Auvelity (dextromethorphan/bupropion) is a prescription drug that’s used to treat major depressive disorder (MDD). Auvelity comes as an oral tablet.
Auvelity is used in adults to treat MDD, which is also called clinical depression, or depression.
To learn more about Auvelity’s uses, see the “What is Auvelity used for?” section below.
Auvelity is an antidepressant medication. It contains two active ingredients: dextromethorphan and bupropion. (An active ingredient is what makes a drug work.)
Auvelity comes as an extended-release (ER) tablet that you swallow. An ER tablet releases medication slowly over time as it passes through your digestive system.
Read on to find out about Auvelity’s side effects, dosage, cost, and more.
Find answers to some commonly asked questions about Auvelity.
Can Auvelity be used for anxiety, attention deficit hyperactivity disorder (ADHD), or bipolar disorder?
Auvelity isn’t usually prescribed to treat these conditions. The Food and Drug Administration (FDA) has approved Auvelity for treating only depression. The drug hasn’t been studied for treating anxiety, ADHD, or bipolar disorder. It’s not known whether it’s effective for these conditions.
Some doctors might prescribe Auvelity off-label for anxiety, ADHD, or bipolar disorder. (With off-label use, a drug is prescribed for a use that’s not approved by the FDA.) But they’ll likely only do so if other treatment options don’t work or are unsuitable. Talk with your doctor about other treatment options for anxiety, ADHD, or bipolar disorder.
What should I know about alternatives to Auvelity, such as Prozac or Spravato?
Prozac belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs are usually one of the first medications doctors prescribe for depression. These drugs are also commonly prescribed for anxiety disorders.
SSRIs have fewer side effects than most other antidepressants. But as with most other antidepressants, they may take about 4 to 6 weeks to start working.
Wellbutrin SR and other drugs containing the active ingredient bupropion are a different kind of antidepressant. (An active ingredient is what makes a drug work.) These drugs work on different brain chemicals than SSRIs. They’re another of the options doctors may prescribe if SSRIs don’t work for depression. Bupropion is one of the active ingredients in Auvelity.
Spravato is a drug that’s used for treatment-resistant depression (depression that hasn’t eased with other treatments). It comes as a nasal (nose) spray that’s used under the guidance of a doctor at a healthcare facility. It’s used together with an antidepressant that you swallow. Spravato acts quickly and may start relieving depression within 24 hours.
The other active drug in Auvelity, dextromethorphan, works in a similar way to Spravato.
To learn more about alternatives to Auvelity and how Auvelity compares with these treatments, talk with your doctor.
How does Auvelity work?
The way a drug works is called its mechanism of action. Auvelity’s mechanism of action for treating depression isn’t fully understood. But it’s known to affect several neurotransmitters in the brain. (Neurotransmitters are chemicals that help nerve cells communicate.)
Auvelity contains two active ingredients: dextromethorphan and bupropion. Dextromethorphan affects the neurotransmitters glutamate and serotonin. Bupropion affects the neurotransmitters dopamine and norepinephrine.*
With depression, there could be changes in the way nerve cells in your brain communicate. And this might affect nerve pathways that usually help manage your emotions, mood, thoughts, and behavior.
Auvelity’s effect on neurotransmitters may improve the function of these nerve pathways. This may help relieve depression.
Auvelity’s effect on glutamate seems to make it work faster than antidepressants that don’t affect this neurotransmitter.
To find out more about how Auvelity works, talk with your doctor or pharmacist.
* Bupropion also stops your body from breaking down dextromethorphan too quickly. This helps dextromethorphan work better than if you took it on its own.
Is Auvelity a controlled substance?
No, Auvelity is not a controlled substance.
Controlled substances are drugs regulated by the United States government because they may have a risk of misuse. Misuse involves using a drug in a way that’s not prescribed, such as taking more than recommended. The government has special rules for prescribing and dispensing controlled substances.
Auvelity isn’t known to have a risk of misuse, so it’s not subject to these rules.
If you have concerns about Auvelity and misuse, discuss them with your doctor.
How effective is Auvelity?
Studies have found Auvelity to be an effective treatment for depression. To find out how the drug performed in these studies, see Auvelity’s prescribing information.
Note that not everyone who takes Auvelity will have the same results. To find out whether this treatment is right for your condition, talk with your doctor.
Auvelity is a prescription medication used to treat major depressive disorder (MDD) in adults. MDD is also called clinical depression, or depression.
With depression, you have feelings of sadness, gloom, and hopelessness that don’t go away. Other symptoms you may have include:
- loss of interest in things you used to enjoy
- lack of energy for daily activities
- changes in your appetite or sleep
- irritability or anxiety
- suicidal thoughts and behaviors*
* Auvelity has a
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist.
You can also check out this article to learn more about saving money on prescriptions.
Like most drugs, Auvelity may cause mild or serious side effects. The lists below describe some of the more common side effects that Auvelity may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Auvelity. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects that Auvelity can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Auvelity’s prescribing information.
Mild side effects of Auvelity that have been reported include:
- increased sweating
- dry mouth
- reduced appetite
- trouble sleeping
- sexual problems, such as reduced sex drive or erectile dysfunction (ED)
- mild allergic reaction*
* To learn more about this side effect, see the “Allergic reaction” section below.
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Auvelity can occur, but they aren’t common. If you have serious side effects from Auvelity, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Serious side effects of Auvelity that have been reported include:
- high blood pressure
- mental health side effects, such as:
- boxed warning: risk of suicidal thoughts and behaviors*
- severe allergic reaction†
* For more information, see the “What should be considered before taking Auvelity?” section below.
† To learn more about this side effect, see the “Allergic reaction” section below.
Some people may have an allergic reaction to Auvelity.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Auvelity. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Your doctor will recommend the dosage of Auvelity that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Form and strength
Auvelity comes as an extended-release tablet that you swallow. An extended-release tablet releases medication slowly over time as it passes through your digestive system.
Auvelity is available in one strength: 45 milligrams (mg) of dextromethorphan and 105 mg of bupropion.
You’ll usually start treatment by taking one tablet once per day in the morning for 3 days. After this, your doctor may increase your dosage to one tablet twice per day. You’ll take the second dose at least 8 hours after the first.
Do not take more than two tablets in 24 hours.
Questions about Auvelity’s dosing
Below are some common questions about Auvelity’s dosing.
- What if I miss a dose of Auvelity? If you miss a dose, skip the missed dose and then take your next scheduled dose as usual. Do not take two doses together or any extra doses to make up for a missed dose.
- Will I need to take Auvelity long term? If Auvelity works for you without causing bothersome side effects, you’ll likely take it long term. Guidelines for treating depression recommend continuing antidepressants for 4 to 9 months after your symptoms lessen. This helps prevent depression from coming back.
- How long does Auvelity take to work? Auvelity may start working to reduce depression symptoms in about 1 week.
Your doctor will explain how you should take Auvelity. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.
Auvelity comes as an extended-release tablet that you swallow whole. An extended-release tablet releases medication slowly over time as it passes through your digestive system.
Accessible medication containers and labels
If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:
- have large print
- use braille
- contain a code you can scan with a smartphone to change the text into audio
Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.
Also, if you’re having trouble opening your medication bottles, let your pharmacist know. Your pharmacist may also recommend tools to help make it simpler to open the drug’s container.
Questions about taking Auvelity
Below are some common questions about taking Auvelity.
- Can Auvelity be chewed, crushed, or split? No, Auvelity must be swallowed whole. If you have trouble swallowing pills, see this article for a few tips that may help. Your doctor can also suggest ways to make taking your medication easier.
- Should I take Auvelity with food? You can take Auvelity with or without food.
- Is there a best time of day to take Auvelity? If you take Auvelity once per day, take your dose in the morning. If you take Auvelity twice per day, be sure to take your doses at least 8 hours apart.
Certain factors can affect whether Auvelity is a good treatment option for you. These may include taking certain medications or having specific medical conditions. Read on to find out more about these factors.
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before taking Auvelity, be sure to tell your doctor about all medications you take, including prescription and over-the-counter kinds. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Auvelity.
For information about drug-condition interactions, see the “Other warnings” section below.
Interactions with drugs or supplements
Auvelity can interact with several kinds of drugs. These drugs include:
- monoamine oxidase inhibitors (MAOIs) antidepressants, such as phenelzine (Nardil)*
- tricyclic antidepressants, such as amitriptyline
- selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac)
- serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor XR)
- antipsychotic drugs for certain mental health conditions, such as aripiprazole (Abilify)
- steroid drugs for inflammation, such as prednisone (Rayos)
- stimulant drugs for narcolepsy or attention deficit hyperactive disorder (ADHD), such as amphetamine/dextroamphetamine (Adderall, Mydayis)
- benzodiazepines for sleeping problems or anxiety, such as alprazolam (Xanax)
- opioid pain relievers, such as oxycodone (OxyContin)
- certain drugs for Parkinson’s disease, such as those containing levodopa alone or with other drugs (Sinemet, Inbrija, Rytary, Stalevo)
- nicotine replacement therapy (Nicorette, others)
- other medications containing bupropion, such as Wellbutrin SR, Wellbutrin XL, Aplenzin, and Forfivo XL
- other medications containing dextromethorphan, such as Mucinex DM and Nuedexta
- the asthma drug theophylline (Theo-24)
- the heart medications quinidine and digoxin (Lanoxin)
- the antibiotic linezolid (Zyvox)*
- the blood disorder treatment methylene blue (ProvayBlue)*
* Due to this interaction, doctors will usually not prescribe Auvelity to people taking this drug or kind of drug. Additionally, they likely will not prescribe Auvelity to people who’ve taken an MAOI antidepressant in the last 14 days.
This list does not contain all kinds of drugs that may interact with Auvelity. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Auvelity.
Auvelity may interact with certain drug tests. If you have a urine drug test for amphetamines while taking Auvelity, the test may show a false positive. This means your urine may test positive for amphetamines even if you haven’t taken these drugs.
If you have a drug test while taking Auvelity, be sure to tell the person giving you the test that you take this medication.
Auvelity is an antidepressant medication. This kind of medication may raise the risk of suicidal thoughts and behaviors in some people younger than 25 years old. This risk is higher when first starting an antidepressant and after changes in dosage. (Note that Auvelity is not prescribed to people younger than 18 years of age.)
While taking Auvelity, you should watch for changes in your mood, emotions, thoughts, and behavior. Contact your doctor right away if you notice changes such as:
- worsening depression
- new or worsening anxiety, irritability, or aggressiveness
- agitation or restlessness
- new or worsening sleeping problems
- mania (extreme levels of excitement and activity), or talking very fast
- impulsive or dangerous behavior
- new or increased thoughts about harming yourself or suicide
If you have concerns about your risk of this possible side effect of taking Auvelity, talk with your doctor.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Textline at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Auvelity can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Auvelity is a good treatment option for you.
Talk with your doctor about your health history before you take Auvelity. Factors to consider include those described below.
Seizure disorders. Auvelity can increase the risk of having seizures. If you have a seizure disorder such as epilepsy, your doctor will likely not prescribe Auvelity. They can recommend treatment options other than Auvelity for you.
Eating disorders. If you have or have had an eating disorder such as anorexia nervosa or bulimia, you may have a higher risk of seizures with Auvelity treatment. Due to this risk, your doctor will likely not prescribe Auvelity. Ask them what other medications are better options for you.
Recently stopping use of alcohol or certain drugs. If you used to drink heavily and have recently stopped drinking alcohol, you may have a higher risk of seizures with Auvelity. You may also have a higher risk of seizures if you’ve recently stopped taking certain drugs. These include benzodiazepines, barbiturates, and seizure medications. In such cases, your doctor will likely not prescribe Auvelity. They can discuss with you other treatment options for depression.
Allergic reaction. If you’ve had an allergic reaction to Auvelity or any of its ingredients, your doctor will likely not prescribe Auvelity. Ask them what other medications are better options for you.
High blood pressure. Auvelity can cause and worsen high blood pressure. If you already have high blood pressure, talk with your doctor about whether Auvelity is right for you. They’ll likely monitor your blood pressure while you take Auvelity.
Bipolar disorder. If you have bipolar disorder, Auvelity could raise your risk of having a manic episode. Before starting Auvelity, talk with your doctor about mental health conditions that you or your family may have had. This will help your doctor determine whether Auvelity is safe for you.
Risk of closed-angle glaucoma. If you have eye angles that are narrower than usual, you may have a risk of closed-angle glaucoma from taking Auvelity. If you’re unsure whether you have narrow eye angles, talk with your doctor. They may recommend getting an eye exam before starting Auvelity treatment.
Kidney or liver problems. If you have a kidney or liver problem, Auvelity could build up in your body. This could raise your risk of side effects. Due to this risk, in certain cases, your doctor may prescribe a dosage of Auvelity that’s lower than usual. But if you have severe liver or kidney problems, you may not be able to take Auvelity. In such cases, your doctor can recommend a different treatment for depression.
Auvelity and alcohol
You should limit or avoid drinking alcohol with Auvelity. Alcohol may raise your risk of mental health side effects during Auvelity treatment. (For examples of such side effects, see the “What are Auvelity’s side effects?” section above.)
You may also be more sensitive to the effects of alcohol while taking Auvelity.
If you drink alcohol and you’re concerned about avoiding alcohol while taking Auvelity, talk with your doctor.
Pregnancy and breastfeeding
Auvelity is not safe to take during pregnancy. If you’re pregnant or plan to become pregnant, talk with your doctor about other medications that may be better options for you.
If you become pregnant while taking Auvelity, contact your doctor right away. They’ll likely recommend switching to a different treatment for depression.
You should not breastfeed while taking Auvelity and for 5 days after stopping treatment with this medication. If you’re breastfeeding or plan to do so, talk with your doctor about other ways to safely feed your child while taking Auvelity.
Do not take more Auvelity than your doctor prescribes. Taking more than this can lead to serious side effects.
Symptoms of overdose
Symptoms caused by an overdose of Auvelity can include:
- nausea and vomiting
- fast or irregular heartbeat
- blurry vision
- problems with muscle coordination
- slow, shallow breathing
- hallucinations (seeing or hearing things that aren’t real)
- loss of consciousness
What to do in case you take too much Auvelity
Call your doctor if you think you’ve taken too much Auvelity. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
If you have questions about taking Auvelity, talk with your doctor or pharmacist. Questions you may want to ask include:
- Does Auvelity have any long-term side effects?
- Is Auvelity more or less likely to cause sexual side effects than other antidepressants?
- Is Auvelity more effective than other antidepressants?
- Will I have withdrawal symptoms when stopping Auvelity treatment?
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.