Conversion from sustained-release to immediate-release bupropion: patient tolerability and economic impact.
OBJECTIVE
To assess patient tolerability and impact on institutional drug acquisition costs of converting patients from sustained-release bupropion to generic immediate-release bupropion.


METHODS
Retrospective medical record review.


METHODS
Veterans Affairs medical center.


METHODS
One hundred three outpatients who had been receiving sustained-release bupropion and were converted to immediate-release bupropion at equal individual doses and frequencies.


RESULTS
Medical records were reviewed for documentation of adverse effects thought to be associated with bupropion treatment; reports of seizure occurrence were specifically sought. Patterns of bupropion dosing were also assessed. Institutional drug acquisition costs were evaluated by comparing actual costs of bupropion for each patient before and after conversion. Adverse effects reported with immediate-release bupropion were those commonly associated with this drug (headache, agitation, chest pain, and gastrointestinal complaints) and were neither unusually frequent nor severe. No seizures were reported after the drug conversion. Mean daily doses of bupropion were not significantly different after conversion. Mean single doses of immediate-release bupropion were below 150 mg; however, six patients did receive single doses of 200 mg. After conversion, the annual institutional drug acquisition cost for bupropion decreased by approximately $48,910.


CONCLUSIONS
Conversion from sustained-release bupropion to immediate-release bupropion appears to be safe. Single 200-mg doses of immediate-release bupropion can apparently be administered to some patients without inducing excessive adverse effects, including seizures. Marked reduction in drug acquisition costs can be achieved with this conversion.
Department of Pharmacy Practice and Administrative Sciences, College of Pharmacy, Idaho State University, Boise, 83702, USA.
Janet L
JL
Mayo
Georgette M
GM
Cahill
Rex S
RS
Lott
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage* / Q000009:adverse effects* / Q000191:economics; D016642:Bupropion / Q000008:administration & dosage* / Q000009:adverse effects* / Q000191:economics; D003692:Delayed-Action Preparations; D016527:Drug Costs; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D018687:Antidepressive Agents, Second-Generation; D003692:Delayed-Action Preparations; D016642:Bupropion