Wellbutrin SR (Bupropion Hydrochloride)
Wellbutrin (Bupropion Hydrochloride) Dosage and Side Effects
WELLBUTRIN is the brand name for bupropion, a prescription drug that's used to treat depression. It's also used to treat seasonal affective disorder (SAD), a type of depression that usually strikes in the fall and winter.
Warnings and Precautions
WELLBUTRIN, like other antidepressants, is required to carry a black-box warning about an increased risk of suicidal thinking and behavior in children, teenagers, and young adults between the ages of 18 and 24.
The black-box warning notes the need to monitor patients taking antidepressants for signs of any worsening of their depression, and for the emergence of suicidal thoughts, especially in the first few months of treatment or when the dose is either increased or decreased.
The warning also extended to Zyban, which contains the same ingredient as WELLBUTRIN and is made by the same company.
You should tell your doctor about all the prescription and over-the-counter (OTC) drugs, vitamins, illegal and recreational drugs, and dietary supplements you're taking, especially if you're on monoamine oxidase inhibitors (MAOIs), such as Marplan (isocarboxazid) or Nardil (phenelzine).
People who have had a seizure or epilepsy, an eating disorder such as bulimia or anorexia nervosa, or are using or withdrawing from alcohol or certain drugs used to treat anxiety, seizures, and insomnia such as Xanax, Valium, and Ativan, are generally not good candidates for WELLBUTRIN.
Also be aware that WELLBUTRIN can cause false-positive urine tests for amphetamines.
Your doctor also needs to know if you have liver or kidney disease, are taking insulin for diabetes, are taking other antidepressants, or are using a nicotine patch, which can increase the risk of high blood pressure.
Pregnancy and WELLBUTRIN
WELLBUTRIN may cause harm to a developing fetus.
Nonetheless, the drug’s benefits to the mother may outweigh the potential risks to her developing fetus.
Data from population studies of pregnant women taking WELLBUTRIN in the first trimester indicated no increased risk of congenital malformations.
A 2010 study in the American Journal of Obstetrics and Gynecology suggested a link between WELLBUTRIN taken in the first trimester and congenital heart defects but found that more data was needed to confirm a connection.
WELLBUTRIN is present in breast milk, and there’s some evidence that it may cause seizures in babies. It may also reduce the amount of breast milk a mother produces.
Talk with your doctor about the safety of breastfeeding while using WELLBUTRIN.
WELLBUTRIN and Weight Loss
WELLBUTRIN has been linked to weight loss, according to the Stanford School of Medicine, anecdotal reports, and other sources.
This distinguishes WELLBUTRIN from several other antidepressants, which are often associated with weight gain.
Studies have found that WELLBUTRIN, when combined with dietary recommendations, can result in significant weight loss.
Nonetheless, the FDA has not approved WELLBUTRIN for weight management.
WELLBUTRIN and Anxiety
Some doctors have prescribed WELLBUTRIN off-label for anxiety disorders, especially when a patient has anxiety and depression.
However, some studies suggest that use of WELLBUTRIN has caused anxiety in people taking the drug for depression or other conditions.
A 2012 report in the journal Current Psychiatry finds that for people who have anxiety and depression, WELLBUTRIN "would not be a first-line choice because it is not FDA-approved to treat anxiety disorders."
Common Side Effects of WELLBUTRIN
- Dry mouth
- Excessive sweating
- Blurred vision
- Rapid heart beat
- Irregular heart beat
- Visual disturbance
- Taste disorders
Tell your doctor if any of those symptoms become severe or do not disappear.
Serious Side Effects of WELLBUTRIN
- Chest pain
- Rapid, irregular heart
- Rise in blood pressure
- Tinnitus (noise or ringing in the ears)
- Irrational fears
- Muscle or joint pain
- Swelling of the face, throat. tongue, lips, eyes, hands, feet, ankles, or lower legs
- Difficulty breathing or swallowing
If any of these serious side effects occur, stop taking WELLBUTRIN and call your doctor immediately or seek emergency medical care without delay.
Interactions with this medication
WELLBUTRIN and Alcohol
Reports of worsening psychiatric or neurological conditions or lowered alcohol tolerance in patients who drink while on WELLBUTRIN have been rare.
Nonetheless, drinking alcohol when taking WELLBUTRIN should be avoided or at least minimized.
WELLBUTRIN and Drug Interactions
Interactions with the following drugs are possible:
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Fluoxetine (Prozac)
- Diazepam (Valium)
- Clopidogrel (Plavix)
- Ticlopidine (Ticlid)
- Orphenadrine (Norflex, Banflex)
- Carbamazepine (Tegretol)
- Clotrimazole (Canesten, Lotrimin)
- Rifampicin (Rifadin)
- Ritonavir (Norvir)
- Lopinavir (Kaletra)
- Elfavirenz (Sustiva)
- St. John's wort
- Phenobarbital (Luminal)
- Caramazepinen (Carbatrol, Tegretol, Equetro, Epitol)
- Phenytoin (Dilantin, Phenytek)
- Venlafaxine (Effexor)
- Nortriptyline (Pamelor)
- Imipramine (Tofranil)
- Desipramine (Norpramin)
- Haloperidol (Haldol)
- Risperidone (Risperdol)
- Thioridazine (Sonapax, Thioril)
- Metropolol (Lopressor)
- Propafenone (Rythmol)
- Flecainide (Tambocor)
Extreme caution must be used when taking WELLBUTRIN with other drugs that lower the "seizure threshold," such as other products containing bupropion, antipsychotic medications, other antidepressants, drugs used for respiratory problems, or certain corticosteroids that may be taken for asthma.
WELLBUTRIN and Other Interactions
WELLBUTRIN may be taken with or without food.
Don't drive or operate dangerous machinery until you know how the medication affects you.
Proper Use of this medication
WELLBUTRIN is available as a standard pill of 75 milligrams (mg) and 100 mg, as a sustained-release pill (100 mg), and as a long-acting extended-release tablet (150 and 300 mg).
The starting dose is usually 200 mg a day, given in two doses of 100 mg.
After three days, your doctor may increase the dose to 300 mg a day, given as 100 mg three times a day, with at least a six-hour interval between doses.
To minimize the risk of seizure, the dose must be increased gradually. The maximum dose is 450 mg a day.
The extended-release version is usually taken once a day in the morning within a 24-hour time frame.
Try to take WELLBUTRIN at the same time every day, and avoid taking it too close to bedtime.
Swallow the pills whole — do not split, chew, or crush them.
Be aware that it might take a month or more to feel improvement from the drug.
Continue to take it, and don't go off WELLBUTRIN without consulting your doctor.
Stopping the drug too abruptly can result in withdrawal or "discontinuation syndrome," which shows up as repetitive, uncontrollable twisting of a part of the body, irritability, anxiety, mania, and headaches.
Make sure you are not taking more than one product containing generic bupropion at one time, as that could result in an overdose.
An overdose of WELLBUTRIN is considered moderately dangerous. Deaths have been reported, but they're rare.
Symptoms of an overdose can include:
- Hallucinations and delusions
- Aggressive behavior
- Rapid heart beat
Call a poison control center or get to an emergency room if you believe you've overdosed.
If a person taking WELLBUTRIN has collapsed or is not breathing, call 911 immediately.
The safety and effectiveness of WELLBUTRIN has not been determined in children younger than 18.
No overall differences in WELLBUTRIN's safety or effectiveness were found in those older than 65.
Missed Dose of WELLBUTRIN
Skip any missed dose, and get back on schedule when it's time for the next dose.
You must allow the full six-hour interval between doses.
Do not double up on doses to recoup the missed one.
Other related products
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.