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Bupropion and dextromethorphan

Generic name: bupropion and dextromethorphan [ byoo-PROE-pee-on-and-deks-troe-meth-OR-fan ]
Brand name: Auvelity
Dosage form: oral tablet, extended release (105 mg-45 mg)
Drug class: Miscellaneous antidepressants

Medically reviewed by Drugs.com on Nov 13, 2022. Written by Cerner Multum.

What is bupropion and dextromethorphan?

Bupropion and dextromethorphan is used in adults to treat major depressive disorder.

Bupropion and dextromethorphan may also be used for purposes not listed in this medication guide.

Bupropion and dextromethorphan side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Bupropion and dextromethorphan may cause serious side effects. Call your doctor at once if you have:

Common side effects of bupropion and dextromethorphan may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Warnings

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Before taking this medicine

You should not use bupropion and dextromethorphan if you are allergic to it, or if you have:

Do not use bupropion and dextromethorphan if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine. Wait at least 14 days after stopping an MAO inhibitor before you take bupropion and dextromethorphan.

Tell your doctor if you have ever had:

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of bupropion and dextromethorphan on the baby.

Bupropion and dextromethorphan may harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Do not breastfeed while using bupropion and dextromethorphan, and for at least 5 days after your last dose.

How should I take bupropion and dextromethorphan?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Bupropion and dextromethorphan is usually taken once a day. Your doctor may change your dose after the third day. Do not take more than 2 tablets in 24 hours.

You may take bupropion and dextromethorphan with or without food.

Swallow the tablet whole and do not crush, chew, or break it.

Your blood pressure will need to be checked often.

Do not stop using bupropion and dextromethorphan suddenly. Ask your doctor before stopping the medicine.

This medicine may cause false results on a drug-screening urine test. Tell the laboratory staff that you use bupropion and dextromethorphan.

Store at room temperature away from moisture and heat.

Bupropion and dextromethorphan dosing information

Usual Adult Dose for Major Depressive Disorder:

Initial dose: 1 tablet orally once a day in the morning for 3 days
Maintenance dose: 1 tablet orally twice a day

Comments:
-Maintenance doses should be administered at least 8 hours apart.
-The maintenance dose should not be exceeded.

Use: For the treatment of major depressive disorder

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take more than one dose at a time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking bupropion and dextromethorphan?

Avoid drinking alcohol.

Avoid driving or hazardous activity until you know how bupropion and dextromethorphan will affect you. Your reactions could be impaired.

What other drugs will affect bupropion and dextromethorphan?

Tell your doctor about all your other medicines, especially:

Other drugs may affect bupropion and dextromethorphan, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

Popular FAQ

Auvelity worked significantly better than Wellbutrin (bupropion) at relieving symptoms of depression in a small randomized double-blind, parallel trial that lasted for 6 weeks. It also had a faster onset of effect, with improvement in the Montgomery-Åsberg Depression Rating Scale (MADRS) score being observed as early as week 1 and differences being statistically significant by week 2. Continue reading

Both Auvelity and Wellbutrin are effective for depression but a small RCT (n=80) reported that Auvelity worked significantly better than Wellbutrin and took less time to start working. 43 people prescribed Auvelity experienced an overall decrease in their Montgomery-Åsberg Depression Rating Scale (MADRS) score of 13.7 points after 6 weeks compared to a decrease of 8.8 points in the 37 people prescribed bupropion (least-squares mean difference=-4.9; 95% CI=-3.1, -6.8). Continue reading

Auvelity works in several different ways because it contains two different ingredients, dextromethorphan and bupropion, although the exact way it works for depression is unknown. The dextromethorphan component targets the NMDA receptor (N-methyl-D-aspartate), the serotonin transporter (SERT), the norepinephrine transporter (NET), and the sigma-1 receptor, to regulate levels of glutamate and other neurotransmitters such as serotonin and norepinephrine. Continue reading

Auvelity is a combination oral tablet for depression containing dextromethorphan and bupropion that works differently from other antidepressants because it has a direct effect on the N-methyl-D-aspartate (NMDA) receptor as well as possibly other traditional neurotransmitter effects. It also works much faster than traditional antidepressants, and it does appear to be more effective. Continue reading

Weight gain has not been reported with Auvelity, but in one 6-week study, participants lost, on average, half a pound, while those taking placebo gained about one pound. Animal studies have also reported that the administration of dextromethorphan/bupropion did not affect body weight, weight gain, or food consumption. Continue reading

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.