Patient: I suffer very severe depression, and the pharmacies in my area are currently out of bupropion hydrochloride (Wellbutrin SR). My prescription for bupropion is 600mg in the form of a 200mg tablet 3 times a day, so I have the option of only taking 400mg in a day if my stomach is bothering me. I have my doctors permission to do this.I have already missed a dose, and it’s very important I get my medications regularly. My father has a prescription of 300mg Wellbutrin XL (the extended release version), and while I know I should never take medications that aren’t prescribed to me I feel keeping my mental stability is more important. In the past I’ve been told never to take more than 300mg of bupropion at once, and was wondering about how I should take the extended release. Should I just take 300mg/day (half my prescribed dose), or would it be safe to take 300mg 2x/day (one in the morning and one at night).My other medication is Cymbalta at 120mg/day. I receive rTMS 2x/week, so it’s important my medications stay as constant as possible. I risk entering a state similar to catatonia without getting my medications, and I’ve already missed my morning dose. I am going to take 300mg of bupropion XL tonight, the question is if it’s safe enough to take another 300mg in the morning – or would my risk of a side effect like a seizure be too great?
Doctor: Thank you for your question. It is important to know the difference between the SR and XL formulations.They are not interchangeableSR is sustained release and releases the medication slowly over a 12 hour period into your body.XL is extended release and releases the medication over a 24 hour period into your body.From clinical experience, when switching from SR to XL, we should calculate your daily dose total on SR (400 to 600mg) and covert it to once a day dosing for XL.In your example. You should start taking XL on a day you have not taken SR. Your starting dose should be 150 mg of XL and slowly over the course of 1 to weeks increased to 600mg XL.XL should never be taken on the same day as SR and never be taken twice a day.I hope this was helpfull. The above switch in medication formulation should never be done without consultation with your regular doctor and pharmacist.
Comments / Follow Ups
Patient: It’s worth noting that my doctor and I are aware of and have discussed the increased risk of seizure at the dose I currently take. I have Ativan I can take in the event that I begin to experience seizure symptoms.
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