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APLENZIN® (bupropion hydrobromide) Patient Testimonial Survey

Please answer all questions

If you are taking this survey, your treatment journey with APLENZIN may be helpful and appropriate to share with a broader audience. Please take a few minutes to provide us with your history by answering the survey questions below. Upon survey completion, you can expect to be contacted by Bausch Health within 1 to 2 weeks about next steps for sharing your story. Thank you for your time!

Please see additional Important Safety Information below. Click here for full
Prescribing Information, including Medication Guide and Boxed Warning.

 

All information that you provide in this survey shall be subject to the Bausch Health PRIVACY POLICY.

3.

Has your healthcare professional diagnosed you with major depressive disorder (MDD)? 

*This question is required.
4.

Has your healthcare professional diagnosed you with seasonal affective disorder (SAD)? 

*This question is required.
5.  Are you currently taking APLENZIN to help treat your MDD or SAD? *This question is required.
6. What dosage strength of APLENZIN are you prescribed to take daily? *This question is required.
7.

How long have you been prescribed APLENZIN?

*This question is required.
8. Have you taken other antidepressants in the past, before being prescribed APLENZIN? *This question is required.
9. Are you currently taking other antidepressant medications in addition to APLENZIN? *This question is required.
10. Is APLENZIN helping you with your depression? *This question is required.
11. How do you pay for your APLENZIN prescription? Please select all that apply. *This question is required.
12. Has your pharmacist ever tried to substitute your APLENZIN prescription with a generic formulation? *This question is required.
13. Would you be interested in participating in a photo- or video-shoot to describe your personal experience with depression and treatment with APLENZIN? *This question is required.
14. If interested, are you willing to travel to New Jersey to shoot a video?
(Travel costs and hotel will be covered. Stay will be an estimated 2 days, 1 night) *This question is required.
15. If we choose to, would you prefer to record the video at your home? *This question is required.
16. Please provide your name, address, email, and phone number below:
This question requires a valid email address.
IMPORTANT SAFETY INFORMATION (cont)

Call your healthcare provider right away if you or your family member has any of the
following symptoms, especially if they are new, worse, or worry you:


· thoughts about suicide or dying
· attempts to commit suicide
· new or worse depression
· new or worse anxiety
· feeling very agitated or restless
· panic attacks
· trouble sleeping (insomnia)
· new or worse irritability
· acting aggressive, being angry, or violent
· acting on dangerous impulses
· an extreme increase in activity and talking (mania)
· other unusual changes in behavior or mood
 
Although APLENZIN is not a treatment for quitting smoking, it contains the same active ingredient (bupropion) as ZYBAN, which is used to help patients quit smoking.

Some people have had serious side effects while taking bupropion to help them quit smoking, including:

New or worse mental health problems, such as changes in behavior or thinking, aggression, hostility, agitation, depression, or suicidal thoughts or actions. Some people had these symptoms when they began taking bupropion, and others developed them after several weeks of treatment, or after stopping bupropion. These symptoms happened more often in people who had a history of mental health problems before taking bupropion than in people without a history of mental health problems.

Stop taking APLENZIN and call your healthcare provider right away if you, your family, or caregiver notice any of these symptoms. Work with your healthcare provider to decide whether you should continue to take APLENZIN. In many people, these symptoms went away after stopping APLENZIN, but in some people, symptoms continued after stopping APLENZIN. It is important for you to follow-up with your healthcare provider until your symptoms go away.

Before taking APLENZIN, tell your healthcare provider if you have ever had depression or other mental health problems. You should also tell your healthcare provider about any symptoms you had during other times you tried to quit smoking, with or without bupropion.
 
What Other Important Information Should I Know About APLENZIN?

· Seizures: There is a chance of having a seizure (convulsion, fit) with APLENZIN, especially in people with certain medical problems or who take certain medicines. Do not take any other medicines while you are taking APLENZIN unless your healthcare provider has said it is okay to take them. If you have a seizure while taking APLENZIN, stop taking the tablets and call your healthcare provider right away.


· High blood pressure (hypertension): Some people get high blood pressure that can be severe while taking APLENZIN.

· Manic episodes: Some people may have periods of mania while taking APLENZIN.
  If you have any of the following symptoms of mania, call your healthcare provider:
· greatly increased energy
· severe trouble sleeping
· racing thoughts
· reckless behavior
· unusually grand ideas
· excessive happiness or irritability
· talking more or faster than usual
· Unusual thoughts or behaviors: Some patients may have unusual thoughts or behaviors while taking APLENZIN, including delusions (e.g., believe you are someone else), hallucinations (seeing or hearing things that are not there), paranoia (feeling that people are against you), or feeling confused. If this happens to you, call your healthcare provider.

· Visual problems: Some people are at risk of glaucoma which can present as: eye pain, changes in vision, or swelling and redness around the eye if they take APLENZIN. You should see an eye doctor to determine whether you are at risk prior to starting therapy. 

· Severe allergic reactions: Some patients have severe allergic reactions to APLENZIN. Stop taking APLENZIN and call your healthcare provider right away if you get a rash, itching, hives, fever, swollen lymph glands, painful sores in the mouth or around the eyes, swelling of the lips or tongue, chest pain, or have trouble breathing. These could be signs of a serious allergic reaction.
 
Do not take APLENZIN if you:
· have or had a seizure disorder or epilepsy
· have or had an eating disorder such as anorexia nervosa or bulimia
· are taking any other medicines that contain bupropion, including WELLBUTRIN, WELLBUTRIN SR, WELLBUTRIN XL, ZYBAN, or FORFIVO XL. Bupropion is the same active ingredient that is in APLENZIN
· drink a lot of alcohol and abruptly stop drinking, or use medicines called sedatives (these make you sleepy), benzodiazepines, or anti-seizure medicines, and you stop using them all of a sudden
· take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid
· do not take an MAOI within 2 weeks of stopping APLENZIN unless directed to do so by your healthcare provider
· do not start APLENZIN if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your healthcare provider
· are allergic to the active ingredient in APLENZIN, bupropion, or to any of the inactive ingredients

 
Although APLENZIN is not a treatment for quitting smoking, it contains the same active ingredient (bupropion) as ZYBAN, which is used to help patients quit smoking. Before taking APLENZIN, tell your healthcare provider if you have ever had depression, suicidal thoughts or actions, or other mental health problems or any symptoms you had during other times you tried to quit smoking with or without bupropion. Also, tell your healthcare provider about your other medical conditions, including if you:
· have liver problems, especially cirrhosis of the liver
· have kidney problems
· have, or have had, an eating disorder such as anorexia nervosa or bulimia
· have had a head injury
· have had a seizure (convulsion, fit)
· have a tumor in your nervous system (brain or spine)
· have had a heart attack, heart problems, or high blood pressure
· are a diabetic taking insulin or other medicines to control your blood sugar
· drink alcohol
· abuse prescription medicines or street drugs
· are pregnant or plan to become pregnant. Talk to your healthcare provider about the risk to your unborn baby if you take APLENZIN during pregnancy, and about registering with the National Pregnancy Registry by calling 1-844-405-6185
· are breastfeeding. APLENZIN passes into your milk in small amounts
 
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Many medicines increase your chances of having seizures or cause other serious side effects if you take them while you are using APLENZIN.

The most common side effects of APLENZIN include: trouble sleeping, stuffy nose, dry mouth, dizziness, feeling anxious, nausea, constipation, and joint aches.

Click here to read the Medication Guide carefully before you start using APLENZIN. If you have any questions about APLENZIN, ask your healthcare provider or pharmacist.

Click here for full Prescribing Information, including Medication Guide and Boxed Warning regarding suicidal thoughts and actions.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. You may also contact Bausch Health Customer Service at 1-800-321-4576.