From the Guidelines
The maximum daily dose of bupropion is 300 mg per day. This dose is based on the standard pharmacotherapy dosing information for bupropion, which is used for smoking cessation, as stated in the 2016 NCCN clinical practice guidelines in oncology 1. The dosing regimen for bupropion typically starts with 150 mg orally, once daily, for days 1-3, and then increases to 150 mg orally, twice daily, for days 4-12 weeks, if tolerated. Some key points to consider when prescribing bupropion include:
- Monitoring for the development or worsening of serious neuropsychiatric issues, such as depression and suicidal ideation/behavior
- Contraindications for patients with seizure risks, those taking MAO inhibitors, or those with closed-angle glaucoma
- Potential side effects, such as insomnia, headache, and dry mouth
- The importance of gradual dose increase to minimize side effects. It's essential to weigh the benefits of bupropion against the potential risks, particularly in patients with a history of seizure disorders or other contraindications, as noted in the guidelines 1.
From the FDA Drug Label
In patients with moderate to severe hepatic impairment (Child-Pugh score: 7 to 15), the maximum bupropion hydrochloride extended-release tablets (XL) dose is 150 mg every other day. In patients with mild hepatic impairment (Child-Pugh score: 5 to 6), consider reducing the dose and/or frequency of dosing [see Dosage and Administration (2.6) and Clinical Pharmacology (12. 3)].
The maximum daily dose of bupropion is not explicitly stated in the label for patients with normal hepatic function. However, the label does provide dosing guidance for patients with hepatic impairment.
- For patients with mild hepatic impairment, the label suggests considering a reduced dose and/or frequency of dosing, but does not specify a maximum daily dose.
- For patients with moderate to severe hepatic impairment, the maximum dose is 150 mg every other day. Since the label does not provide a clear maximum daily dose for patients with normal hepatic function, no conclusion can be drawn. 2
From the Research
Maximum Daily Dose of Bupropion
The maximum daily dose of bupropion is a crucial aspect of its administration to ensure safety and efficacy.
- The recommended maximum daily dose of bupropion is 300mg for smoking cessation, as stated in the study 3.
- However, for other indications such as depression, the maximum daily dose is 450mg, as mentioned in the study 4.
- It is essential to note that doses above 450mg per day may increase the risk of seizures and other adverse reactions, as reported in the study 4.
- The study 5 also highlights the importance of not exceeding the recommended daily dose to minimize the risk of major motor seizures.
Dosage Considerations
When considering the dosage of bupropion, it is crucial to take into account the individual's specific needs and medical history.
- The study 6 demonstrates the effectiveness of bupropion sustained-release for smoking cessation in patients with chronic posttraumatic stress disorder, with a final dose of 150mg twice daily (300mg daily total).
- The study 7 provides an overview of bupropion prescription details, potential indications, and treatment duration in children, young adults, and adults, highlighting the variability in dosage and treatment regimens.
- It is essential to follow the manufacturer's dosage recommendations and to monitor patients closely for any adverse reactions, as emphasized in the study 3.