Bupropion XL 450 mg
FORFIVO XL
Pronunciation: byoo-PROE-pee-on (for-FYE-voe)
“Boop ropin’ Well booty”
Strong CYP2D6 inHibitor
Skinny → weight loss possible
What it isBupropion HCl 450 mg single-tablet XL (FORFIVO XL, 2011) — one tablet replaces 3x150 XL at the top dose.
Why this oneSame molecule and receptor pharmacology as the parent card — the formulation (and its label) is the difference.
What limits itClass warnings of the parent molecule apply unchanged.
FDA-approved for
- depression (2011)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Major depressive disorder (MDD) | Adults | Do not initiate with FORFIVO XL; use another bupropion formulation to titrate. Use in patients on 300 mg/day of another bupropion formulation ≥2 weeks who require 450 mg/day | 450 mg QD | 450 mg/day |
Renal Not recommended (no lower dose strength available)
Hepatic Not recommended (no lower dose strength available)
450 mg is the only available strength; do not exceed 450 mg/day and do not initiate therapy with FORFIVO XL.
Instructions
- Take one 450 mg tablet once daily, with or without food
- Swallow whole; do not chew, divide, or crush
- Do not initiate therapy with FORFIVO XL; use another bupropion formulation for titration and for tapering before discontinuation
- Allow at least 14 days between MAOI and FORFIVO XL in either direction
Available strengths
- ER tab 450 mg
- tab 75, 100 mg
Contraindications
- Seizure disorder
- Current use of other bupropion products
- Current or prior diagnosis of bulimia or anorexia nervosa
- Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs
- Use of MAOIs (intended to treat psychiatric disorders) concomitantly or within 14 days of discontinuing FORFIVO XL, or starting FORFIVO XL in a patient treated with reversible MAOIs such as linezolid or intravenous methylene blue
Cautions
- Neuropsychiatric adverse events (in smoking cessation use)
- Seizure risk — dose-dependent; discontinue if seizure occurs
- Hypertension — assess and monitor blood pressure
- Activation of mania/hypomania — screen for bipolar disorder
- Psychosis and other neuropsychiatric reactions
- Angle-closure glaucoma
- Hypersensitivity reactions (including anaphylactoid reactions, Stevens-Johnson syndrome)
Adverse reactions
- Dry mouth, nausea
- Insomnia, dizziness
- Pharyngitis, abdominal pain
- Agitation, anxiety, tremor, palpitation
- Sweating, tinnitus, myalgia, anorexia, urinary frequency, rash
Pregnancy First-trimester epidemiologic data have not identified an increased overall risk of congenital malformations; weigh against risks of untreated depression.
Lactation Bupropion and metabolites present in human milk (~2% of maternal weight-adjusted dose); seizures reported in breastfed infants.
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 450 mg | ER tab | 30 qd | $239.87 | not offered |
Other forms: Bupropion (WELLBUTRIN) · Bupropion hydrobromide ER (APLENZIN) · Bupropion SR (WELLBUTRIN SR) · Bupropion XL (WELLBUTRIN XL)
Available combined with: dextromethorphan / bupropion · naltrexone / bupropion
⚠ BOXED WARNING
- Suicidal thoughts and behaviors in patients under 25
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityDose-related seizures and delayed cardiotoxicity are prominent in overdose, especially with extended-release products.
Active metabolites
Open Bupropion XL 450 mg in the interactive console ↗
