TM Owner Bausch Health
Wellbutrin XL 300mg Tablet
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Indications & Clinical Uses
- Wellbutrin XL 300 mg extended-release tablets contain bupropion hydrochloride, an antidepressant, taken once daily in the morning for major depressive disorder (MDD) and for the prevention of seasonal affective disorder (SAD).
- It is not approved for smoking cessation.
- Wellbutrin XL is an extended-release once-daily product and must not be confused with Wellbutrin SR (sustained-release, taken twice daily), immediate-release bupropion, or other bupropion brands such as Aplenzin and Forfivo XL; if switching, the healthcare provider sets the dose.
- Tablets are swallowed whole, with or without food.
- For MDD, treatment starts at 150 mg once daily and increases to 300 mg after 4 days; for SAD, treatment starts in autumn at 150 mg, rises to 300 mg after 7 days, and is tapered to 150 mg before stopping.
Side Effects
- The most common side effects (5% or more and at least twice the placebo rate) are dry mouth, nausea, difficulty sleeping, dizziness, sore throat, abdominal pain, agitation, anxiety, tremor, palpitations, sweating, ringing in the ears, muscle pain, loss of appetite, urinary frequency and rash.
- BOXED WARNING: antidepressants increased the risk of suicidal thinking and behaviour in children, adolescents and young adults, so everyone starting treatment needs close monitoring for worsening mood or suicidal thoughts.
- Serious effects include dose-related seizures, raised blood pressure, angle-closure glaucoma, mania or hypomania, and psychosis with delusions, hallucinations or paranoia.
- Stop the tablets and seek urgent help if a seizure or these symptoms occur.
Precautions & Warnings
- The boxed warning calls for close monitoring for suicidal thoughts and behaviour at the start and at dose changes.
- Wellbutrin XL is contraindicated in seizure disorder, current or past bulimia or anorexia nervosa, abrupt stopping of alcohol, benzodiazepines, barbiturates or antiepileptic drugs, MAO inhibitor use within 14 days either way, and bupropion hypersensitivity.
- Blood pressure should be checked before and during treatment, and bipolar disorder screened for.
- In moderate to severe liver impairment the maximum is 150 mg every other day; dose reduction may be needed in kidney impairment (GFR below 90 mL/min).
- Safety in children has not been established.
- No overall increase in birth defects was identified, and a pregnancy registry exists (1-844-405-6185).
- Bupropion passes into breast milk.
- Do not crush, divide or chew tablets.
Avoid Interactions
- Medicines that increase risk or bupropion effects: MAO inhibitors (contraindicated; hypertensive reaction), levodopa and amantadine (CNS toxicity), medicines that lower the seizure threshold, and alcohol, which should be minimised or avoided.
- Bupropion inhibits CYP2D6, so levels of venlafaxine, nortriptyline, haloperidol, metoprolol, propafenone and flecainide can rise and doses may need reducing.
- Medicines that reduce bupropion effect: CYP2B6 inducers such as ritonavir, lopinavir, efavirenz, carbamazepine, phenobarbital and phenytoin can lower levels, and the dose must not exceed the maximum.
- Bupropion may reduce the activation of tamoxifen.
- Tell your healthcare provider about all medicines and supplements you take.
References
Frequently Asked Questions
Wellbutrin XL (bupropion) is an extended-release antidepressant used to treat major depressive disorder and to prevent seasonal affective disorder (SAD). It is taken as a 150 mg or 300 mg tablet once daily in the morning. It is not approved for stopping smoking.
Take Wellbutrin XL (bupropion) once daily in the morning, with or without food. Swallow the tablet whole; do not crush, divide or chew it. For depression, treatment starts at 150 mg and moves to 300 mg after about 4 days.
Common Wellbutrin XL (bupropion) side effects include dry mouth, nausea, difficulty sleeping, dizziness, anxiety, tremor and sweating. Seek urgent help for a seizure, hallucinations, severe agitation or eye pain. It has a boxed warning for suicidal thoughts and behaviour in children, adolescents and young adults.
Avoid Wellbutrin XL (bupropion) if you have a seizure disorder or an eating disorder such as bulimia or anorexia, or take an MAO inhibitor or stopped one in the last 14 days. Minimise or avoid alcohol, and do not suddenly stop alcohol, benzodiazepines or antiepileptics.
Only under your healthcare provider's direction. Wellbutrin XL (bupropion) is extended-release and taken once daily, while Wellbutrin SR is taken twice daily. When switching, the same total daily dose is kept where possible. Never use the two together or swap them yourself.
Wellbutrin XL (bupropion) has not been shown to raise the overall risk of birth defects, but untreated depression also carries risks, so decide with your healthcare provider. A pregnancy registry exists (1-844-405-6185). Bupropion passes into breast milk, at about 2% of the mother's dose.
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