people:

• feeling depressed (see also section 2 "Special warnings and precautions for use of Bupropion Sandoz", in "suicidal thoughts and worsening of depression"),
• confusion,
• difficulty concentrating,
• accelerated heart rate,
• weight loss.

Rare Adverse Effects:may affect up to 1 in 1,000 people:

• seizures.

Very Rare Adverse Effects:may affect up to 1 in 10,000 people:

• palpitations, fainting,
• muscle contractions, muscle stiffness, uncontrolled movements, walking or coordination problems,
• feeling restless, irritability, hostility, aggression, nightmares, tingling or numbness, memory loss,
• yellowing of the skin or whites of the eyes (jaundice) that may be associated with an increase in liver enzymes, hepatitis,
• severe allergic reactions; skin rash accompanied by joint and muscle pain,
• changes in blood sugar levels,
• increased or decreased frequency of urination,
• severe skin rashes that can affect the mouth or other parts of the body and can be life-threatening,
• worsening of psoriasis (thickening or redness of the skin),
• feelings of unreality or strangeness (dissociation); seeing or hearing things that do not exist (hallucinations); feeling or believing unrealistic things (illusions); severe distrust (paranoia).

Adverse Effects of Unknown Frequency:cannot be estimated from the available data:

• decrease in sodium levels in the blood (hyponatremia).
• thoughts of self-harm or suicide during treatment with bupropion or shortly after stopping treatment (see section 2, "What you need to know before taking Bupropion Sandoz"). If you have these thoughts, contact your doctor or go to the hospital immediately,
• loss of contact with reality and inability to think or judge clearly (psychosis); other symptoms may include hallucinations and/or illusions,
• reduction in the number of red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia),
• changes in mental state (e.g., agitation, hallucinations, coma) and other effects, such as body temperature above 38 °C, increased heart rate, unstable blood pressure, and exaggerated reflexes, muscle stiffness, lack of coordination, and/or gastrointestinal disorders (e.g., nausea, vomiting, diarrhea), while taking Bupropion Sandoz with medications used to treat depression (such as paroxetine, citalopram, escitalopram, fluoxetine, and venlafaxine).

Reporting Adverse Effects

If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that is not listed in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.

5. Storage of Bupropion Sandoz

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiration date stated on the bottle after CAD/EXP. The expiration date is the last day of the month indicated.

Do not store above 25°C.

Keep in the original packaging to protect from light and moisture.

Medicines should not be disposed of via wastewater or household waste. Deposit the packaging and any unused medicines in the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and any unused medicines. This will help protect the environment.

6. Package Contents and Additional Information

Composition of Bupropion Sandoz:

• The active ingredient is bupropion hydrochloride. Each modified-release tablet contains 150 mg of bupropion hydrochloride.

• The other ingredients are: povidone, hydrochloric acid, sodium stearyl fumarate, ethylcellulose, hydroxypropylcellulose, methacrylic acid and ethyl acrylate copolymer (1:1) type A, anhydrous colloidal silica, macrogol 1500, triethyl citrate, hypromellose, macrogol 400, macrogol 8000.

Appearance of the Product and Package Contents

White to slightly yellowish, round, rounded on the upper and lower sides, smooth on both faces.

Package sizes:

10, 30, 90 modified-release tablets.

The modified-release tablets are packaged in white, opaque bottles with a child-resistant screw cap. The bottles contain two desiccant sachets, which should not be ingested, one containing activated carbon granules and silica gel, and the other containing silica gel granules and oxygen absorber.

Package sizes:

500 modified-release tablets.

The modified-release tablets are packaged in white, opaque bottles. The bottles contain two desiccant sachets, which should not be ingested, one containing activated carbon granules and silica gel, and the other containing silica gel granules and oxygen absorber.

Not all package sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Sandoz Farmacéutica, S.A.

Centro Empresarial Parque Norte

Edificio Roble

C/ Serrano Galvache, 56

28033 Madrid

Spain

Manufacturer

Lek Pharmaceuticals d.d.

Verovškova 57

1526 Ljubljana

Slovenia

or

Lek Pharmaceuticals d.d.

Trimlini 2D, 9220

Lendava

Slovenia

or

Lek S.A

Ul. Domaniewska 50 C

02-672 Warszawa

Poland

or

Salutas Pharma GmbH

Otto-von-Guericke-Allee 1,

39179 Barleben

Germany

or

S.C. Sandoz, S.R.L.

Str. Livezeni nr. 7A

RO-540472 Targu-Mures

Romania

Date of the Last Revision of thisLeaflet:March 2023

Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/