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Dextromethorphan and Bupropion

Dextromethorphan and bupropion is a prescription combination medicine used to treat major depressive disorder in adults and agitation associated with dementia due to Alzheimer's disease.

Brand name Auvelity
Drug classes Aminoketone
Rx Form 1
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026 Content updated Oct 2, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

✓No current FDA shortage listed · checked Oct 5, 2026
Dextromethorphan and Bupropion at a glance The quick version — the full detail is in the Patient Information Guide below.
Dr. Brian Staiger, PharmD, BCPS
The Pharmacist’s Take By · Clinical pharmacist · Written

Auvelity is a first-of-its-kind combination for major depressive disorder and agitation from Alzheimer's dementia in adults, available since about 2022, pairing dextromethorphan (acting on NMDA and sigma-1 brain receptors) with bupropion, which slows its breakdown and adds norepinephrine and dopamine effects; it is usually not the first antidepressant tried. Many people tolerate it reasonably well; dizziness, nausea and headache are the most noticed side effects. The boxed warning covers suicidal thoughts and behaviors in children and young adults, so watch closely for new or worsening depression, especially early and after dose changes. It can cause seizures, raise blood pressure and interact with many drugs, so share your full medication list.

Clinical pearls

  • Swallow the extended-release tablet whole, never crushed, chewed or split, and space twice-daily doses at least 8 hours apart.
  • Avoid over-the-counter cough medicines with dextromethorphan and other bupropion products like Wellbutrin or Zyban to avoid doubling up.
  • Never combine it with an MAOI antidepressant; allow at least 14 days between stopping one and starting the other.
  • Do not suddenly stop alcohol, sedatives such as benzodiazepines, or seizure medicines while taking it, because withdrawal raises seizure risk.
How we write & review this content — our editorial policy →
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾

Auvelity and other antidepressants can increase the risk of suicidal thoughts and behaviors in children, teenagers, and young adults. This risk was seen in short-term clinical studies of antidepressant medicines. Auvelity is not approved for anyone under 18 years old. If you or a family member are taking Auvelity, watch closely for new or worsening feelings of depression, thoughts of self-harm, or any unusual changes in mood or behavior — especially in the first few weeks of treatment or after a dose change. Contact a doctor right away if these occur.

Read the full warning on DailyMed →
How you get itPrescription only
Comes asExtended-release tablet
Earliest FDA record2022
Companies listing it with the FDA1
FDA label last updatedAug 17, 2026
FDA’s strongest warning (boxed)Yes, read the warning

Patient information guide A plain-language walkthrough of Dextromethorphan and Bupropion, written from its FDA label.

What Dextromethorphan and Bupropion is used for

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Dextromethorphan and bupropion is a combination medicine available as Auvelity, approved for the following uses in adults:

  • Major depressive disorder (MDD): Auvelity is approved to treat MDD in adults.
  • Agitation associated with dementia due to Alzheimer's disease: Auvelity is approved for ongoing (not as-needed) treatment of agitation in adults with Alzheimer's-related dementia.

How Dextromethorphan and Bupropion works

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Auvelity works through two active ingredients. Dextromethorphan blocks the NMDA receptor — a brain receptor involved in nerve signaling and mood regulation — and activates the sigma-1 receptor. Bupropion works in two ways: it slows down the liver enzyme (CYP2D6) that normally breaks down dextromethorphan, allowing it to build up to therapeutic levels; and it also mildly affects norepinephrine and dopamine signaling, brain chemicals tied to mood and motivation. The precise way these actions relieve depression or Alzheimer's-related agitation is not fully understood.

Dextromethorphan and Bupropion dosage

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Auvelity extended-release tablets are taken by mouth, once daily to start, with the frequency gradually increased based on the condition being treated and tolerability. For major depressive disorder, the dose typically increases to twice daily after a few days. For agitation associated with Alzheimer's disease, the dose is stepped up more slowly over several weeks. When taking two doses per day, they should be spaced at least 8 hours apart.

  • Can be taken with or without food
  • Swallow tablets whole — never crush, chew, or split them
  • Do not take more than two doses in a single day
  • If you miss a dose, follow your prescriber's guidance — do not double up

Dosing details from the FDA-approved label

From the Dextromethorphan and Bupropion prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.

  • Major depressive disorder (MDD)
    • Starting dosage 45 mg/105 mg once daily in the morning
    • On day 4, increase to 45 mg/105 mg twice daily, given at least 8 hours apart
    • Administer orally with or without food
    • Swallow tablets whole, do not crush, divide, or chew
    • Maximum: 45 mg/105 mg twice daily; do not exceed two doses within the same day
  • Agitation associated with dementia due to Alzheimer's disease
    • Starting dose 30 mg/105 mg once daily in the morning
    • On day 8, increase to 30 mg/105 mg twice daily, given at least 8 hours apart, based on tolerability
    • On day 15, increase to 45 mg/105 mg twice daily, given at least 8 hours apart, based on tolerability
    • Maximum: 45 mg/105 mg twice daily; do not exceed two doses within the same day
    • Administer orally with or without food; swallow tablets whole
  • MDD with moderate renal impairment (eGFR 30 to 59 mL/minute/1.73 m²)
    • Starting and maximum dosage 45 mg/105 mg once daily in the morning
    • Maximum: 45 mg/105 mg once daily in the morning
    • Moderate renal impairment adjustment
  • Agitation associated with dementia due to Alzheimer's disease with moderate renal impairment (eGFR 30 to 59 mL/minute/1.73 m²)
    • Starting dosage 30 mg/105 mg once daily in the morning
    • On day 8, increase to 45 mg/105 mg once daily in the morning, based on tolerability
    • Maximum: 45 mg/105 mg once daily in the morning
    • Moderate renal impairment adjustment
  • MDD with concomitant strong CYP2D6 inhibitors
    • Starting and maximum dosage 45 mg/105 mg once daily in the morning
    • Maximum: 45 mg/105 mg once daily in the morning
    • Co-administered with strong CYP2D6 inhibitors
  • Agitation associated with dementia due to Alzheimer's disease with concomitant strong CYP2D6 inhibitors
    • Starting dosage 30 mg/105 mg once daily in the morning
    • On day 8, increase to 45 mg/105 mg once daily in the morning, based on tolerability
    • Maximum: 45 mg/105 mg once daily in the morning
    • Co-administered with strong CYP2D6 inhibitors
  • MDD in known CYP2D6 poor metabolizers
    • Starting and maximum dosage 45 mg/105 mg once daily in the morning
    • Maximum: 45 mg/105 mg once daily in the morning
    • Known CYP2D6 poor metabolizers
  • Agitation associated with dementia due to Alzheimer's disease in known CYP2D6 poor metabolizers
    • Starting dosage 30 mg/105 mg once daily in the morning
    • On day 8, increase to 45 mg/105 mg once daily in the morning, based on tolerability
    • Maximum: 45 mg/105 mg once daily in the morning
    • Known CYP2D6 poor metabolizers
  • Switching to or from a monoamine oxidase inhibitor (MAOI) antidepressant
    • At least 14 days must elapse between discontinuation of an MAOI intended to treat depression and initiation of AUVELITY. At least 14 days must be allowed after stopping AUVELITY before starting an MAOI antidepressant
Read the label’s full dosing text

2 DOSAGE AND ADMINISTRATION Prior to initiating treatment with AUVELITY: assess blood pressure; screen patients for history of bipolar disorder, mania, or hypomania; and determine if patients are receiving any other medications that contain bupropion or dextromethorphan. ( 2.1 ) For MDD, the starting dosage is AUVELITY 45 mg/105 mg once daily in the morning. On day 4, increase to the maximum recommended dosage of AUVELITY 45 mg/105 mg twice daily, separated by at least 8 hours. Do not exceed two doses within the same day. ( 2.2 ) For agitation associated with dementia due to Alzheimer’s disease, the starting dosage is AUVELITY 30 mg/105 mg once daily in the morning. On day 8, increase to AUVELITY 30 mg/105 mg twice daily, separated by at least 8 hours, based on tolerability. On day 15, increase to the maximum recommended dosage of AUVELITY 45 mg/105 mg twice daily, separated by at least 8 hours, based on tolerability. Do not exceed two doses within the same day. ( 2.3 ) Swallow tablets whole, do not crush, divide, or chew. ( 2.2 , 2.3 ) Moderate renal impairment: For patients with MDD or agitation associated with dementia due to Alzheimer’s disease, the maximum recommended dosage is one tablet of 45 mg/105 mg by mouth once daily in the morning. ( 2.4 , 8.6 ) CYP2D6 poor metabolizers: For patients with MDD or agitation associated with dementia due to Alzheimer’s disease, the maximum recommended dosage is one tablet of 45 mg/105 mg by mouth once daily in the morning. ( 2.6 , 8.8 , 12.3 ) 2.1 Important Recommendations Prior to Initiating and During Treatment with AUVELITY Prior to initiating and during treatment with AUVELITY: assess blood pressure and monitor periodically during treatment [see Warnings and Precautions ( 5.3 )] . screen patients for a personal or family history of bipolar disorder, mania, or hypomania [see Warnings and Precautions ( 5.4 )] . screen patients to determine if they are receiving any other medications that contain bupropion or dextromethorphan [see Warnings and Precautions ( 5.2 , 5.5 , 5.8 )] . 2.2 Recommended Dosage for the Treatment of Major Depressive Disorder The recommended starting dosage ofis AUVELITY (45 mg of dextromethorphan hydrobromide and /105 mg of bupropion hydrochloride) is one tablet once daily in the morning.

Excerpted — the section continues on the label. Read the full Dosage and Administration section on DailyMed →

Dextromethorphan and Bupropion side effects

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The most common side effects reported in clinical trials of Auvelity include:

Common side effects

  • Dizziness
  • Nausea
  • Headache
  • Diarrhea
  • Drowsiness (somnolence)
  • Dry mouth
  • Excessive sweating (hyperhidrosis)
  • Sexual dysfunction
  • Anxiety
  • Decreased appetite

When to get medical help

  • Call your doctor right away or seek emergency care if you notice new or worsening thoughts of suicide or self-harm, especially in young adults
  • Get medical help immediately if you have a seizure — stop taking Auvelity and do not restart
  • Contact your doctor if your blood pressure rises significantly, as Auvelity can cause high blood pressure
  • Seek immediate care if you experience symptoms of serotonin syndrome: agitation, rapid heart rate, high fever, muscle twitching, or confusion
  • Tell your doctor if you develop signs of mania or hypomania: unusually elevated mood, racing thoughts, decreased need for sleep, or impulsive behavior
  • Seek care for signs of a severe allergic reaction: rash, swelling, difficulty breathing
  • Tell your doctor if you notice unusual mood changes, hallucinations, or other neuropsychiatric symptoms
  • Contact your doctor if you develop symptoms of low sodium (hyponatremia): headache, confusion, weakness, or difficulty concentrating

More serious reactions — including seizures, significant blood pressure increases, serotonin syndrome (agitation, rapid heart rate, fever, muscle twitching), signs of mania, and new or worsening suicidal thoughts — require immediate medical attention. Stop Auvelity and call your doctor or go to an emergency room if these occur.

Dextromethorphan and Bupropion warnings and precautions

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  • Suicidal thoughts and behaviors: Antidepressants, including Auvelity, increase the risk of suicidal thoughts and behaviors in young adults up to age 24. All patients should be monitored closely, especially early in treatment. Auvelity is not approved for anyone under 18.
  • Seizure risk: Auvelity can cause seizures; the risk increases with higher doses. Stop taking it and do not restart if a seizure occurs. People with seizure disorders, bulimia, anorexia nervosa, or those abruptly stopping alcohol or sedatives must not take Auvelity.
  • High blood pressure: Auvelity can raise blood pressure. Blood pressure should be checked before starting and monitored regularly during treatment.
  • Serotonin syndrome: Taking Auvelity with SSRIs, tricyclic antidepressants, or other serotonergic drugs raises the risk of serotonin syndrome — a potentially life-threatening condition.
  • Activation of mania or hypomania: Auvelity may trigger manic episodes, particularly in people with bipolar disorder. Screen for bipolar history before starting.
  • Embryo-fetal toxicity: Auvelity may harm an unborn baby. Pregnant women should discuss risks with their doctor; breastfeeding is not recommended.
  • Dizziness and falls: Auvelity can cause dizziness. Use caution when driving or operating machinery.
  • Low sodium (hyponatremia): Can occur, particularly in association with SIADH (a condition where the body retains too much water), and may cause confusion or weakness.

Dextromethorphan and Bupropion interactions

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Auvelity has several important drug and substance interactions to be aware of:

  • MAOIs (e.g., phenelzine, selegiline, linezolid, IV methylene blue): Never combine — risk of dangerous high blood pressure (hypertensive crisis) and serotonin syndrome. Wait at least 14 days between these medicines and Auvelity.
  • SSRIs and tricyclic antidepressants: Increase the risk of serotonin syndrome when taken with Auvelity.
  • Drugs that lower the seizure threshold: Combining with Auvelity can raise the risk of seizure.
  • Strong CYP2D6 inhibitors: Increase dextromethorphan blood levels; may require a dose adjustment of Auvelity.
  • Strong CYP2B6 inducers: Reduce blood levels of both active ingredients, potentially making Auvelity less effective; avoid this combination.
  • CYP2D6-metabolized drugs: Auvelity can raise levels of drugs processed by CYP2D6, or reduce the effect of drugs that need CYP2D6 to become active.
  • Digoxin: Auvelity may lower digoxin blood levels; monitoring is recommended.
  • Dopaminergic drugs (e.g., levodopa, amantadine): Can cause CNS toxicity — restlessness, tremor, dizziness, gait problems.
  • Alcohol: Can worsen neuropsychiatric side effects and reduce alcohol tolerance; minimize or avoid while on Auvelity.
  • Drug-lab test note: Auvelity can cause a false-positive urine drug screen for amphetamines; a confirmatory test can distinguish the two.

Interactions listed in the FDA-approved label

From the Dextromethorphan and Bupropion prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.

  • Monoamine oxidase inhibitors (MAOIs), including linezolid or intravenous methylene blue: Concomitant use increases the risk of hypertensive crisis and serotonin syndrome. Contraindicated in patients taking MAOIs or who have taken MAOIs within the preceding 14 days. Allow at least 14 days after stopping AUVELITY before starting an MAOI.
  • Serotonergic drugs: Concomitant use increases the risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. If it occurs, consider discontinuation of AUVELITY and/or the concomitant serotonergic drug.
  • Drugs that lower seizure threshold: AUVELITY contains bupropion which can cause seizure; co-administration may increase risk of seizure. Use caution. Discontinue AUVELITY and do not restart treatment if the patient experiences a seizure.
  • Strong inhibitors of CYP2D6: Increases plasma concentrations of dextromethorphan. Dosage adjustment is necessary (maximum one tablet of 45 mg/105 mg once daily in the morning). Monitor for adverse reactions potentially attributable to dextromethorphan, such as somnolence and dizziness.
  • Strong inducers of CYP2B6: Decreases plasma concentrations of dextromethorphan and bupropion and may decrease efficacy of AUVELITY. Avoid co-administration. Consider alternatives to strong CYP2B6 inducers if needed.
  • Drugs metabolized by CYP2D6 (CYP2D6 substrates): Can increase the exposures of drugs that are substrates of CYP2D6; drugs requiring metabolic activation by CYP2D6 could have reduced efficacy. It may be necessary to decrease the dose of CYP2D6 substrates, particularly drugs with a narrow therapeutic index. Drugs requiring activation by CYP2D6 may need increased doses.
  • Digoxin: May decrease plasma digoxin levels. Monitor plasma digoxin levels.
  • Dopaminergic drugs (levodopa, amantadine): CNS toxicity was reported when bupropion was co-administered with levodopa or amantadine; adverse reactions include restlessness, agitation, tremor, ataxia, gait disturbance, vertigo, and dizziness. Use caution when administering concomitantly.
  • Alcohol: Bupropion can increase adverse neuropsychiatric events or reduce alcohol tolerance. Consumption of alcohol should be minimized or avoided during treatment.
  • Urine immunoassay screening tests for amphetamines: False-positive results have been reported in patients taking bupropion, even following discontinuation of bupropion therapy. Confirmatory tests, such as gas chromatography/mass spectrometry, will distinguish bupropion from amphetamines.
Read the label’s full interactions text

7 DRUG INTERACTIONS Strong CYP2D6 inhibitors: For patients with MDD or agitation associated with dementia due to Alzheimer’s disease, maximum recommended dosage is one tablet of 45 mg dextromethorphan hydrobromide/105 mg bupropion hydrochloride by mouth once daily in the morning. ( 2.5 , 7.1 ) Strong CYP2B6 inducers: Avoid use. ( 7.1 ) CYP2D6 Substrates: Increases the exposures of drugs that are substrates of CYP2D6. ( 7.1 ) Digoxin: May decrease plasma digoxin levels. Monitor digoxin levels. ( 7.1 ) Drugs that lower seizure threshold: Coadministration may increase risk of seizure. ( 7.1 ) Dopaminergic drugs: Central Nervous System (CNS) toxicity can occur with concomitant use. ( 7.1 ) Drug-laboratory test interactions: AUVELITY can cause false-positive urine test results for amphetamines. ( 7.2 ) 7.1 Drugs Having Clinically Important Interactions with AUVELITY Table 4: Clinically Important Drug Interactions with AUVELITY Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact Concomitant use of AUVELITY with MAOIs increases the risk of hypertensive crisis and serotonin syndrome. Intervention AUVELITY is contraindicated in patients taking MAOIs (including MAOIs such as linezolid or intravenous methylene blue) or in patients who have taken MAOIs within the preceding 14 days. Allow at least 14 days after stopping AUVELITY before starting an MAOI [see Dosage and Administration ( 2.7 ), Contraindications ( 4 ), Warnings and Precautions ( 5.3 , 5.8 )] Serotonergic Drugs Clinical Impact Concomitant use of AUVELITY with other serotonergic drugs increases the risk of serotonin syndrome. Intervention Monitor for symptoms of serotonin syndrome when AUVELITY is used concomitantly with other drugs that may affect the serotonergic neurotransmitter systems. If serotonin syndrome occurs, consider discontinuation of AUVELITY and/or concomitant serotonergic drug [see Dosage and Administration ( 2.1 ), Warnings and Precautions ( 5.8 )] .

Excerpted — the section continues on the label. Read the full Drug Interactions section on DailyMed →

Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.

🌿178 supplements and herbs with documented Dextromethorphan and Bupropion interactions, ranked by severity Check Dextromethorphan and Bupropion against a supplement or herb →

Before taking Dextromethorphan and Bupropion

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  • Do not take Auvelity if you have a seizure disorder
  • Do not take Auvelity if you have a current or past diagnosis of bulimia or anorexia nervosa
  • Do not take Auvelity if you are abruptly stopping alcohol, benzodiazepines, barbiturates, or antiepileptic drugs
  • Do not take Auvelity if you are currently taking or have taken an MAOI within the last 14 days
  • Do not take Auvelity if you are allergic to bupropion, dextromethorphan, or any ingredient in the product
  • Tell your doctor if you or a family member have had bipolar disorder, mania, or hypomania
  • Tell your doctor if you are pregnant or planning to become pregnant — Auvelity may cause fetal harm and is not recommended during pregnancy
  • Breastfeeding is not recommended while taking Auvelity
  • Tell your doctor if you have moderate kidney impairment — dosing limits apply
  • Avoid Auvelity if you have severe liver impairment
  • Let your doctor know if you are a known CYP2D6 poor metabolizer — your dose may need adjustment
  • Tell your doctor about all other medications containing bupropion or dextromethorphan to avoid doubling up

Dextromethorphan and Bupropion overdose

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Taking too much Auvelity is a medical emergency. Symptoms of overdose may include seizures, nausea, vomiting, confusion, rapid heart rate, loss of consciousness, and respiratory depression (slowed or difficult breathing). Because bupropion slows the breakdown of dextromethorphan, an Auvelity overdose may be more severe or longer-lasting than an overdose of dextromethorphan alone. If you suspect an overdose, call Poison Control at 1-800-222-1222 or go to the nearest emergency room immediately.

What Dextromethorphan and Bupropion does in the body

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At the maximum recommended dose, Auvelity does not cause a clinically meaningful prolongation of the QT interval — a measure of the heart's electrical activity. This means it is not expected to increase the risk of a type of abnormal heart rhythm associated with QT prolongation at approved doses.

How your body processes Dextromethorphan and Bupropion

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After taking Auvelity, both dextromethorphan and bupropion are absorbed relatively quickly — blood levels of dextromethorphan peak around 3 hours and bupropion around 2 hours after a dose. Because bupropion blocks the enzyme that normally clears dextromethorphan from the body, dextromethorphan builds up to much higher levels than it would on its own; steady levels are reached within about 8 days. Dextromethorphan has a half-life (the time for half the drug to leave the body) of about 22 hours when taken with bupropion, compared to a much shorter half-life when taken alone. Bupropion is processed by the liver into several active metabolites (breakdown products that are also active in the body), and both drugs are primarily eliminated through the urine.

How to store Dextromethorphan and Bupropion

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Store AUVELITY in original bottle at 20°C to 25°C (68°F to 77°F), excursions permitted to 15°C to 30°C (59°F to 86°F) .

Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →

178

Supplements & herbs that interact with Dextromethorphan and Bupropion

178 supplements and herbal products have documented interactions with Dextromethorphan and Bupropion in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 4
  • Moderate · 134
  • Minor · 40
ACTIVATED CHARCOAL Major GRAPEFRUIT Major LITHIUM Major ST. JOHN'S WORT Major 1,3-DMAA Moderate 5-HTP Moderate ACACIA RIGIDULA Moderate ACETYL-L-CARNITINE Moderate +170 more
Every supplement checked against Dextromethorphan and Bupropion — ranked by severity The full interaction hub: 4 major · 134 moderate · 40 minor · every one linked to its full report. Check Dextromethorphan and Bupropion against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

1

Nutrient depletion considerations

Dextromethorphan and Bupropion has been associated with lower levels of 1 nutrient in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.

SODIUM Moderate Depletion
See the full Dextromethorphan and Bupropion nutrient depletion report

Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.

Dextromethorphan and Bupropion: pharmacist answers to common questions

Quick, plain-English answers to the questions patients ask most about Dextromethorphan and Bupropion — the kind of thing our pharmacy team would talk through with you at the counter.

What is Auvelity actually used for — I thought dextromethorphan was just a cough medicine?

▾
You're right that dextromethorphan is found in many over-the-counter cough medicines, but at prescription doses combined with bupropion in Auvelity, it works on brain receptors in a completely different way. Auvelity is approved to treat major depressive disorder (MDD) in adults and to manage agitation in adults with dementia due to Alzheimer's disease. It's a carefully designed prescription medicine — very different from a cough syrup.

Why are there two drugs in one pill — what does the bupropion do?

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Bupropion plays two roles. First, it slows down the liver enzyme that would normally break down dextromethorphan very quickly, so dextromethorphan can reach and maintain levels in your body that are actually therapeutic. Second, bupropion itself has antidepressant effects through brain chemicals like norepinephrine and dopamine. The two ingredients are designed to work as a team.

How do I take it, and does it matter if I take it with food?

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You take Auvelity as a tablet by mouth — it can be taken with or without food, whichever is easier for you. Swallow it whole; don't crush, chew, or split the tablet. If you're taking it twice a day, space the doses at least 8 hours apart and don't take more than two doses in one day. Your prescriber will likely start you at once daily and gradually increase — stick with that schedule and don't adjust it on your own.

What side effects should I actually expect, and which ones should I call my doctor about?

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The most common side effects are dizziness, nausea, headache, diarrhea, drowsiness, dry mouth, and sweating — most of these tend to be manageable. Call your doctor right away if you have a seizure, notice your blood pressure spiking, experience symptoms of serotonin syndrome (agitation, fast heart rate, fever, muscle twitching), or feel any new or worsening thoughts of self-harm. These are serious and need prompt attention.

I heard there's a warning about suicidal thoughts — should I be worried?

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This is a real and important warning that applies to all antidepressants, including Auvelity. In clinical studies, antidepressants were linked to a higher rate of suicidal thoughts in young adults up to age 24. This doesn't mean it will happen to you, but it does mean you and your family should watch for any new or worsening low mood, unusual behavior, or thoughts of self-harm — especially in the first few weeks. If anything like this comes up, contact your doctor right away or go to an emergency room.

Are there medications I absolutely cannot take with Auvelity?

▾
Yes — the most critical ones are MAOIs (a class of older antidepressants that includes medications like phenelzine, tranylcypromine, linezolid, and IV methylene blue). Mixing these with Auvelity can cause a dangerous reaction, including severely high blood pressure or serotonin syndrome. You need to wait at least 14 days between stopping an MAOI and starting Auvelity, and 14 days after stopping Auvelity before starting an MAOI. Always give your pharmacist and doctor a full list of everything you take so they can check for interactions.

Is Dextromethorphan and Bupropion available over the counter?

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No. Dextromethorphan and Bupropion is a prescription medicine: every Dextromethorphan and Bupropion product listed with the FDA is prescription only, so it is not sold over the counter. Your prescriber decides whether it is appropriate for you, and your pharmacist dispenses it.

When was Dextromethorphan and Bupropion first available?

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The earliest FDA record we hold for Dextromethorphan and Bupropion is from 2022: its first approval in Drugs@FDA or its earliest product listing in the NDC Directory, whichever is older. Many older medicines were in use before their first formal FDA approval, so this is the earliest date on record, not necessarily when Dextromethorphan and Bupropion was first used.

Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →

More about Dextromethorphan and Bupropion on HelloPharmacist

📊Dextromethorphan and Bupropion supplement interactions178 checked — ranked by severity 🌿Drug & Supplement CheckerDextromethorphan and Bupropion vs. vitamins & herbs 💬Ask a PharmacistFree answer, usually < 24h 🔎NDC & pricing lookupFind Dextromethorphan and Bupropion NDCs & costs 🅰️Browse Drugs A–ZLook up any medication
Detailed data & references for Dextromethorphan and Bupropion Forms & strengths, pricing, billing codes, manufacturers, safety reports and sourcing — the data behind the page. Most people can stop here. Each section below opens on a tap.

Dextromethorphan and Bupropion forms and strengths (how it comes)

Dextromethorphan and Bupropion is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Extended-release tablet

By mouth
Brands Auvelity
How this form is used
What it may be used for
  • Auvelity extended-release tablets are used to treat major depressive disorder (MDD) in adults
  • Auvelity extended-release tablets are used to treat agitation associated with dementia due to Alzheimer's disease in adults (not on an as-needed basis)
Important instructions
  • Auvelity tablets are taken by mouth once or twice daily; for MDD, the dose is increased to twice daily on day 4; for Alzheimer's-related agitation, the dose is gradually increased over several weeks based on tolerability
  • Auvelity can be taken with or without food
  • Swallow Auvelity tablets whole — do not crush, chew, or divide them
  • When taken twice daily, Auvelity doses should be separated by at least 8 hours; do not take more than two doses in one day
Available strengths 4 strengths
30 mg / 105 mg 45 mg / 105 mg 105 mg / 30 mg 105 mg / 45 mg
10 FDA-listed product records ⓘ

Dextromethorphan and Bupropion on the U.S. market: products, makers and brands

How Dextromethorphan and Bupropion appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

1 company lists 4 Dextromethorphan and Bupropion product records with the FDA, mostly as extended-release tablet; the earliest marketing or approval year on record is 2022. Brand names on the directory include Auvelity; the rest are generics.

1
Dose forms ⓘ
1
Labelers (makers, repackagers, distributors)
1
Brand names
4
FDA-listed product records ⓘ
2022
Earliest FDA record ⓘ

Also listed with the FDA, not a patient dose form: Kit (5) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

How widely Dextromethorphan and Bupropion is used (Medicaid data)

A general measure of how commonly Dextromethorphan and Bupropion is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Dextromethorphan and Bupropion is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

134,150
Medicaid prescriptions filled (Q1–Q4 2025)
$137.6M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Dextromethorphan and Bupropion prescribed? Of the 1,601 medications we measure, Dextromethorphan and Bupropion ranks #463 by Medicaid prescriptions — more than 71% of them.

Where Dextromethorphan and Bupropion ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5
Total prescriptions — #463 of 1,601
#458 Magnesium Sulfate, Pot... 136,236 Rx #459 Lubiprostone 135,857 Rx #460 Hydroxyurea 135,027 Rx #461 Leucovorin 134,894 Rx #462 Ranolazine 134,744 Rx #463 Dextromethorphan and B... 134,150 Rx #464 Desonide Topical 133,862 Rx #465 Desonide 133,862 Rx #466 Liothyronine 133,453 Rx #467 Dextroamphetamine 132,973 Rx #468 Epinephrine / Lidocain... 132,083 Rx

Utilization by Dextromethorphan and Bupropion product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

bupropion hydrochloride 105 MG / dextromethorphan hydrobromide 45 MG Extended Release Oral Tablet

134,150 Medicaid prescriptions (Q1–Q4 2025) 100% of Dextromethorphan and Bupropion prescriptions shown $137.6M gross reimbursement (before rebates) ≈ $1,026 per prescription (gross)

Summed across the 2 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2611260

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Dextromethorphan and Bupropion, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 2 of 5 listed Dextromethorphan and Bupropion NDCs with Medicaid activity.

Compare Dextromethorphan and Bupropion products

A representative set of FDA-listed product records for Dextromethorphan and Bupropion — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Strength Route Manufacturer / Labeler Category ⓘ Details
💊Extended-release tablet
DEXTROMETHORPHAN HYDROBROMIDE 105 mg/1; BUPROPION HYDROCHLORIDE 30 mg Oral Axsome Therapeutics, Inc. NDA View NDC →
DEXTROMETHORPHAN HYDROBROMIDE 105 mg/1; BUPROPION HYDROCHLORIDE 45 mg Oral Axsome Therapeutics, Inc. NDA View NDC →
💊Kits
— — Axsome Therapeutics, Inc. × 2 listings NDA View NDC →

Showing 4 of 4 products — FDA National Drug Code Directory. See every product, package size and price: browse all 4 Dextromethorphan and Bupropion NDCs →

Dextromethorphan and Bupropion recall history

A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.

The FDA’s enforcement reports list no Dextromethorphan and Bupropion recalls since July 2021.

✅No Dextromethorphan and Bupropion recalls on record since July 2021

Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one exact multiple-ingredient concept (MIN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). A product with a different ingredient combination belongs on a different page.

Multiple ingredients (MIN) Dextromethorphan and Bupropion RxCUI 2611256 1 dose form · 2 strengths

Look up RxCUI 2611256 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

💵 What Dextromethorphan and Bupropion costs pharmacies (NADAC benchmark)

The national average invoice price pharmacies pay for the drug itself, from CMS's NADAC survey (data as of Sep 30, 2026). This is a supply-cost benchmark — not a retail price and not what you'd pay at the counter.

FormStrengthPharmacy acquisition benchmark
Tablet, Multilayer, Extended Release · Oral 105; 45 mg/1; mg $19.90 per tablet NDC details & price history
Tablet, Multilayer, Extended Release · Oral DEXTROMETHORPHAN HYDROBROMIDE 105 mg/1; BUPROPION HYDROCHLORIDE 45 mg $19.90 per tablet NDC details & price history
Tablet, Multilayer, Extended Release · Oral DEXTROMETHORPHAN HYDROBROMIDE 45 mg/1; BUPROPION HYDROCHLORIDE 105 mg $19.90 per tablet NDC details & price history
Why show this? Your out-of-pocket cost depends on insurance, pharmacy markup, and discounts — but the acquisition benchmark tells you whether the medication itself is inexpensive or costly, which strengths cost more per dose, and whether a cash-price quote is in a reasonable range. Each row links to the NDC-level record with its full price history.

Source: CMS National Average Drug Acquisition Cost (NADAC), a survey of retail pharmacy invoice prices. Benchmarks shown are the range across package sizes of a representative product for each form and strength — other manufacturers' products may differ.

Dextromethorphan and Bupropion brand names

Dextromethorphan and Bupropion is sold under one brand name in the FDA directory — Auvelity. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.

Auvelity

Who makes Dextromethorphan and Bupropion: manufacturers and labelers

One company lists Dextromethorphan and Bupropion products with the FDA. By number of product records, the largest are Axsome Therapeutics, Inc.. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.

Axsome Therapeutics, Inc. 4

Dextromethorphan and Bupropion drug class (RxNorm)

Dextromethorphan and Bupropion belongs to the Uncompetitive N-methyl-D-aspartate Receptor Antagonist class.

Pharmacologic class Uncompetitive N-methyl-D-aspartate Receptor Antagonist, Sigma-1 Agonist
Drug family (ATC) Other antidepressants, Opium alkaloids and derivatives
How it works Uncompetitive NMDA Receptor Antagonists, Sigma-1 Receptor Agonists

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

Sources for this Dextromethorphan and Bupropion page

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Aug 17, 2026
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Dextromethorphan and Bupropion.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Dextromethorphan and Bupropion after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
1
Finished products in the current FDA directory
4
Companies listing them (makers, repackagers, distributors)
1
FDA labeler codes behind them ⓘ
1
Linked representative label ⓘ
Axsome Therapeutics, Inc.
Linked label effective
Aug 17, 2026
Composite sections available
25
Linked SPL Set ID
dcefda7c-9a68-278e-e053-2995a90aec79
Linked SPL Document ID
948d108e-f3a6-4e83-a4f2-ff8edf184e1b
Open the linked representative label on DailyMed ↗

How this page is built

HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Axsome Therapeutics, Inc. is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →