Bupropion SR
WELLBUTRIN SR
Pronunciation: byoo-PROE-pee-on (WEL-byoo-trin)
“Boop ropin’ Well booty”
Strong CYP2D6 inHibitor
Skinny → weight loss possible
What it isBupropion sustained-release (WELLBUTRIN SR, 1996) inhibits norepinephrine and dopamine reuptake; depression.
Why this oneSlower delivery reduces peak burden while retaining an activating, sexually sparing profile; BID dosing; space doses >=8 h apart.
What limits itDo not crush; high peaks increase seizure risk. Avoid in eating or seizure disorders, and expect CYP2D6 interactions.
FDA-approved for
- depression (1996)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Major depressive disorder | Adults | 150 mg QAM | 150 mg BID (300 mg/day) | 200 mg BID (400 mg/day) |
Titration After 3 days may increase to 300 mg/day; wait several weeks before 400 mg/day; ≥8 h between doses
Renal Reduce dose and/or frequency (GFR <90 mL/min)
Hepatic Moderate–severe (Child-Pugh 7–15): max 100 mg/day or 150 mg every other day; mild: reduce dose/frequency
Do not exceed 400 mg/day (seizure risk)
Instructions
- Swallow whole; do not crush, divide, or chew
- Take with or without food
- Do not exceed 200 mg in any single dose
- Increase dose gradually to reduce seizure risk
Available strengths
- ER tab 100, 150, 200 mg
- tab 75, 100 mg
Contraindications
- Seizure disorder
- Current or prior diagnosis of bulimia or anorexia nervosa
- Patients undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs
- Use of MAOIs (intended to treat psychiatric disorders) concomitantly with WELLBUTRIN SR or within 14 days of discontinuing treatment; starting WELLBUTRIN SR in a patient treated with reversible MAOIs such as linezolid or intravenous methylene blue is contraindicated
Cautions
- Seizure (dose-related)
- Hypertension/elevated blood pressure
- Activation of mania/hypomania
- Psychosis and other neuropsychiatric reactions
- Angle-closure glaucoma
- Neuropsychiatric adverse events in smoking-cessation use
- Hypersensitivity reactions
Adverse reactions
- Headache
- Dry mouth
- Nausea
- Insomnia
- Dizziness
- Pharyngitis
- Constipation
- Agitation
- Anxiety
- Tremor
- Sweating
- Weight loss
Pregnancy First-trimester epidemiologic data show no increased risk of congenital malformations overall
Lactation Bupropion and metabolites present in human milk; seizures reported in breastfed infants
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 100 mg | ER tab | 30 qd | $2.04 | offered |
| 150 mg | ER tab | 30 qd | $2.40 | offered |
| 200 mg | ER tab | 30 qd | $3.11 | offered |
Other forms: Bupropion (WELLBUTRIN) · Bupropion hydrobromide ER (APLENZIN) · Bupropion XL (WELLBUTRIN XL) · Bupropion XL 450 mg (FORFIVO 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
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