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Wellbutrin XL
(Bupropion
Hydrochloride)
Patient Information
Pronounced: Well-BEW-trin
Generic name: Bupropion hydrochloride
Other brand name: Wellbutrin SR
Why is Wellbutrin prescribed?
Wellbutrin, a relatively new antidepressant medication, is given to help
relieve certain kinds of major depression.
Major depression involves a severely depressed mood (for 2 weeks or more)
and loss of interest or pleasure in usual activities accompanied by sleep
and appetite disturbances, agitation or lack of energy, feelings of guilt or
worthlessness, decreased sex drive, inability to concentrate, and perhaps
thoughts of suicide.
Unlike the more familiar tricyclic antidepressants, such as Elavil,
Tofranil, and others, Wellbutrin tends to have a somewhat stimulating
effect.
The drug is available in regular and sustained-release formulations (Wellbutrin
SR).
Most important fact about Wellbutrin
Although Wellbutrin occasionally causes weight gain, a more common effect
is weight loss: Some 28 percent of people who take this medication lose 5
pounds or more. If depression has already caused you to lose weight, and if
further weight loss would be detrimental to your health, Wellbutrin may not
be the best antidepressant for you.
How should you take Wellbutrin?
Take Wellbutrin exactly as prescribed by your doctor. The usual dosing
regimen is 3 equal doses spaced evenly throughout the day. Allow at least 6
hours between doses. Your doctor will probably start you at a low dosage and
gradually increase it; this helps minimize side effects.
You should take Wellbutrin SR, the sustained-release form, in 2 doses, at
least 8 hours apart. Swallow Wellbutrin SR tablets whole; do not chew,
divide, or crush them.
If Wellbutrin works for you, your doctor will probably have you continue
taking it for at least several months.
--If you miss a dose...
Take it as soon as you remember. If it is within 4 hours of your next
dose, skip the one you missed and go back to your regular schedule. Never
take 2 doses at the same time.
--Storage instructions...
Store at room temperature. Protect from light and moisture.
What side effects may occur when taking Wellbutrin?
Side effects cannot be anticipated. If any develop or change in
intensity, inform your doctor as soon as possible. Only your doctor can
determine if it is safe for you to continue taking Wellbutrin.
Seizures are perhaps the most worrisome side effect.
-
More common side effects of Wellbutrin may include:
Abdominal pain (Wellbutrin SR), agitation, anxiety (Wellbutrin SR),
constipation, dizziness, dry mouth, excessive sweating, headache, loss
of appetite (Wellbutrin SR), nausea, palpitations (Wellbutrin SR),
vomiting, skin rash, sleep disturbances, sore throat (Wellbutrin SR),
tremor
-
Other side effects of Wellbutrin may include:
Acne, allergic reactions (severe), bed-wetting, blisters in the mouth
and eyes (Stevens-Johnson syndrome) blurred vision, breathing
difficulty, chest pain, chills, complete or almost complete loss of
movement, confusion, dry skin, episodes of over-activity, elation, or
irritability, extreme calmness, fatigue, fever, fluid retention,
flu-like symptoms, gum irritation and inflammation, hair color changes,
hair loss, hives, impotence, incoordination and clumsiness, indigestion,
itching, increased libido, menstrual complaints, mood instability,
muscle rigidity, painful ejaculation, painful erection, retarded
ejaculation, ringing in the ears, sexual dysfunction, suicidal ideation,
thirst disturbances, toothache, urinary disturbances, weight gain or
loss
Why should this drug not be prescribed?
Do not take Wellbutrin if you are sensitive to or have ever had an
allergic reaction to it.
Since Wellbutrin causes seizures in some people, do not take it if you
have any type of seizure disorder or if you are taking another medication
containing bupropion, such as Zyban, the quit smoking aid. If you have a
seizure while taking Wellbutrin, stop taking the drug and never take it
again.
Do not take Wellbutrin while abruptly giving up alcohol or sedatives,
including tranquilizers such as Librium, Valium, and Xanax. Rapid withdrawal
increases the risk of seizures.
If you have had any kind of heart trouble or liver or kidney disease, be
sure your doctor knows about it before you start taking this drug. It must
be used with extreme caution if you have severe cirrhosis of the liver. A
reduced dosage may be needed if you have any sort of liver or kidney
problem.
You should not take Wellbutrin if you currently have, or formerly had, an
eating disorder. For some reason, people with a history of anorexia nervosa
or bulimia seem to be more likely to experience Wellbutrin-related seizures.
Do not take Wellbutrin if, within the past 14 days, you have taken a
monoamine oxidase inhibitor (MAO inhibitor) drug, such as the
antidepressants Marplan, Nardil or Parnate. This particular drug combination
could cause you to experience a sudden, dangerous rise in blood pressure.
Special warnings about Wellbutrin
All antidepressants carry an FDA
warning about the possibility of causing suicidal thoughts or behaviors
in children, adolescents and even adults.
More info on that here.
If you take Wellbutrin, you may be vulnerable to seizures if your dosage
is too high or if you ever suffered brain damage or experienced seizures in
the past.
Stop taking Wellbutrin and call your doctor immediately if you have
difficulty breathing or swallowing; notice swelling in your face, lips,
tongue, or throat; develop swollen arms and legs; or break out with itchy
eruptions. These are warning signs of a potential severe allergic reaction.
The danger of seizures is greater in people addicted to narcotics,
cocaine, or stimulants, and in those using over-the-counter stimulants or
diet pills. Alcohol abuse or withdrawal also increases the risk, as does the
use of other antidepressants or major tranquilizers. The risk is higher,
too, if you are taking insulin or oral diabetes medication.
Since Wellbutrin may impair your coordination or judgment, do not drive
or operate dangerous machinery until you find out how the medication affects
you.
Possible food and drug interactions when taking Wellbutrin
Do not drink alcohol while you are taking Wellbutrin; an interaction
between alcohol and Wellbutrin could increase the possibility of a seizure.
If Wellbutrin is taken with certain other drugs, the effects of either
could be increased, decreased, or altered. It is especially important to
check with your doctor before combining Wellbutrin with the following:
Beta blockers (used for high blood pressure and heart conditions) such as
Inderal, Lopressor, and Tenormin
Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Cyclophosphamide (Cytoxan)
Heart-stabilizing drugs such as Rythmol and Tambocor
Levodopa (Larodopa)
Major tranquilizers such as Haldol, Risperdal,
Thorazine, and Mellaril
MAO inhibitors (such as the antidepressants Parnate and Nardil)
Nicotine patches such as Habitrol, NicoDerm CQ, and Nicotrol patch
Orphenadrine (Norgesic)
Other antidepressants such as Elavil, Norpramin, Pamelor, Paxil, Prozac,
Tofranil, and Zoloft
Phenobarbital
Phenytoin (Dilantin)
Steroid medications such as Prednisone
Theophylline (Theo-Dur)
Special information if you are pregnant or breastfeeding
If you are pregnant or plan to become pregnant, notify your doctor
immediately. Wellbutrin should be taken during pregnancy only if clearly
needed.
Wellbutrin does pass into breast milk and may cause serious reactions in
a nursing baby; therefore, if you are a new mother, you may need to
discontinue breastfeeding while you are taking this medication.
Recommended dosage for Wellbutrin
No single dose of Wellbutrin should exceed 150 milligrams.
ADULTS
Wellbutrin
At the beginning, your dose will probably be 200 milligrams per day,
taken as 100 milligrams 2 times a day. After at least 3 days at this dose,
your doctor may increase the dosage to 300 milligrams per day, taken as 100
milligrams 3 times a day, with at least 6 hours between doses. This is the
usual adult dose. The maximum recommended dosage is 450 milligrams per day
taken in doses of no more than 150 milligrams each.
Wellbutrin SR
The
usual starting dose is 150 milligrams in the morning. After 3 days, if you
do well, your doctor will have you take another 150 milligrams at least 8
hours after the first dose. It may be 4 weeks before you feel the benefit
and you will take the drug for several months. The maximum recommended dose
is 400 milligrams a day, taken in doses of 200 milligrams each.
If you have severe cirrhosis of the liver, your dosage should be no more
than 75 milligrams once a day. With less serious liver and kidney problems,
the dosage will be somewhat reduced.
CHILDREN
The safety and effectiveness in children under 18 years old have not been
established.
OLDER ADULTS
Although they are more sensitive to antidepressant drugs, older people
have responded no differently to Wellbutrin than younger people.
Overdosage
Any medication taken in excess can have serious consequences. If you
suspect an overdose of Wellbutrin, seek medical attention immediately.
-
Symptoms of Wellbutrin overdose may
include: Hallucinations, heart failure, loss of consciousness, rapid
heartbeat, seizures
-
Symptoms of Wellbutrin SR overdose may
include: Blurred vision, confusion, jitteriness, lethargy,
light-headedness, nausea, seizures, vomiting
-
An overdose that involves other drugs in
combination with Wellbutrin may also cause these symptoms: Breathing
difficulties, coma, fever, rigid muscles, stupor
Last updated: 12/2005
Full Wellbutrin XL Prescribing Information
Wellbutrin XL Medication Guide
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