Wellbutrin SR instructions for administration

Instructions for administration
General Dosing Considerations Initial Treatment Increasing the Dosage Above 300 mg/day Maintenance Treatment Dosage Adjustment for Patients with Impaired Hepatic Function Dosage Adjustment for Patients with Impaired Renal Function

General Dosing Considerations
It is particularly important to administer WELLBUTRIN SR Tablets in a manner most likely to minimize the risk of seizure (see WARNINGS). 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 first week of treatment. Insomnia may also be minimized by avoiding bedtime doses. If distressing, untoward effects supervene, dose escalation should be stopped. WELLBUTRIN SR should be swallowed whole and not crushed, divided, or chewed. Return to top

Initial Treatment
The usual adult target dose for WELLBUTRIN SR Tablets is 300 mg/day, given as 150 mg twice daily. Dosing with WELLBUTRIN SR Tablets 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 hours between successive doses. Return to top

Increasing the Dosage Above 300 mg/day
As with other antidepressants, the full antidepressant effect of WELLBUTRIN SR Tablets may not be evident until 4 weeks of treatment or longer. An increase in dosage to the maximum of 400 mg/day, given as 200 mg twice daily, may be considered for patients in whom no clinical improvement is noted after several weeks of treatment at 300 mg/day. Return to top

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. In a study in which patients with major depressive disorder, recurrent type, who had responded during 8 weeks of acute treatment with WELLBUTRIN SR were assigned randomly to placebo or to the same dose of WELLBUTRIN SR (150 mg twice daily) during 44 weeks of maintenance treatment as they had received during the acute stabilization phase, longer-term efficacy was demonstrated. Based on these limited data, it is unknown whether or not the dose of WELLBUTRIN SR 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. Return to top

Dosage Adjustment for Patients with Impaired Hepatic Function
WELLBUTRIN SR should be used with extreme caution in patients with severe hepatic cirrhosis. The dose should not exceed 100 mg every day or 150 mg every other day in these patients. WELLBUTRIN SR 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. Return to top

Dosage Adjustment for Patients with Impaired Renal Function
WELLBUTRIN SR should be used with caution in patients with renal impairment and a reduced frequency and/or dose should be considered. Return to top