Wellbutrin XL

(bupropion XL) 

 

 

 

 Full Prescribing Information 

 DailyMed Drug Information 

 

 

 

 

 Forms/Strengths 

 

 Extended-release (XL): 150 mg, 300 mg 

 

 

 Dosing 

 

 Age:   

 Onset: ~60 min 

 Duration: 8-12 hours 

 

 Considerations: Monitor for neuropsychiatric symptoms, especially in children and adolescents. 

 

 Initial Dose: 150 mg once daily 

 Titration: Increase to 300 mg once daily after 3 days if tolerated 

 Max Dose: 450 mg/day 

 

 

 Quick Facts 

 

 Inhibits reuptake of dopamine and norepinephrine; improves mood and energy 

 Extended-release formulation for once-daily dosing and stable plasma levels 

 Unique antidepressant profile; fewer sexual side effects and weight neutral 

 Common side effects: dry mouth, insomnia, headache, nausea 

 Caution: increased seizure risk at high doses or in susceptible individuals 

 

 

 Indications 

 

 Major depressive disorder (ICD-10: F32, F33) 

 Seasonal affective disorder (ICD-10: F33.0) 

 Smoking cessation (ICD-10: Z72.0) 

 

 

 Off-Label Uses 

 

  Attention-deficit/hyperactivity disorder (ADHD) (ICD-10: F90.0) 

 

 

 How to Take 

 

 Take once daily in the morning at the same time each day . 

 Can be taken with or without food ; taking with food may help reduce nausea. 

 Swallow the tablet whole ; do not crush, chew, or split. 

 Avoid taking close to bedtime , as it may cause insomnia. 

 Do not abruptly stop taking; tapering may be required to prevent withdrawal effects. 

 

 

 Side Effects 

 

 Common: Insomnia, dry mouth, headache, nausea 

 Serious: Seizures, hypertension, neuropsychiatric symptoms 

 

 

 Monitoring / Labs 

 

 Blood pressure monitoring 

 Monitor for worsening depression or suicidal thoughts 

 

 

 Education 

 

 

 When to Call the Doctor: 

 

 Severe mood changes, aggression, or suicidal thoughts . 

 Unexplained seizures , confusion, or hallucinations. 

 Signs of allergic reaction (rash, itching, swelling, difficulty breathing). 

 Unusual bruising or bleeding. 

 Severe headache, blurred vision, or persistent nausea ( signs of high blood pressure ). 

 

 

 

 Safety Tips: 

 

 Monitor mood and behavioral changes , especially in patients with a history of depression or bipolar disorder. 

 Avoid alcohol , as it may increase the risk of seizures. 

 Use caution if you have a history of seizures, eating disorders, or head trauma , as Wellbutrin may lower the seizure threshold. 

 May cause dry mouth —increase hydration if needed. 

 Be cautious when driving or operating machinery until individual response is known. 

 

 

 

 Parent Tips for Pediatric Patients (if prescribed off-label): 

 

 Monitor for increased agitation, irritability, or changes in mood . 

 Be aware of appetite suppression —encourage balanced meals. 

 Observe for difficulty sleeping ; discuss timing adjustments with the provider if needed. 

 

 

 

 

 Additional Information 

 

 

 Contraindications: 

 

 History of seizures or conditions that lower seizure threshold (e.g., eating disorders, head trauma, alcohol withdrawal). 

 Use within 14 days of MAOI therapy (risk of hypertensive crisis). 

 Severe hepatic impairment , as it may increase drug accumulation. 

 

 

 

 Pregnancy: 

 

 Category C ; use only if benefits outweigh risks. 

 Limited human data, but potential risk for fetal harm is unclear. 

 

 

 

 Lactation: 

 

 Excreted in breast milk ; use with caution as effects on the infant are unknown. 

 

 

 

 Drug Interactions: 

 

 CYP2B6 inhibitors (e.g., ticlopidine, clopidogrel) may increase Wellbutrin levels. 

 CYP2B6 inducers (e.g., carbamazepine, rifampin) may decrease effectiveness. 

 Other medications that lower seizure threshold (e.g., tramadol, antipsychotics, theophylline) may increase seizure risk. 

 Serotonergic drugs (e.g., SSRIs, SNRIs, MAOIs) may increase the risk of serotonin syndrome.