From the FDA Drug Label
Bupropion hydrochloride extended-release tablets, USP (XL) are supplied for oral administration as 150 mg and 300 mg creamy-white to pale yellow round coated tablets imprinted with black ink on one side and plain on other side To increase bupropion from 150 mg ER to 200 mg, you would not be able to use the available ER tablets as they are only available in 150 mg and 300 mg strengths.
- The ER formulation is the most appropriate to use in this scenario, as it is an extended-release formulation.
- Since there is no 200 mg ER tablet available, you may need to consider alternative formulations or dosing strategies, but this information is not provided in the drug label. 1 1
From the Research
To increase bupropion from 150 mg ER to 200 mg, you would need to use bupropion SR (sustained-release) tablets, specifically the 100 mg SR tablets, as bupropion ER 200 mg is not a standard available dose, and this formulation offers the flexibility to achieve the desired dose. The SR formulation is taken twice daily, unlike the ER (extended-release) formulation which is taken once daily. When switching from ER to SR, it's essential to divide the total daily dose into two separate doses taken at least 8 hours apart to maintain steady blood levels and minimize side effects. This change in formulation is necessary because bupropion ER typically comes in 150 mg and 300 mg strengths, while the SR formulation offers the flexibility to achieve the 200 mg daily dose. According to a study published in 2005 2, conversion from sustained-release to immediate-release bupropion appears to be safe, and single 200-mg doses of immediate-release bupropion can be administered to some patients without inducing excessive adverse effects, including seizures. However, it's crucial to monitor for any changes in effectiveness or side effects and discuss them with your healthcare provider, as changing formulations may affect how your body responds to the medication.
Some key points to consider when increasing the dose of bupropion include:
- The risk of seizure associated with bupropion use, particularly at higher doses, as reported in studies such as 3, 4, and 5
- The importance of monitoring for adverse effects, such as those reported in 2 and 6
- The need to adjust the dosing schedule when switching from ER to SR formulation to maintain steady blood levels and minimize side effects
- The potential for individual variability in response to the medication, as noted in 2 and 6
It's also important to note that the most recent study 6 published in 2021, highlights the factors associated with seizure development after bupropion overdose, which can inform clinical decision-making when adjusting the dose of bupropion.