Monograph Details
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Central Nervous System
> Mood disorders
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WELLBUTRIN XL |
| Manufacturer |
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GlaxoSmithKline Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Aminoketone. |
| Generic Name |
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Bupropion HCl 150mg, 300mg; ext-rel tabs. |
| Also |
• WELLBUTRIN
• WELLBUTRIN SR
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| Indications |
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Depression. Seasonal affective disorder. |
| Children |
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<18yrs: not recommended. |
| Adults |
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Swallow whole. Avoid bedtime dosing. ≥18yrs: Depression: initially 150mg once daily in the AM for at least 3 days; if tolerated, increase to 300mg once daily at least 24 hrs apart. May increase after several weeks to max 450mg once daily. Seasonal affective disorder: start in autumn, taper and stop in early spring. 150mg once daily in AM; if tolerated, increase to 300mg once daily after 1 week. Max 300mg/day. Severe hepatic cirrhosis: max 150mg every other day. Mild-moderate hepatic cirrhosis, or renal impairment: consider reduced dose and/or dose frequency. |
| Contraindications |
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Seizure disorders. Bulimia. Anorexia nervosa. Within 14 days of MAOIs. Abrupt withdrawal of sedatives or alcohol. Other forms of bupropion (eg, Zyban). |
| Precautions |
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Seizure risk or history. Discontinue if seizure occurs; do not restart. Bipolar disorder. Psychosis. Unstable heart disease. CHF. Recent MI. Hepatic or renal dysfunction. Suicidal tendencies. Maintain at lowest effective dose. Write Rx for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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See Contraindications. Avoid alcohol. Levodopa, amantadine may increase toxicity. Caution with drugs that lower seizure threshold (eg, quinolones, theophylline, antidiabetics, anorectics, CNS stimulants, systemic steroids, antidepressants, antipsychotics) or factors that lower seizure threshold (eg, opiate or cocaine addiction, excessive use of alcohol or sedatives). Caution with drugs metabolized by CYP2B6 (eg, orphenadrine, cyclophosphamide) or CYP2D6 including tricyclic antidepressants, SSRIs (eg, paroxetine, fluoxetine, sertraline), antipsychotics (eg, haloperidol, risperidone, thioridazine), β-blockers (eg, metoprolol), Class 1C antiarrhythmics (eg, propafenone, flecainide); consider dose reduction. May be affected by metabolic enzyme inducers (eg, carbamazepine, phenobarbital, phenytoin), or inhibitors (eg, cimetidine). Monitor for hypertension with nicotine replacement. |
| Adverse Reactions |
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CNS stimulation (eg, agitation, insomnia, seizures, tremor, dizziness), mania/hypomania, psychosis, weight change, dry mouth, headache, migraine, GI effects, edema, rash (rarely may be serious, eg, erythema multiforme, Stevens-Johnson syndrome), palpitations, urinary frequency, sweating, tinnitus, myalgia, hypertension. |
| Extra Text |
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Note: Register pregnant women exposed to bupropion by calling (800) 336-2176. |
| How Supplied |
XL tabs—30, 90
SR tabs—60
Immediate-rel tabs—100 |
| Additional Resources |
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• Related Prescribing Note |
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