Maximum Dose of Wellbutrin SR
The maximum recommended dose for Wellbutrin SR (bupropion sustained-release) is 400 mg per day, administered as 200 mg twice daily. 1
Dosing Information
Wellbutrin SR follows a specific dosing schedule:
- Starting dose: 100-150 mg once daily
- Maintenance dose: 100-150 mg twice daily
- Maximum dose: 400 mg per day (200 mg twice daily) 1
It's important to note that the maximum daily dose should not exceed 400 mg to minimize the risk of adverse effects, particularly seizures, which become more common at higher doses.
Dosing Considerations
Titration Schedule
- Begin with lower doses and gradually increase
- Allow adequate time between dose increases (typically 3-7 days) to assess tolerance and efficacy
- The 400 mg maximum daily dose should be divided into two equal doses of 200 mg each
Special Populations
Hepatic Impairment:
- Moderate to severe impairment: Maximum 150 mg every other day
- Mild impairment: Consider reduced dose and/or frequency 2
Renal Impairment:
- Consider reduced dose and/or frequency
- Monitor closely for adverse reactions 2
Elderly Patients:
- No specific dose adjustments required based on age alone
- However, consider potential for decreased renal function in elderly patients 2
Safety Considerations
Seizure Risk
The risk of seizures increases at higher doses, which is why the maximum dose is capped at 400 mg per day. Exceeding this dose significantly increases seizure risk.
Other Dose-Related Adverse Effects
- Acute dystonia (including neck stiffness, trismus, and TMJ pain) has been reported as a dose-related phenomenon 3
- Mania/hypomania may be dose-related, with increased risk at doses exceeding 450 mg daily 4
Drug Interactions
Bupropion interacts with multiple medications that may necessitate dose adjustments, including:
- MAO inhibitors
- CYP2D6 inhibitors
- Drugs that lower seizure threshold 2
Clinical Applications
Bupropion SR at appropriate doses has been studied for:
- Depression (primary indication)
- ADHD in adults (off-label use) 5
- Treatment of SSRI-induced sexual side effects 6
- Combination therapy with SSRIs for treatment-resistant depression 7
When using bupropion for these conditions, maintaining the maximum dose at 400 mg per day is essential for safety while still providing therapeutic benefit.