From the Guidelines
Bupropion dosing should be initiated at 150 mg once daily in the morning for 3-7 days, then increased to 150 mg twice daily (300 mg total) if tolerated, with a maximum recommended dose of 400 mg/day, as supported by the most recent clinical practice guideline on pharmacological interventions for adults with obesity 1. When considering the dosing of Bupropion, also known as Wellbutrin, it is essential to take into account the specific formulation being used, as this can impact the dosing schedule.
- For sustained-release (SR) formulations, doses should be taken at least 8 hours apart to minimize seizure risk.
- For extended-release (XL) formulations, the full daily dose is taken once in the morning. The dosing may also vary depending on the patient's specific condition, such as smoking cessation or depression.
- For smoking cessation, treatment begins 1-2 weeks before the quit date at 150 mg daily for 3 days, then 150 mg twice daily for 7-12 weeks. It is crucial to consider potential interactions and contraindications, such as the use of monoamine oxidase inhibitors or a history of seizures, as well as monitoring for neuropsychiatric adverse effects, including suicidal thoughts and behaviors, especially in individuals younger than 24 years 1. Dose adjustments are necessary for patients with hepatic or renal impairment, typically reducing to 150 mg daily, and elderly patients may also require lower doses due to decreased clearance 1.
From the FDA Drug Label
In the first study, the bupropion dose range was 300 mg to 600 mg per day administered in 3 divided doses; 78% of patients were treated with doses of 300 mg to 450 mg per day. The second study included 2 fixed doses of bupropion (300 mg and 450 mg per day) and placebo. The third study, outpatients were treated with bupropion 300 mg per day The initial bupropion dose was 150 mg once daily for 1 week, followed by up-titration to 300 mg once daily.
The appropriate dosing for Bupropion (Wellbutrin) is:
- 300 mg to 450 mg per day administered in divided doses for the treatment of Major Depressive Disorder (MDD)
- 150 mg once daily for 1 week, followed by up-titration to 300 mg once daily for the prevention of seasonal major depressive episodes associated with Seasonal Affective Disorder (SAD) 2
From the Research
Dosing Information for Bupropion (Wellbutrin)
- The appropriate dosing for Bupropion (Wellbutrin) is maintained at 450 mg/day or less in a divided schedule, as stated in the study 3.
- For smoking cessation, the recommended dose is 300 mg/day, as indicated in the study 4.
- Bupropion is available in three oral formulations: immediate release (IR), sustained release (SR), and extended/modified release (XR), with all three formulations being bioequivalent in terms of systemic exposure to bupropion 5, 6.
- The most common formulation and dose at initiation is bupropion extended-release 24-hour 150 mg, as reported in the study 7.
Formulations and Dosage
- Bupropion IR is administered three times daily 5, 6.
- Bupropion SR is administered twice daily 5, 6.
- Bupropion XR is administered once daily 5, 6.