Provided by You Health for patients

Bupropion XL (generic for Wellbutrin XL®)

The following provides a medication overview of Bupropion XL and how to effectively and safely use it to support weight loss. You will also receive a medication guide with your medication, which contains full information about Bupropion XL. Please read all of the information before taking your medication and at each refill.
What is Bupropion XL?
Bupropion promotes weight loss by curbing cravings and reducing appetite. While bupropion is FDA approved to treat depression, seasonal affective disorder (SAD), and to help people quit smoking, it’s commonly prescribed off-label by leading obesity specialists and weight clinics to help with weight loss.
In this medication overview
  1. Usage

    How to get the most out of your treatment

  2. Side Effects

    What to look out for when using your treatment

  3. Warnings

    Important safety information

Usage

  1. To get started, follow your provider's dosing instructions
    You will begin treatment by taking a starting dose of one tablet (150mg) per day for the first 14 days before increasing your dose to two tablets (300 mg) per day. Be sure to follow the instructions your provider sent to help your body safely adjust to Bupropion XL.
  2. Swallow the tablet whole
    Swallow the tablet whole. Do not break, crush or chew it.
  3. Avoid insomnia
    If you have trouble sleeping, 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, for the XL form, 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.

Side effects

The most common side effects of Bupropion XL include: The most common side effects of Bupropion XL include: trouble sleeping, stuffy nose, dry mouth, dizziness, feeling anxious, nausea, constipation, pharyngitis, abdominal pain, agitation, tremor, palpitation, sweating, tinnitus, myalgia, anorexia, urinary frequency, and rash.
These are not all the side effects of Bupropion XL. You can message a provider through your Hims & Hers account if you have any questions about your treatment, including any side effects you may be experiencing. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.


Warnings

IMPORTANT SAFETY INFORMATION
WARNING: CHANGES IN THINKING AND BEHAVIOR, DEPRESSION, AND SUICIDAL THOUGHTS OR ACTIONS
Suicidal Thoughts or Actions and Antidepressant Drugs Antidepressants may increase the risk of suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment. Depression or other serious mental illnesses are the most important causes of suicidal thoughts and actions. People who have (or have a family history of) bipolar illness or suicidal thoughts or actions may have a particularly high risk. Pay close attention to any changes, especially sudden changes in mood, behaviors, thoughts, or feelings. Contact your healthcare provider right away if symptoms such as anxiety, irritability, impulsivity, trouble sleeping, aggressive behavior or suicidal thoughts are new, worse or worry you. If your symptoms are severe seek immediate in-person medical care. Bupropion XL has not been evaluated for use in patients under the age of 18.
Contact your healthcare provider right away if you or your family member has any of the following symptoms, especially if they are new, worse, or worry you:
  • thoughts about suicide or dying
  • attempts to commit suicide
  • new or worse depression
  • new or worse anxiety
  • feeling very agitated or restless
  • panic attacks
  • trouble sleeping (insomnia)
  • new or worse irritability
  • acting aggressive, being angry, or violent
  • acting on dangerous impulses
  • an extreme increase in activity and talking (mania)
  • other unusual changes in behavior or mood
Although Bupropion XL is not a treatment for quitting smoking, it contains the same active ingredient (Bupropion) as Zyban®, which is used to help patients quit smoking.
Some people have had serious side effects while taking Bupropion XL to help them quit smoking, including:
  • New or worse mental health problems, such as changes in behavior or thinking, aggression, hostility, agitation, depression, or suicidal thoughts or actions. Some people had these symptoms when they began taking Bupropion XL, and others developed them after several weeks of treatment, or after stopping Bupropion XL. These symptoms happened more often in people who had a history of mental health problems before taking Bupropion XL than in people without a history of mental health problems.
Stop taking Bupropion XL and message your healthcare provider right away if you, your family, or caregiver notice any of these symptoms. Work with your healthcare provider to decide whether you should continue to take Bupropion XL. In many people, these symptoms went away after stopping Bupropion XL, but in some people, symptoms continued after stopping Bupropion XL. It is important for you to follow-up with your healthcare provider until your symptoms go away.
Before taking Bupropion XL, tell your healthcare provider if you have ever had depression or other mental health problems. You should also tell your healthcare provider about any symptoms you had during other times you tried to quit smoking, with or without Bupropion XL.
What Other Important Information Should I Know About Bupropion XL?
  • Seizures: There is a chance of having a seizure (convulsion, fit) with Bupropion XL, especially in people with certain medical problems or who take certain medicines. Do not take any other medicines while you are taking Bupropion XL unless your healthcare provider has said it is okay to take them. If you have a seizure while taking Bupropion XL, stop taking the tablets and message your healthcare provider right away.
  • High blood pressure (hypertension): Some people get high blood pressure that can be severe while taking Bupropion XL.
  • Manic episodes: Some people may have periods of mania while taking Bupropion XL. If you have any of the following symptoms of mania, message your healthcare provider:
    • greatly increased energy
    • severe trouble sleeping
    • racing thoughts
    • reckless behavior
    • unusually grand ideas
    • excessive happiness or irritability
    • talking more or faster than usual
  • Unusual thoughts or behaviors: Some patients may have unusual thoughts or behaviors while taking Bupropion XL, including delusions (e.g., believe you are someone else), hallucinations (seeing or hearing things that are not there), paranoia (feeling that people are against you), or feeling confused. If this happens to you, message your healthcare provider.
  • Visual problems: Some people are at risk of glaucoma which can present as: eye pain, changes in vision, or swelling and redness around the eye if they take Bupropion XL. You should see an eye doctor to determine whether you are at risk prior to starting therapy.
BUPROPION XL may cause serious eye problems including:
  • A sudden decrease in vision with or without eye pain and redness.
  • A blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma).
These eye problems 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 and seek urgent in-person evaluation. Please also message your provider team as soon as you are able.
  • Ringing in the ears: Rarely, some people may have ringing in the ears if they take BUPROPION XL. In a small percentage of people this may be permanent. If this occurs, immediately stop taking the medication and seek in-person evaluation by your primary care healthcare provider or an otolaryngologist (ENT) specialist.
  • Severe allergic reactions: Some patients have severe allergic reactions to Wellbutrin XL. Stop taking Bupropion XL and message your healthcare provider right away if you get a rash, itching, hives, fever, swollen lymph glands, painful sores in the mouth or around the eyes, swelling of the lips or tongue, chest pain, or have trouble breathing. These could be signs of a serious allergic reaction.
Do not take Bupropion XL if you:
  • have or had a seizure disorder or epilepsy
  • have or had an eating disorder such as anorexia nervosa or bulimia
  • are taking any other medicines that contain Bupropion XL, including Wellbutrin® or Wellbutrin® SR , Aplenzin®, Zyban®, or Forfivo® LL. Bupropion XL is the same active ingredient that is in Wellbutrin® XL
  • drink a lot of alcohol and abruptly stop drinking, or use medicines called sedatives (these make you sleepy), benzodiazepines, or anti-seizure medicines, and you stop using them all of a sudden
  • take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid
    • do not take an MAOI within 2 weeks of stopping Bupropion XL unless directed to do so by your healthcare provider
    • do not start Bupropion XL if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your healthcare provider
  • are allergic to the active ingredient in Bupropion XL, or to any of the inactive ingredients. Inactive ingredients include: Unspecified ethylcellulose, methacrylic acid-ethyl acrylate copolymer type A, polyvinyl alcohol, polyethylene glycol 1450, polyethylene glycol 3350, povidone, silicon dioxide, triethyl citrate, titanium dioxide, talc, soybean lecithin, ferrosoferric oxide, shellac, cysteine hydrochloride, magnesium stearate.
Also, tell your healthcare provider about your other medical conditions, including if you:
  • have liver problems, especially cirrhosis of the liver
  • have kidney problems
  • have, or have had, an eating disorder such as anorexia nervosa or bulimia
  • have had a head injury
  • have had a seizure (convulsion, fit)
  • have a tumor in your nervous system (brain or spine)
  • have had a heart attack, heart problems, or high blood pressure
  • are a diabetic taking insulin or other medicines to control your blood sugar
  • drink alcohol
  • abuse prescription medicines or street drugs
  • are pregnant or plan to become pregnant. Talk to your healthcare provider about the risk to your unborn baby if you take Bupropion XL during pregnancy, and about registering with the National Pregnancy Registry by calling 1-844-405-6185
  • are breastfeeding. Bupropion XL passes into your milk in small amounts
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Many medicines increase your chances of having seizures or cause other serious side effects if you take them while you are using Bupropion XL.
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
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.
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.
This is only a summary of the most important information about Bupropion XL. Need more information?
Ask your healthcare provider or pharmacist.