Indications for: WELLBUTRIN XL
Major depressive disorder (MDD). Seasonal affective disorder (SAD).
Swallow whole. Avoid bedtime dosing. ≥18yrs: MDD: initially 150mg once daily in the AM for at least 4 days; if tolerated, increase to 300mg once daily in the AM at least 24hrs apart. May increase after several weeks to max 450mg once daily. SAD: start in autumn, taper and stop in early spring. 150mg once daily in AM; if tolerated, increase to 300mg once daily after 1 week. Max 300mg/day. Moderate to severe hepatic impairment: max 150mg every other day. Renal or mild hepatic impairment: consider reduced dose and/or dose frequency.
<18yrs: not established.
WELLBUTRIN XL Contraindications:
Seizure disorders. Bulimia. Anorexia nervosa. During or within 14 days of discontinuing MAOIs. Concomitant linezolid or IV methylene blue. Abrupt withdrawal of alcohol, benzodiazepines, barbiturates, or antiepileptics. Other forms of bupropion (eg, Zyban).
Suicidal thoughts and behaviors.
WELLBUTRIN XL Warnings/Precautions:
Not for treating bipolar depression or for smoking cessation. Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor all patients for clinical worsening or unusual behavioral changes. Monitor for neuropsychiatric adverse events (eg, behavioral changes, agitation, depression, suicidal ideation); evaluate and consider treatment continuation under closer monitoring, or discontinuation if occur. Pre-existing psychiatric disorders. Bipolar disorder. Mania/hypomania. Psychosis. Risk of seizures; discontinue if seizure occurs: do not restart. Angle-closure glaucoma. Unstable heart disease. CHF. Recent MI. Monitor BP before initiating and periodically during treatment. Hepatic or renal impairment (monitor closely). Reevaluate periodically. Maintain at lowest effective dose. Write ℞ for smallest practical amount. Elderly. Pregnancy. Nursing mothers.
WELLBUTRIN XL Classification:
WELLBUTRIN XL Interactions:
See Contraindications. Do not start with concomitant linezolid or IV methylene blue; if treatment necessary, discontinue bupropion before starting. Monitor for 2 weeks or until 24hrs after last dose of linezolid or IV methylene blue, whichever comes first. Avoid alcohol. Levodopa, amantadine may increase CNS toxicity. Caution with drugs that lower seizure threshold (eg, theophylline, antidiabetics, anorectics, CNS stimulants, systemic steroids, tricyclic antidepressants, antipsychotics) or factors that lower seizure threshold (eg, opiate or cocaine addiction, excessive use of alcohol or sedatives). Caution with CYP2B6 inhibitors (eg, ticlopidine, clopidogrel) or drugs metabolized by CYP2D6 including antidepressants (eg, venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, sertraline), antipsychotics (eg, haloperidol, risperidone, thioridazine), β-blockers (eg, metoprolol), Class 1C antiarrhythmics (eg, propafenone, flecainide); consider dose reduction. Caution with CYP2B6 inducers (eg, ritonavir, lopinavir, efavirenz, carbamazepine, phenobarbital, phenytoin), tamoxifen; consider dose increase. May antagonize digoxin; monitor. May cause false (+) urine immunoassay test results for amphetamine.
Dry mouth, nausea, insomnia, dizziness, pharyngitis, abdominal pain, agitation, anxiety, tremor, palpitation, sweating, tinnitus, myalgia, anorexia, urinary frequency, rash (rarely may be serious, eg, erythema multiforme, Stevens-Johnson syndrome), headache, blurred vision, tachycardia; hypertension.
Generic Drug Availability:
XL tabs 150mg—30, 90; 300mg—30; SR tabs—60; Tabs—contact supplier