Provided by You Health for patients

Generic for Wellbutrin XL® (Bupropion ER XL)

In this medication overview

Bupropion ER XL (bupropion hydrochloride) is a prescription medicine used to treat major depressive disorder (MDD), seasonal affective disorder (SAD), and to help people quit smoking (smoking cessation). Bupropion may also be helpful when prescribed “off-label” for bipolar disorder, attention deficit hyperactivity disorder (ADHD), and sexual dysfunction due to SSRI antidepressants.

Usage

1. To get started, review the directions on your prescription label and follow your provider's dosing instructions. If you are not already taking bupropion, your provider will likely want you to begin by taking a starting dose (150mg) for the first 7 days before increasing your dose. Be sure to follow the instructions your provider sent to help your body safely adjust to bupropion.

2. Swallow the tablet whole Swallow the tablet whole. Do not break, crush or chew it.

3. Avoid insomnia It is best to take this medication in the morning to avoid insomnia.

4. Missed a dose? If you miss a dose of this medicine, do not take an extra tablet to make up for the dose you forgot. Wait and take your next dose at your regular time the next day. Do not double doses.

Do not abruptly stop taking bupropion ER XL or change your dose without talking with your healthcare provider first, even when you feel better. Studies have shown that a taper can reduce possible side-effects caused by stopping the medication abruptly.

• If you are taking bupropion ER XL 150mg, you may stop taking your medication without tapering.

• If you are taking bupropion ER XL 300mg, take one tablet every other day for two weeks then you may stop medication.

• If you are taking bupropion ER XL 450mg (three 150mg tablets), take two 150mg tablets daily for one week, then one 150mg tablet daily for one week, then you may stop medication.

Your healthcare provider can also provide individualized guidance for tapering your medication.

While depressed mood and lack of interest in activities may need up to 4-6 weeks to improve, disturbances in sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working.

Warnings

SUICIDALITY AND ANTIDEPRESSANT DRUGS

Bupropion ER XL and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. If you are experiencing a mental health crisis, please call or text 988 to be connected with help, or go to your nearest hospital emergency department. Be sure to let your care team know what happened. Pay particular attention to such changes when bupropion ER XL is started or when the dose is changed.

Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.

IMPORTANT SAFETY INFORMATION

Do not take bupropion ER XL (bupropion hydrochloride) if you:

• Are allergic to bupropion, as contained in bupropion hydrochloride, or any of the ingredients in bupropion

• Take any medication for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to: isocarboxazid, phenelzine, rasagiline, selegiline, tranylcypromine

• Are already taking a medication containing bupropion

• Are taking tamoxifen

• Have a recent (within 5 years) history of a seizure disorder

• Have a history of anorexia nervosa or bulimia nervosa

• Have active anorexia nervosa or bulimia nervosa, or are in remission for less than 12 months

• Drink large amounts of alcohol, use recreational drugs or abuse prescription medications - or suddenly stop substance abuse habits

Before you take bupropion, tell your healthcare provider if you:

• Have thoughts of suicide or harming yourself

• Have a history of psychiatric or medical problems, including bipolar disorder

• Have taken any medication in the past for your condition, whether effective or not

• Have suffered adverse or side effects from previous medication therapies

• Are pregnant, plan to become pregnant, or are breastfeeding

• Drink alcohol or use/abuse recreational or prescription drugs

Inform your healthcare provider

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.

Bupropion ER XL may affect the way other medicines work, and other medicines may affect the way bupropion ER XL works, potentially causing side effects. Especially tell your healthcare provider if you take any of the following:

• Take any medicines called monoamine oxidase inhibitor (MAOI), or if you have stopped taking a MAOI in the last 14 days

• Beta blockers (metoprolol, propranolol, nebivolol)

Medication disposal

If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.

If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can visit FDA- Disposal of Unused Medicines for more information or follow these simple steps to dispose of most medicines in your trash at home:

• Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;

• Place the mixture in a container such as a sealed plastic bag;

• Throw away the container in your trash at home; and

• Remove all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

Side effects

Bupropion ER XL can cause serious side effects and should be reported to your provider immediately. These side effects are rare and include:

• Confusion

• Fainting

• Seizures

• Inability to concentrate

• Auditory or visual hallucinations

• Paranoia

Although it is rare, bupropion ER XL may cause serious eye problems including a sudden decrease in vision with or without eye pain and redness, or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These eye problems rarely occur, but can lead to permanent loss of vision if not treated. Should you notice any new eye symptoms, including any new problems with your vision, immediately discontinue use of bupropion ER XL and seek urgent in-person evaluation. Please also message your provider team as soon as you are able.

During treatment with this medication, common side effects of this medication may go away as your body adjusts to the medication. The most common side effects of bupropion ER XL are:

• Constipation

• Mild diarrhea

• Nausea and vomiting

• Decrease in appetite

• Dizziness

• Increased sweating

• Weight loss

• Headache

• Dry Mouth

• Trouble sleeping

• Sleepiness

Bupropion ER XL may also worsen anxiety symptoms so if you experience any worsening, reach out to your provider.

Where to find more side effects information

For more information, read the drug information that comes with your medication, ask your healthcare provider, or ask your pharmacist.

Telemedicine Disclosure

Frequently Asked Questions

Can I continue taking this medication if I become pregnant?

The safety of this medication during pregnancy has not been evaluated. If you become pregnant or decide to try to conceive, please alert your provider who will direct you to follow up with your primary care provider or OBGYN for continued management.

Can I drink alcohol while taking this medication?

Drinking alcohol while taking mental health medication is not advised. While many people use alcohol to try to help with anxiety and depression, research shows that over time alcohol actually worsens anxiety and depression. It can also increase the side effects of some medications, such as drowsiness, dizziness and coordination problems. It is recommended to avoid drinking alcohol while taking your medication, especially if you will be driving, operating dangerous machinery, or participating in dangerous activities. If you find that you are binge drinking on a daily or almost daily basis, our recommendation is to try to cut back on alcohol use to a healthier level.

Can I take cannabis while taking this medication?

Using cannabis products can worsen depression and increase the side effects of some medications, such as drowsiness, dizziness and coordination problems. It is recommended to avoid cannabis use while taking your medication, especially if you will be driving, operating dangerous machinery, or participating in dangerous activities.

Is it safe to stop taking Xanax now that I’m going to start my daily mental health medication?

If you are taking a benzodiazepine (Ativan, Xanax, Klonopin, Valium, etc) and you start feeling better, you should talk to your prescriber about tapering down from the benzodiazepine. Abruptly stopping the daily use of a benzodiazepine can lead to dangerous side effects such as seizures, so careful monitoring by your primary care provider is recommended.