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Tips for tapering off Wellbutrin, SR, XR, XL / Zyban (buproprion)

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brassmonkey

The half life of Wellbutrin is 37 hours.  The hour by hour fluctuation of this med is negligible, so hour by hour dosing would be of little to no value.  All it would do is add to anxiety and the probability of not getting your dose correct for the day.  Splitting the dose morning and evening might have some benefit, but more than likely not.  I'm glad that splitting your  dose worked for you HikingAlong, but I don't think hourly dosing of this medication is warranted.

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felin

Very interesting Hiking. I am going to look into this!!

 

Can't wait for the day that my brain is working on it's own again!!

 

Thank you so much for taking the time to give me your input!!

 

Brass, hmmm....what do you suggest though if I've tried the dreaded purple pill and it made me so sick?? Thx

 

Also, when you say that the half life of Wellbutrin is 37 hours are you referring to IR, SR, XR, XL or all?

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ChessieCat
27 minutes ago, felin said:

Also, when you say that the half life of Wellbutrin is 37 hours are you referring to IR, SR, XR, XL or all?

 

From:  https://en.wikipedia.org/wiki/Bupropion

 

See under the heading:  Pharmacodynamics for the following table:

 

Human pharmacology

 

  Bupropion R,R- S,S- Threo- Erythro-
  Hydroxy Hydroxy hydro hydro
  bupropion bupropion bupropion bupropion
Exposure (concentration over time; bupropion exposure = 100%) and half-life
Exposure 100% 800% 160% 310% 90%
Half-life 10 h (IR) 21 h 25 h 26 h 26 h
17 h (SR)

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HikingAlong

That looks like the half life of IR is 10 Hours. I don't understand why it needs an ER version if that's really how it works in a human system.

 

I only know my own experience, which was that it worked for me to have 3-4 doses through the day.

 

Hiking

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Altostrata

10 hours is a short half-life. You may metabolize it even faster. If several doses throughout the day works for you, that makes sense. Strongly recommend taking the doses on a regular schedule and keep notes of how much you're taking -- this will be important while tapering.

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firepink

So I only have Bupropion SR - right now dividing each 150mg pill into eighths is fine (I'm at 15/16 total dose right now), but in the future if I need to start a liquid taper is that at all possible to do with an SR pill? I was unclear as to whether the instruction to only liquid taper with IR pills is due to some chemical or physical limitation of the SR pill or if it's just that turning an SR pill into a liquid turns it into an IR liquid. Could anyone clarify, please?

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Altostrata

You can only make a liquid from immediate-release buproprion. The other types contain binders that will not dissolve well.

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    firepink

    Thank you!

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    Hoonie

    I am in my 3rd month of taking bupropion, which was prescribed for suicidal depression. I initially started on 150mg daily and this was increased to 300mg daily (in an attempt to stop my headaches). I think I want to come off them, and not to be started on any other psychiatric medication.

    The preparation of bupropion I am currently taking is a "modified release" form (Elontril®). I have searched the 4 pages of this thread for the words "modified" and "Elontril", and there were no hits. Does anyone know which preparation from the list "IR, SR, XR, XL" this refers to? My medication seems to have been manufactured in Spain by GlaxoSmithKline, "liberacíon modificada" translating to "modified release".

     

    Cheers

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    Altostrata

    Hello, Hoonie. Please start a topic for yourself in the Introductions forum, where we can answer questions about your particular situation.

     

    Please ask a pharmacist to identify what kind of bupropion you have. We can't keep up with all the brands.

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    emergingfromhell
    19 hours ago, Hoonie said:

    I am in my 3rd month of taking bupropion, which was prescribed for suicidal depression. I initially started on 150mg daily and this was increased to 300mg daily (in an attempt to stop my headaches). I think I want to come off them, and not to be started on any other psychiatric medication.

    The preparation of bupropion I am currently taking is a "modified release" form (Elontril®). I have searched the 4 pages of this thread for the words "modified" and "Elontril", and there were no hits. Does anyone know which preparation from the list "IR, SR, XR, XL" this refers to? My medication seems to have been manufactured in Spain by GlaxoSmithKline, "liberacíon modificada" translating to "modified release".

     

    Cheers

     

    If you take it once a day, it’s likely extended release (XL which is the same is XR). It releases over time or you’d have to take more than one a day. X

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    Altostrata

    Different countries have different brands and forms of this drug.

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    felin

    I am going to Primary Care next week to discuss a plan of action. Not looking forward to going to IR but see no other option.

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    Daisyca

    Ok tomorrow is the big day - I have an appointment with my Dr. and I'm going to ask about starting a 10% taper off of 150mg XL Wellbutrin.  Thank you for the links to tapering advice here, I have read them and this is what I think the taper should look like for the first month:

    Ask for a prescription for 75mg IR tablets

    Cut them into 4ths. (18.75 mg ea piece)

    Take one 75mg tablet and 3 pieces of another for a total of 131.25mg daily.

     

    However, what I don't know is how do I split this 131.25 IR dosage so that I am taking multiple dosages in one day? From what I understand the Immediate Release tablets need several dosages a day, so I won't be able to take the full amount just in the morning. An even split of 131.25 would be 65.63mg, twice a day. If I calculated correctly, the closest I could get to that would be 3.5 pieces (56.25mg) in the morning and then again at night? But that only gets me 112.50mg a day, which is a greater taper than the 10% reduction that I am looking for. Am I missing something here???

     

    I am very nervous to propose this to my Dr., especially if I don't have it worked out exactly. :(  Any advice appreciated. Thank you.

     

     

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    Altostrata

    I would take 75mg in the early part of the day and the rest in the later part of the day.

     

    The two doses don't have to be exactly equal. Taking less in the evening may enable better sleep.

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    firepink

    Daisyca - Altostrata also seems to be good with your plan, so take the following with a huge grain of salt! Switching from one a day XR to twice a day IR is already a change for your brain,  so if you do switch entirely to IR I'd take a week or two to just be on 75mg IR 2x/day before starting the taper so as to only do one switch at a time. If your doctor / insurance allows it, I might even be more cautious and use mostly SR with just a bit of IR to keep the release a bit more even - you could split SR 100 or 150s into halves or quarters and use that for the majority of your dose and then use the 75s to fine tune the taper so you don't go down 25+mg at a time (although I currently split the SR 150s into 1/8s, you might be able to do that with the SR 100s with a good pill cutter).  Also, I take less in the afternoon when my two doses aren't even, and that has worked well for me (n value of one).

     

    All of the above is just my two cents based on my personal experience and (possible over extreme) caution in tapering. Good luck!

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    Daisyca

    Thank you for the advice. The appointment did not go as planned this morning. :(  I am trying to stay positive but am feeling very defeated right now. I asked about the 75mg IR prescription to taper off slowly, but my Dr. said that most people just stop taking wellbutrin without tapering. I said I was not most people, and given my withdrawal symptoms from stopping Abilify, which took me several months to recover from and were very severe, that I was concerned about just stopping wellbutrin without a taper. So the Dr. said she does not prescribe the IR tablets because they give the body a more immediate release  which can be shocking to the system (as if just stopping altogether doesn't shock the system). I tried to make my point, but she seemed unmoved. She then suggested that I just skip dosages with my 150mg, like take every other day. I read that people should never do that with this drug. I am so confused. She also suggested adding Prozac for awhile, to which I said no. She also said that some withdrawal symptoms would be normal and might take several weeks to even out. This is what I am trying to avoid!! 

     

    I ended up leaving with a prescription for 100mgSR. My question is now, how do I use this to taper safetly? Can I go back and forth between 150mg and 100mg like every other day for awhile? Should I then taper further with just 100mg every other day? It seems as though I won't have the opportunity to taper off below the 100, that I will just have to stop? Unless I cut the 100 into halves and take half in the  morning half in afternoon?  I am frozen in fear of how I might feel/react during this time. This really sucks!!!!

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    HikingAlong

    DaisyCa,

     

    You do have options.

     

    I did most of my Wellbutrin taper by making a solution in water. It's complicated at first, but I got really used to it, and ended up doing my gabapentin taper that way, and now I'm using a solution to taper off Tramadol. There's a post somewhere on this board about how to do it.

     

    You could talk to a different doctor.

     

    If you have insurance, you could keep going back to your doctor to talk to her over and over until she gets it.

     

    Trust your gut.

     

    HikingAlong

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    mdwstrx

    Hello,

    I've unsuccessfully been encouraging a young acquaintance to consider tapering 300 mg Buproprion XL - he having been on the drug for 3 years

    for a first and brief depression.  I believe there is a fear and and an attitude of "if it's not broke, let's not mess with it.

     

    "There isn't much in the forums regarding someone on Buproprion alone -  instead, it seems there is more on those who use it as an adjunct to another AD.

     

    While the advice for tapering Bupropion XL is very helpful, it certainly doesn't seem like a simple taper.

    I suspect that also discourages someone who is afraid to rock the boat.

     

    I guess I'm seeking any thoughts as to how best to educate this person on the need for coming off

    the drug.  His doctor isn't the original prescriber and most likely is just as happy to keep writing a prescription, sadly.

     

    Is it more difficult/dangerous the longer one stays on this drug?

     

    Any thoughts would certainly be welcome.

     

    Thank you.

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    HikingAlong

    Well... for me, Welbutrin was the most difficult one to get off. I got off twice, and both times felt like dying or killing myself at times. I had to go so fricking slowly. 

    The motivation for me, the second time, was remembering how I became a real person when I wasn't on it. I had drive and stamina and liveliness. And my brain worked. 

     

    After the first little while, when the AD makes you feel so good, it just gradually becomes like any addictive substance. You take it to not feel so bad. Which is very different from feeling good.

     

    I don't know what will motivate your friend.  It's scary to change. They have to want to do it. Eventually, they will. 

     

    It's not our job to change other people, but just to hold up a light to the way out.

     

    Heidi

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    Colonial
    25 minutes ago, mdwstrx said:

    Hello,

    I've unsuccessfully been encouraging a young acquaintance to consider tapering 300 mg Buproprion XL - he having been on the drug for 3 years

    for a first and brief depression.  I believe there is a fear and and an attitude of "if it's not broke, let's not mess with it.

     

    "There isn't much in the forums regarding someone on Buproprion alone -  instead, it seems there is more on those who use it as an adjunct to another AD.

     

    While the advice for tapering Bupropion XL is very helpful, it certainly doesn't seem like a simple taper.

    I suspect that also discourages someone who is afraid to rock the boat.

     

    I guess I'm seeking any thoughts as to how best to educate this person on the need for coming off

    the drug.  His doctor isn't the original prescriber and most likely is just as happy to keep writing a prescription, sadly.

     

    Is it more difficult/dangerous the longer one stays on this drug?

     

    Any thoughts would certainly be welcome.

     

    Thank you.

     

    I was on the same dose for only 6 months, and it took me over 3 years to get off, as You can see by my signature taper.

    I see your making the assumption that there is a "need" for Him to come off it.  

    I would advise you NOT to pressure Him into doing so, until He truly knows what He is getting in to AND if he is willing to commit to years of tapering.

    If not, it may be best to let Him stay on it.  The Neurological symptoms  My Wellbutrin did is not funny , and if I had not ALREADY been out on disability, I would not have been able to accomplish it.  For Him to attempt it half halfheartedly because of a friends pressure will either lead to an early failure with a reinstatement which is worse than leaving him be where he is now, or it will disable him to the point of being non functional and, if He is working, not be able to and loose His employment.

     

    For this NOT to turn into a disaster, it has to be something he really wants to do and not half heartedly be peer pressured into doing.

    Because when things go wrong, you will be the one to blame if He can't hack the commitment and the symptoms.

     

    Granted, DONE CORRECTLY, it can be done well, but it's years of commitment, and if He feels "pressured", He may try to go faster than recommended and injure his health to a point that seems  irrevocable.

     

    I'm sure you want whats best for your friend, but this is a serious life altering possible mistake you could be pressuring him into if He's "attempting" for the wrong reasons and reinstates full strength because he's half hearted and only trying to please others.

     

    I would suggest leaving him be until HE wants off, only and until then do most people have the sheer guts and determination to live through what could be this hell on earth for him if he's "Double Minded" on doing it, and panics and makes the mistake of a lifetime.

     

    This isn't a "lets try and see how it goes" game with an "easy fix" if he decideds he wants out... this is for real and its no going back once the hell starts.

    And you dont want a withdrawal induced suicide on your conscious if he cant hack the torture.

    Because we've had those here..

     

    My topic thread says paxil liquid, but it also Chronicles my Wellbutrin issues as well.

     

     

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    emergingfromhell
    35 minutes ago, mdwstrx said:

    Hello,

    I've unsuccessfully been encouraging a young acquaintance to consider tapering 300 mg Buproprion XL - he having been on the drug for 3 years

    for a first and brief depression.  I believe there is a fear and and an attitude of "if it's not broke, let's not mess with it.

     

    "There isn't much in the forums regarding someone on Buproprion alone -  instead, it seems there is more on those who use it as an adjunct to another AD.

     

    While the advice for tapering Bupropion XL is very helpful, it certainly doesn't seem like a simple taper.

    I suspect that also discourages someone who is afraid to rock the boat.

     

    I guess I'm seeking any thoughts as to how best to educate this person on the need for coming off

    the drug.  His doctor isn't the original prescriber and most likely is just as happy to keep writing a prescription, sadly.

     

    Is it more difficult/dangerous the longer one stays on this drug?

     

    Any thoughts would certainly be welcome.

     

    Thank you.

    Look into Cinderella therapeutics tapering strips! You might need to ask questions regarding xl. I hadn’t yet found them when I went from 300-150 Wellbutrin so I I used a combo of instant release and xl, but I did use this company for tapering my Prozac and it really helped. You probably need to go much slower than they recommend which they’re willing to accommodate..
     

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    mdwstrx

    @HikingAlong @Colonial @emergingfromhell

    Thank you all for your replies.  It is so helpful to get input from those who've been there.

     

    3 hours ago, HikingAlong said:

    Well... for me, Welbutrin was the most difficult one to get off.

    Congratulations on getting off Heidi!  I'm sorry to hear it was so difficult for you. I'd hoped that it might not be so because of the first sentence on the Tips page, "Wellbutrin (bupropion) is an atypical antidepressant with a lower reported rate of withdrawal syndrome compared to the SSRIs and SNRIs such as Paxil, Effexor, or Cymbalta." Do you think your other drugs  taken at the time were a factor?

     

    3 hours ago, HikingAlong said:

    It's not our job to change other people, but just to hold up a light to the way out.

    I would normally agree with you however, I'm not trying to change as much as I'm tying to point out the paradigm shift that so many of us have had due to our experiences with withdrawal.  For ex...  I thought I could never come off... needed it like a diabetic etc... It was a chemical imbalance... I stayed on the AD for so many years because I was afraid to come off.  I wish someone had been with me to encourage me.  But encouraging and pushing is a fine line.  Thanks for the reminder.

     

    3 hours ago, Colonial said:

    I would advise you NOT to pressure Him into doing so, until He truly knows what He is getting in to AND if he is willing to commit to years of tapering.

    I think pressuring would be wrong too.  But he can't know what he's getting into w/o being educated.  Your response reminded me of the gravity of the undertaking and how it truly must be his decision.  I'll ask you the same, do you think your other drugs taken at the time were a factor in how difficult it was for you to taper?  I also noted you cut from 300 to 150 mg on the first taper.   Congratulations to you too for getting off! I am still tapering escitalopram and have a couple more years, even at 3.3 mg. 

     

    2 hours ago, emergingfromhell said:

    Look into Cinderella therapeutics tapering strips!

    Thank you for the advice! I will research those here on this site and see what the mods have to say about them and the XL.  Did you come off completely?  How was your taper?  As difficult as the other two responders?   

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    Colonial
    3 minutes ago, mdwstrx said:

    I'll ask you the same, do you think your other drugs taken at the time were a factor in how difficult it was for you to taper?  I also noted you cut from 300 to 150 mg on the first taper.   Congratulations to you too for getting off! I am still tapering escitalopram and have a couple more years, even at 3.3 mg. 

     

    It's hard to say, the fact that I started withdrawing off of 2 drugs withing 2 months of each other, Jan and March, and the doctor said he never had anyone have a problem dropping Wellbutrin in half like that, added to the fact that (innocent fools we both were), that I had ONLY been on it 6 months it wouldnt be a problem, but it wasn't until July I was in serious trouble.  Didn't know that Wellbutrin was a Paxil booster, etc.  You can see from my sig line I knew to start slow with the Paxil but didn't realise that the small amount of time on a drug was irrelevant to tapering the Wellbutrin. But the 2 meds did have different symptoms to some extent, at least that I could see.  Once I found this site I learned to get off the Wellbutrin first, since it was the more stimulating drug.  I still get the Neurological Symptoms every Autumn and just had a bad flare up again, coincidentally, 2 nights ago.  But every time I make too big of a Paxil drop the Wellbutrin symptoms come back too and I'm smelling colors and tasting numbers and smelling smoke or burnt steak, missing time, the usual.  Thank You Glaxo Smith Kline.  I think the difficulty was I just didn't take enough time in between drops.  Dropped in half and then made another a month later, than another 20 days later, etc.  The thing is, you know you feel bad, but you tough it out, until the day you make one drop too quick or 1 mg too many, and its the straw that broke the camels back, and then its too late and your done for.  I had to hold for 9 months before I could restart and I almost died 2 times, once almost driving the car off the road when my vision went tunnel blind on me, , going to bed with the oven on, etc. All the "accidental deaths" that really are due to WD Syndrome that never get counted as such, it's sad.  To be honest, I think the biggest bother also was changing half my paxil extend tab to the liquid, that was wicked.  that really, after 20 years of it in that form, the change was too much.

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    HikingAlong

    I do wish the moderators would take the word of those who have struggled to get off Welbutrin, and change the basic Welbutrin info on this site to reflect our real life experiences. Some people do get off it easily. But they don't need the support here. It's those who struggle that need to see that their experience is normal. It's the drug, not the person. I don't know any better advice than to take it extremely slowly. 

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    Colonial
    4 hours ago, HikingAlong said:

    I do wish the moderators would take the word of those who have struggled to get off Welbutrin, and change the basic Welbutrin info on this site to reflect our real life experiences. Some people do get off it easily. But they don't need the support here. It's those who struggle that need to see that their experience is normal. It's the drug, not the person. I don't know any better advice than to take it extremely slowly. 

     

    The reason Wellbutrin gets a "free ride", is because some of the most horrid symptoms are so delayed, than neither You nor Your doctor connect the WD with the symptom.  Neither of You connect the dots that Your struggling with such horrid symptoms 4 months out after going off the med.  I had symptoms that were so delayed, that if I had not already been a member of this site, I would not have known they were Wellbutrin related.  I would not have known when my menstrual cycles went so far off kilter 4 months after dropping my dose in half that that was the cause.  It's just inconceivable to most people that such delayed reactions can lie in wait to strike. That is why the WD symptons are under reported for this drug.  Their havoc is all misdiagnosed as other physical or neurological issues. Which is just, Im' sure, how the manufacturer wants it...

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    MollyMac
    Posted (edited)

    Title added:  Wellbutrin only exists in Prolonged Release Form in Ireland.  What to do?

     

    Hi everyone,

    Manymoredays has been very kindly advising me on cycling off Wellbutrin, but I've hit a huge wall. My doctor, pharmacist and psych here in Ireland say that Wellbutrin only exists in prolonged release form in Ireland. Apparently this is what I have been on all along. I'm on 150mg. 

     

    In Ireland this drug is only prescribed for smoking cessation for 9 weeks. I was put on it for exhaustion, and now I'm stuck. It's been 3 years. 

     

    How do I cycle down off 150mg prolonged release when that is all I have to work with? I'm really upset. I feel like I'm leading the professionals in the dark, while trying to remain calm. 

    Edited by manymoretodays
    merged with Wellbutrin topic, title added

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    manymoretodays

    I replied in your topic MollyMac, @MollyMac and have asked for further input. 

    And yes, yes.......stay calm and good job doing so.  It can be difficult for many of us, if not most, to get professional support to taper cautiously.

    You're not alone here, in that.

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    MollyMac
    19 hours ago, manymoretodays said:

    I replied in your topic MollyMac, @MollyMac and have asked for further input. 

    And yes, yes.......stay calm and good job doing so.  It can be difficult for many of us, if not most, to get professional support to taper cautiously.

    You're not alone here, in that.

    Thank you SO much. I would like to start soon. Things are quieter now, I have the space to do it.

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    Altostrata

    Regarding tapering from 150mg bupropion XR when you cannot substitute the immediate-release tablets:

    49 minutes ago, Altostrata said:

    Hello, MollyMac. There is a gadget for splitting pills, but to be honest, it probably isn't any better than a sharp knife for cutting a tablet into thirds or fourths.

     

    ....

     

    If I were you, I would cut your tablet into quarters (37.5mg each), take 4 times a day, such as 8 a.m., 12 noon, 4 p.m., 8 p.m. You may have to get used to that for a week or so, because each quarter might release its contents quickly.

     

    Then, you are in a position to drop one quarter (37.5mg); change your quarter-tablet schedule to 8 a.m., 2 p.m., 8 p.m. This is a little steeper than we'd like, but all you can do with an extended-release tablet, you can't make a liquid from it.

     

    This may work for you. If not, are you able to get tapering strips in Ireland? Your GP would have to order them.

     

    Let us know how you're doing.

     

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    MollyMac
    On 5/1/2020 at 8:20 PM, Altostrata said:

    Then, you are in a position to drop one quarter (37.5mg); change your quarter-tablet schedule to 8 a.m., 2 p.m., 8 p.m. This is a little steeper than we'd like, but all you can do with an extended-release tablet, you can't make a liquid from it.

     

    Hi, me again - with all the questions. I'm so sorry for asking so many. If my prolonged release tablet becomes extended release once I cut it into quarters - can I still not make a liquid from it? 

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    Altostrata

    No, you cannot make a liquid from any bupropion extended-release or sustained-release tablet. The tablets are held together with a glue that clumps when water is added.

     

    You can make a liquid only with immediate-release bupropion.

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