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 (Wellbutrin) XL is 450 mg per day for patients with normal hepatic function, but this information is not explicitly stated in the provided text. However, according to the FDA label for bupropion hydrochloride extended-release tablets (XL), the typical dosage is 300 mg once daily, and the dose can be increased to a maximum of 450 mg per day, but the text does not provide this information. Key points:
- The provided text does not explicitly state the maximum daily dose for patients with normal hepatic function.
- The maximum daily dose for patients with moderate to severe hepatic impairment is 150 mg every other day.
- For patients with mild hepatic impairment, the dose and/or frequency of dosing should be reduced. 1
From the Research
The maximum daily dose of bupropion (Wellbutrin) XL is 450 mg per day, taken as a single daily dose in the morning. This extended-release formulation is designed to provide steady medication levels throughout the day. Patients typically start at a lower dose of 150 mg daily for several days before potentially increasing to 300 mg daily, with further increases to 450 mg if needed and tolerated. It's essential not to exceed this 450 mg maximum daily dose as higher doses significantly increase the risk of seizures, which is a serious potential side effect of bupropion, as reported in studies such as 2 and 3. The medication works by inhibiting the reuptake of dopamine and norepinephrine in the brain, which helps improve mood in depression and reduces cravings in those using it for smoking cessation.
Some key points to consider when prescribing bupropion XL include:
- Starting with a lower dose and gradually increasing as needed and tolerated
- Not exceeding the maximum daily dose of 450 mg
- Taking the medication in the morning to avoid sleep disturbances
- Not crushing, chewing, or splitting the tablets to avoid disrupting the extended-release mechanism
- Being aware of potential interactions with other medications, as discussed in 4
- Considering the pharmacokinetic properties and various formulations of bupropion, as reviewed in 5 and 4
It's also important to note that bupropion has been used as an add-on strategy in difficult-to-treat bipolar depressive patients, as reported in 6, and has been shown to be effective in reducing depressive symptoms without inducing switches to hypomania or mania, while adhering to the recommended daily dose of 450 mg.