Wellbutrin XL Dosage/Direction for Use

General Dosing Considerations: It is particularly important to administer Wellbutrin XL tablets in a manner most likely to minimize the risk of seizure (see Warnings and Precautions). Gradual escalation in dosage is also important if agitation, motor restlessness and insomnia, often seen during the initial days of treatment, are to be minimized. If necessary, these effects may be managed by temporary reduction of dose or the short-term administration of an intermediate- to long-acting sedative hypnotic. A sedative hypnotic usually is not required beyond the 1st week of treatment. In Wellbutrin XL, insomnia is a very common adverse event which is often transient. Insomnia may also be minimized by avoiding bedtime doses. If distressing, untoward effects supervene, dose escalation should be stopped. Wellbutrin XL should be swallowed whole and not crushed, divided or chewed as this may lead to an increased risk of adverse effects including seizures.
Wellbutrin XL may be taken without regard to meals.
Adults: Depression/Major Depressive Disorder (MDD): Initial Treatment: The usual adult target dose is 300 mg/day, given once daily in the morning. Dosing with Wellbutrin XL should begin at 150 mg/day given as a single daily dose in the morning. If the 150 mg initial dose is adequately tolerated, an increase to the 300 mg/day target dose, given as 150 mg twice daily, may be made as early as day 4 of dosing. There should be an interval of at least 8 hrs between successive doses.
Increasing the Dosage >300 mg/day: As with other antidepressants, the full antidepressant effect of Wellbutrin XL may not be evident until 4 weeks of treatment or longer.
An increase in dosage to the maximum of 450 mg/day, given as a single dose, may be considered for patients in whom no clinical improvement is noted after several weeks of treatment at 300 mg/day.
Maintenance Treatment: It is generally agreed that acute episodes of depression require several months or longer of sustained pharmacological therapy beyond response to the acute episode.
It is unknown whether or not the dose of Wellbutrin XL needed for maintenance treatment is identical to the dose needed to achieve an initial response. Patients should be periodically reassessed to determine the need for maintenance treatment and the appropriate dose for such treatment.
Seasonal Affective Disorder: For the prevention of seasonal major depressive episodes associated with seasonal affective disorder, Wellbutrin XL should generally be initiated in the autumn prior to the onset of depressive symptoms. Treatment should continue through the winter season and should be tapered and discontinued in early spring. The timing of initiation and duration of treatment should be individualized based on the patient's historical pattern of seasonal major depressive episodes. Patients whose seasonal depressive episodes are infrequent or not associated with significant impairment should not generally be treated prophylactically.
Dosing with Wellbutrin XL should begin at 150 mg/day given as a single daily dose in the morning. If the 150 mg initial dose is adequately tolerated, the dose of Wellbutrin XL should be increased to the 300 mg/day dose after 1 week. If the 300 mg dose is not adequately tolerated, the dose can be reduced to 150 mg/day. The usual adult target dose for Wellbutrin XL is 300 mg/day, given once daily in the morning.
For patients taking 300 mg/day during the autumn-winter season, the dose should be tapered to 150 mg/day for 2 weeks prior to discontinuation.
Doses of Wellbutrin XL >300 mg/day have not been studied for the prevention of seasonal major depressive episodes.
Switching Patients from Wellbutrin Tablets or from Wellbutrin SR Sustained-Release Tablets: When switching patients from Wellbutrin tablets to Wellbutrin XL or from Wellbutrin SR sustained-release tablets to Wellbutrin XL, give the same total daily dose when possible. Patients who are currently being treated with Wellbutrin tablets at 300 mg/day (for example, 100 mg 3 times a day) may be switched to Wellbutrin XL 300 mg once daily. Patients who are currently being treated with Wellbutrin SR sustained-release tablets at 300 mg/day (for example, 150 mg twice daily) may be switched to Wellbutrin XL 300 mg once daily.
Hepatic Impairment: Wellbutrin XL should be used with extreme caution in patients with severe hepatic cirrhosis. The dose should not exceed 150 mg every other day in these patients. Wellbutrin XL should be used with caution in patients with hepatic impairment (including mild to moderate hepatic cirrhosis) and a reduced frequency and/or dose should be considered in patients with mild to moderate hepatic cirrhosis (see Warnings, Precautions, and Pharmacology: Pharmacokinetics under Actions).
Renal Impairment: Wellbutrin XL should be used with caution in patients with renal impairment. Wellbutrin XL should be initiated at a reduced frequency and/or dose (see Precautions). A reduced frequency and/or dose of Wellbutrin XL should be considered (see Precautions and Pharmacology: Pharmacokinetics under Actions).