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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by TomV on February 28, 2001, at 10:42:06
I have 100 mg pills of Wellbutrin SR, but I don't want to start that high. Is there anything I need to be concerned about (other than the med not doing its "Sustained release thing")if I cut the pills into, say quarters? I most likely will work up to 100mg anyway, but I'm a start low , go slow guy.
By the way, my PDoc and I never discussed at what level I should start the med, so I never got a chance to discuss it with him.
TomV
Posted by Cam W. on February 28, 2001, at 11:27:53
In reply to Wellbutrin SR... can I cut up my pills?, posted by TomV on February 28, 2001, at 10:42:06
Tom - Cutting open a Wellbutrin Sr tablet will destroy it's long acting effect. The 100mg dose of the SR version is a low dose. To go lower would require you to take lower doses of the regular Wellbutrin (not available in Canada). If you do cut it, the parameters of dosing will also change, necessitating a dosing interval change, as well. Also, receiving a precise dose (ie 25mg) is nearly impossible after cutting an SR tablet because you will not know which part is filler and which is actual drug once you dump the powder from inside the tablet.
Do talk to your doctor about this. Both of you need to be on the same page with regards to your treatment, including dosing of medications.
Hope this helps - Cam
Posted by terra miller on February 28, 2001, at 13:43:12
In reply to Re: Wellbutrin SR... can I cut up my pills? - No, posted by Cam W. on February 28, 2001, at 11:27:53
> "Tom - Cutting open a Wellbutrin Sr tablet will destroy it's long acting effect. The 100mg dose of the SR version is a low dose. To go lower would require you to take lower doses of the regular Wellbutrin "
Hi, Cam. I'm taking the 100mg SR tablets and my pdoc and I have discussed possibilities of dropping to 75mg regular Wellbutrin, spread out over the day. Do you know anything about the differences between the regular and the SR varieties. Be grateful for a good lead. :-)
Thanks. Terra.
Posted by Cam W. on February 28, 2001, at 13:57:07
In reply to Re: Wellbutrin SR... can I cut up my pills? - No » Cam W., posted by terra miller on February 28, 2001, at 13:43:12
Terra - The only real difference between the regular and SR versions are the drug delivery system between the two. The regular version is absorbed all at once, while the SR version is absorbed more slowly over time. This means that the regular version needs to be taken more often because it is excreted quicker, because it is absorbed quicker. This is in order to maintain adequate, therapeutic blood levels of the drug. You need to maintain an adequate blood level so that the drug is working to prevent a relapse of depressive symptoms.
I have no practical experience with the regular version of Wellbutrin because it is not marketed in Canada, so the above information is based on my experience with long-acting versions of any drug and from what I have read about Wellbutrin.
I hope this helps - Cam
Posted by terra miller on February 28, 2001, at 23:50:59
In reply to Re: Wellbutrin SR... can I cut up my pills? - No » terra miller, posted by Cam W. on February 28, 2001, at 13:57:07
> Terra - The only real difference between the regular and SR versions are the drug delivery system between the two. The regular version is absorbed all at once, while the SR version is absorbed more slowly over time. This means that the regular version needs to be taken more often because it is excreted quicker, because it is absorbed quicker. This is in order to maintain adequate, therapeutic blood levels of the drug. You need to maintain an adequate blood level so that the drug is working to prevent a relapse of depressive symptoms.
>
> I have no practical experience with the regular version of Wellbutrin because it is not marketed in Canada, so the above information is based on my experience with long-acting versions of any drug and from what I have read about Wellbutrin.
>
> I hope this helps - Cam
Cam, Thanks so much for responding. Do you think taking 75mg of the regular 2-3 times a day would be more beneficial than 100mg SR twice a day? My pdoc thinks my metabolism churns this up fast, ie: doesn't feel very SR to me. It's a total bellcurve over 5-6 hour period. It's like taking tylenol for me. I take the first, then the second per orders, then i have to wait until the next day with it feeling like i have no drug in my system at all. So I'm wondering if 75mg 3 times a day wouldn't be more stabilizing?Have you heard of anybody having issues with lowered body temperatures? Mine has dropped to @ 97 degrees, 96 was the lowest. I'm pretty cold.
Please reply. Thanks.
Terra
Posted by Cam W. on March 1, 2001, at 0:42:03
In reply to Re: Wellbutrin SR... vs. regular.. lower temps. » Cam W., posted by terra miller on February 28, 2001, at 23:50:59
Terra - For you, it sounds like 75mg three times daily may be the way to go, especially if your body reacts the way you describe to the SR tablets.
As for low body temperature, I have not heard of Wellbutrin causing this, but I am not a diagnostician, so I am not able to adequately give you a differential diagnosis on this. - Cam
Posted by JohnL on March 2, 2001, at 2:50:20
In reply to Wellbutrin SR... can I cut up my pills?, posted by TomV on February 28, 2001, at 10:42:06
> I have 100 mg pills of Wellbutrin SR, but I don't want to start that high. Is there anything I need to be concerned about (other than the med not doing its "Sustained release thing")if I cut the pills into, say quarters? I most likely will work up to 100mg anyway, but I'm a start low , go slow guy.
>
> By the way, my PDoc and I never discussed at what level I should start the med, so I never got a chance to discuss it with him.
>
> TomVHi Tom,
You can cut or break Wellbutrin into any size you want. It will affect the slow release though, so as Cam said you would have to take more frequent doses. Here's an example. Let's say you wanted to do 50mg, but all you have are 100mg pills. You could cut each tab into quarters. Do one quarter (25mg) in the morning and one more at lunch.They don't have to be accurate. If one chunk of a tab is say 10 milligrams larger or smaller than another it isn't going to make any difference.
One thing to keep in mind though is that Wellbutrin degrades quickly once the inside is exposed to air. So break or cut the pills as needed. Don't do a whole batch in advance.
And one final note, there have been clinical studies that showed that just once daily dosing of regular Wellbutrin was just as good as twice or three times or even sustained release. Since you expressed desire to go slow and low, I see no reason you couldn't start with just 25mg once a day. As I mentioned, there are clinical studies supporting once daily dosing. It will take longer to get to therapeutic doses, but that's ok if you are doing it the way you are most comfortable with it.
I say you can customize your dose any way you want. Results and side effects will be the determining factors as to how well or not well it works. Just be aware the pills will degrade fast once they are cut. Use cut or broken pills within a couple days.
John
Posted by terra miller on March 2, 2001, at 20:45:36
In reply to Re: Wellbutrin SR... can I cut up my pills?yes+no, posted by JohnL on March 2, 2001, at 2:50:20
John,
My pdoc today told me to cut up my 100mg pills. I'm finding this humorous and annoying all at the same time. It's his way of saving me money since the 100mg are samples and the 75mg he'd have to write a prescription for. Is it really true that the SR version will cease to be SR once cut? What does that mean since I'm beginning to feel a little like russian-roulette time.
It seems being at 100mg taken twice a day has reset my body's thermostat to 97.6 from 98.6 and I need to dose back so I don't freeze. Pdoc says it's a very rare side-effect.
Terra
Posted by JohnL on March 3, 2001, at 3:24:39
In reply to Re: Wellbutrin SR... can I cut up my pills?yes+no » JohnL, posted by terra miller on March 2, 2001, at 20:45:36
> John,
>
> My pdoc today told me to cut up my 100mg pills. I'm finding this humorous and annoying all at the same time. It's his way of saving me money since the 100mg are samples and the 75mg he'd have to write a prescription for. Is it really true that the SR version will cease to be SR once cut? What does that mean since I'm beginning to feel a little like russian-roulette time.
>
> It seems being at 100mg taken twice a day has reset my body's thermostat to 97.6 from 98.6 and I need to dose back so I don't freeze. Pdoc says it's a very rare side-effect.
>
> TerraHi Terra,
I don't know for sure about whether cutting the tabs affects the sustained release or not. Whether it does or not though I think makes little difference. In clinical trials the differences were insignificant when once daily dosing was compared to SR dosing or multiple dosing. The SR version is more of a convenience thing. I wouldn't be concerned about it. I think you are doing the right thing. I do admit that after a while it does become a pain in the butt to have to cut a pill everyday. But it is a good way to save money on prescription costs. It's just not as convenient.
John
Posted by terra miller on March 3, 2001, at 15:41:16
In reply to Re: Wellbutrin SR... can I cut up my pills?yes+no, posted by JohnL on March 3, 2001, at 3:24:39
i tried to cut a 100mg pill in half this morning. mind you, i was not very awake and so i already didn't want to be messing with this. but, it doesn't break or cut in half. what is does is turn into a powdery mess. so i gave up on the idea and took another 100mg pill. i think they must have made this way on purpose.
i have about 10days when i see my pdoc face to face again. i'll just freeze until then, and then i'll ask for the prescription for the 75mg reg. version.
my eyes are really bugging out on me as well. i had this effect with serzone, too. hoping the decrease will help that. otherwise, the wellbutrin is leveling me out and it's good to "feel" normal again.
bottom line: i don't think the pills cut.
terra
Posted by Iden on March 8, 2001, at 16:38:18
In reply to Re: Wellbutrin SR... the pills don't cut, posted by terra miller on March 3, 2001, at 15:41:16
> i tried to cut a 100mg pill in half this morning. ...... it doesn't break or cut in half.
I agree that the Wellbutrin SR tablets are hard. I have used a pill cutter that I bought at a drug store. With that, I was able to cut a tablet, not just in half, but into quarters. Even that isn't perfect but works well enough.Iden
Posted by JohnX on March 9, 2001, at 3:21:39
In reply to Re: Wellbutrin SR... the pills don't cut » terra miller, posted by Iden on March 8, 2001, at 16:38:18
> > i tried to cut a 100mg pill in half this morning. ...... it doesn't break or cut in half.
>
>
> I agree that the Wellbutrin SR tablets are hard. I have used a pill cutter that I bought at a drug store. With that, I was able to cut a tablet, not just in half, but into quarters. Even that isn't perfect but works well enough.
>
> Iden
Can you break the pill with a nut-cracker or something and then grind it up enough to dissolve in an acidic solution like orange juice, and then drink the OJ in proportion to the dose you need?
Will this really quickly absorb the med through the stomach lining, instead of through the intestine?-John
Posted by Iden on March 9, 2001, at 21:41:09
In reply to Re: Wellbutrin SR... the pills don't cut » Iden, posted by JohnX on March 9, 2001, at 3:21:39
> > > i tried to cut a 100mg pill in half this morning. ...... it doesn't break or cut in half.
> >
> >
> > I agree that the Wellbutrin SR tablets are hard. I have used a pill cutter that I bought at a drug store. With that, I was able to cut a tablet, not just in half, but into quarters. Even that isn't perfect but works well enough.
> >
> > Iden
>
>
> Can you break the pill with a nut-cracker or something and then grind it up enough to dissolve in an acidic solution like orange juice, and then drink the OJ in proportion to the dose you need?
> Will this really quickly absorb the med through the stomach lining, instead of through the intestine?
>
> -JohnI have read that Wellbutrin SR is adversely affected by humidity and cut tablets should be used withing 24 hours. I cannot find the reference at this time, so it should be confirmed.
Iden
This is the end of the thread.
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