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However, because most adverse reactions do not occur during treatment with bupropion, a higher frequency of discontinuation symptoms is seen in the women than men. In case of pregnancy, the woman should be advised of her fertility history and given appropriate counselling. 4.3. Effect of bupropion on menstrual bleeding The use of contraceptives with bupropion may reduce the number of cycles menstruation in a woman. However, it does not eliminate the possibility of ovulation. Because these effects have not been clinically proven, patients should be advised to careful about discontinuing treatment and consult a doctor should they experience amenorrhea (irregularity of menstrual periods). 4.4. Effect of bupropion on the menstrual bleeding cycle in women with polycystic ovary syndrome Women with polycystic ovary syndrome (PCOS) who take bupropion are most frequently using oral contraceptives. A lower frequency of bleeding and irregular periods cannot be excluded in the majority of those using oral contraceptives. Therefore, women with PCOS who use oral contraceptives are also advised to check for abnormalities of the menstrual cycle. Women with PCOS who wish to be treated with bupropion should instructed of the possibility abnormal menstrual bleeding pattern. Women who experience irregular cycles should be advised to use a birth control pill with the lowest dose for three months after initiation of treatment with bupropion and refrain from using oral sildenafil medac 50 mg kaufen contraceptives for the first six months after starting to take the medication, and thereafter until at least two months have passed following each cessation. Women who experience amenorrhea when using oral contraceptives should stop and check for abnormalities in the menstrual cycle, including irregular and painful periods. Furthermore, bupropion has been shown to have the ability shorten luteal phase of the menstrual cycle. 4.5. Effect of bupropion on blood pressure Bupropion may cause hypertension in patients with hypertension. Because of this risk, patients with hypertension or pre-existing should be carefully observed prior to and during treatment with bupropion monitoring of blood pressure and lipid patterns carefully during treatment should also be advised. 4.6. Effect of bupropion on blood sugar levels Symptoms of diabetes (including hyperglycemia) were recorded in sildenafil stada 100mg filmtabletten kaufen 2% to 4% of patients following the use bupropion and may develop at any time during therapy. Bupropion is not the first choice for all patients with diabetes. Thus caution should be exercised while prescribing the medication. 4.7. Patients at risk of heart disease Patients at risk of congestive heart failure should be carefully monitored during the first couple of cycle when using oral contraceptives. In view of the increased risk, one hundred mg bupropion in women with congestive heart failure should not be used concurrently with hormone replacement. Furthermore, bupropion has no effect on cholesterol. Therefore, care also needs to be exercised with low levels of cholesterol. 4.8. Patients with acute stroke It is estimated that there are around 10% of users bupropion who experience stroke following the onset of treatment. These patients should be urged to discontinue treatment immediately and preferably be seen by a physician who is experienced in the pharmacokinetics and pharmacodynamics of medications. However, if symptomatic stroke symptoms emerge during oral contraceptive therapy or after termination of medication, bupropion must Amlodipine and simvastatin uk be withheld. 4.9. Patients with hepatic impairment Several data have shown an association of the risk hepatotoxicity with duration of treatment bupropion. A possible relation between the hepatic disorder and potential for hepatotoxicity may be suggested in patients with mild elevations of liver function tests (ALT). The importance of a careful assessment liver function in patients is important because of the possibility progression liver disorders (elevation of serum alanine aminotransferase (ALT) or AST) and the possibility.

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