Wegovy and Bupropion Interaction: What Patients and Prescribers Need to Know

Is there a known interaction between Wegovy and bupropion?

Wegovy's prescribing information has a short drug interactions section. It names insulin and insulin secretagogues, because of hypoglycemia risk, and oral medicines in general, because semaglutide delays gastric emptying [1]. Bupropion is not among the drugs named.

The bupropion interactions in the Contrave label run through other pathways. Bupropion inhibits CYP2D6 and can raise concentrations of some antidepressants, antipsychotics, beta-blockers such as metoprolol, and Type 1C antiarrhythmics such as propafenone and flecainide. Its levels are changed by CYP2B6 inhibitors and inducers, and it is contraindicated with MAO inhibitors [2]. Semaglutide is not among the drugs named. Semaglutide is not broken down by CYP enzymes, and the Wegovy label describes very low potential to inhibit or induce them [1].

The Wegovy label does not report a study of semaglutide together with bupropion.

What does bupropion's seizure risk mean here?

Seizure risk with bupropion is dose related. The Zyban label puts it at about 0.1% (1 in 1,000) with sustained-release bupropion up to 300 mg/day and about 0.4% (13 of 3,200) with immediate-release bupropion at 300 to 450 mg/day. For the immediate-release form the estimated incidence rises almost tenfold between 450 and 600 mg/day [3]. Labeled daily maximums differ by product: 400 mg for Wellbutrin SR, 300 mg for smoking-cessation sustained-release bupropion and Zyban, and 450 mg for the immediate-release tablets [3].

The Contrave label contraindicates its bupropion in people with a seizure disorder and in people with bulimia or anorexia nervosa, which it says increase the risk for seizure. It also contraindicates abrupt discontinuation of alcohol, benzodiazepines, barbiturates or antiepileptic drugs, and calls for extreme caution with other drugs that lower the seizure threshold [2].

Seizures are not among the warnings in the Wegovy label [1]. The seizure-related cautions sit on the bupropion side of this pairing.

Does Wegovy affect how bupropion is absorbed?

Wegovy delays gastric emptying, and its label says this has the potential to affect absorption of oral medicines. The label advises increased clinical or laboratory monitoring for oral drugs with a narrow therapeutic index or that require clinical monitoring [1]. The same label reports that in clinical pharmacology trials with semaglutide 1 mg once-weekly injection, semaglutide did not affect the absorption of the orally administered medicines tested [1]. Bupropion is not among the drugs the label names from those studies.

Does bupropion affect Wegovy?

The labeling reviewed does not describe bupropion changing Wegovy exposure or effect [1][2].

What about Contrave, which also contains bupropion?

Contrave is naltrexone plus extended-release bupropion, with a top dose of 32 mg naltrexone and 360 mg bupropion a day [2]. Its label contraindicates use with other bupropion-containing products, including Wellbutrin, Wellbutrin SR, Wellbutrin XL, Aplenzin and Zyban [2].

Wegovy's label says not to combine it with other semaglutide-containing products or any other GLP-1 receptor agonist [1]. Contrave is neither.

Other label points on each drug

• The Wegovy label records a mean heart rate increase of 1 to 4 bpm, with a rise of 20 bpm or more in 26% of treated patients vs 16% on placebo [1].
• The Contrave label warns about increased blood pressure and heart rate and recommends monitoring, especially in people with cardiac or cerebrovascular disease [2].
• Bupropion carries the antidepressant class boxed warning on suicidal thoughts and behaviors in children, adolescents and young adults, with close monitoring of patients of all ages [2]. Wegovy removed its own suicidal behavior and ideation warning in 02/2026, and the current Wegovy label carries no such warning [1].