BupropionBupropion Hydrochloride

About Bupropion

Bupropion weakly blocks norepinephrine and dopamine reuptake, not serotonin; how it relieves depression is unknown. It is labeled for major depressive disorder, and Wellbutrin XL, its generics and Aplenzin also for preventing seasonal affective disorder episodes from autumn to early spring; safety and effectiveness in children are not established. Doses rise gradually. Immediate-release tablets start at 100 mg twice a day and usually reach 100 mg three times a day, never more than 450 mg a day or 150 mg in one dose. SR tablets start at 150 mg each morning, usually reach 150 mg twice a day, and go no higher than 200 mg twice a day. XL tablets start at 150 mg each morning, with a target of 300 mg once a day. Forfivo XL, a single 450 mg tablet, is only for people already taking another bupropion product who need 450 mg a day. Aplenzin’s 174, 348 and 522 mg tablets equal 150, 300 and 450 mg of the hydrochloride. Liver or kidney impairment can call for a lower dose.

The boxed warning says antidepressants increased the risk of suicidal thoughts and behaviors in children, adolescents and young adults in short-term trials, so everyone taking it is watched for worsening mood or suicidal thoughts. Bupropion is stopped for good after a seizure. It must not be taken with a seizure disorder, a current or past eating disorder (bulimia or anorexia), during abrupt withdrawal from alcohol, benzodiazepines, barbiturates or antiseizure drugs, with an MAO inhibitor or within 14 days before or after one, or with an allergy to it, and it is not started in someone receiving linezolid or intravenous methylene blue. Other warnings cover raised blood pressure, checked before and during treatment; mania; psychosis; angle-closure glaucoma; allergic reactions; and mood changes or suicidal thoughts in people taking it to stop smoking. Common side effects include dry mouth, nausea, trouble sleeping, dizziness, anxiety and tremor.

Each release form is rated equivalent only to its own brand, so a pharmacist cannot exchange one for another. Every bupropion tablet is swallowed whole, never crushed, divided or chewed. The Wellbutrin immediate-release brand and Zyban, the SR tablet labeled to help people stop smoking, have been discontinued. Labels updated in 2024 and 2025 list reports of Brugada pattern or syndrome (a heart rhythm disorder), DRESS (a severe drug reaction) and aseptic meningitis. Bupropion can make urine drug screens falsely positive for amphetamines. First-trimester studies have not shown a higher overall risk of birth defects, and it passes into breast milk.

Taking Bupropion

How to take it

Immediate-release doses at least 6 hours apart, SR doses at least 8 hours apart, and XL tablets or Aplenzin once each morning, with or without food. Swallow tablets whole, and avoid a dose close to bedtime if it keeps you awake. An empty tablet shell in the stool is not a lost dose.

If you miss a dose

Skip the missed dose and take the next one at the usual time, leaving the full scheduled time between doses. Never take a double dose, since seizure risk rises with the dose.

Storage

At room temperature in a tightly closed container, away from light, heat and moisture, out of reach of children. XL tablets may have an odor.

Interactions to know about

Never with an MAO inhibitor or within 14 days of one. Other bupropion products (including Auvelity and Contrave), antipsychotics, antidepressants, theophylline and systemic steroids add to the seizure risk; clopidogrel raises its levels, and carbamazepine, phenytoin, ritonavir and efavirenz lower them. It raises levels of drugs cleared by CYP2D6, such as metoprolol and some antidepressants, may weaken tamoxifen, and needs care with levodopa or amantadine. Keep alcohol to a minimum.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Bupropion differs from pharmacy to pharmacy

Generic SR and XL tablets have many makers. A prescription that names Wellbutrin SR or Wellbutrin XL and blocks substitution is priced as a brand, as are Aplenzin and Forfivo XL, which no other tablet can replace at the counter. The schedule sets the count: immediate-release tablets three times a day, SR twice, XL once.

Ways to pay less for Bupropion without insurance

• Ask for a generic, and check that the prescription names your release form without blocking substitution.
• Ask whether bupropion is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Once your dose is settled, ask for a ninety-day supply.
• If Aplenzin or Forfivo XL is prescribed, ask the prescriber whether generic tablets at an equivalent dose would suit you, or ask the maker about a savings program for cash payers.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Bupropion

1. 1.Is this the release form my prescriber intended, and is my generic rated equivalent to it?
2. 2.How far apart should my doses be, and how late can I take one?
3. 3.Do any of my other medicines interact with it or raise my seizure risk?
4. 4.Should I tell the lab that I take it before a urine drug screen?

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