Wellbutrin XL Ghost Tablets In The Stool

In our latest question and answer, the pharmacist discusses why you may see undigested (i.e. "ghost tablets") Wellbutrin XL in your stool.

Question

Are Bupropion/Wellbutrin shells supposed to be empty when they are passed, or are they supposed to be full of a white powdery substance? I was taking Bupropion HCL XL 300mg and passing full tablets. I suffer from IBS-D and also take Nexium acid reducer, either of which might be causing the pills to pass before the medication is absorbed. My depression was not improving while taking this dosage for 5 months, but it had previously improved immediately when I initially began taking 150mg dosage (which do not have the same casing that the 300mg do). I recently switched back to 150mg, taking twice daily now, and my depression symptoms started improving again within 24 hours. I have researched this matter extensively but have not been able to get a definitive answer to this question.

Asked by Kamu On Aug 22, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Aug 22, 2022
Last updated Apr 21, 2024

Key points

  • You may see what looks like intact Wellbutrin XL tablets in your stool. These are sometimes referred to as 'ghost tablets'.
  • If you see a 'ghost tablet' in your stool, that is okay. The drug has been released from the tablet and all that remains is the intact shell.
  • Several drugs can leave ghost tablets in the stool aside from Wellbutrin and is simply due to how these drugs are manufactured to be released in our system when we take a dose.

Seeing "ghost" tablets (i.e. intact tablets) in the stool is a fairly common occurrence for many different medications but can certainly be alarming. Ghost tablets are simply the intact remnants of a pill or tablet that have made it through your digestive tract. They often look just like a pill you have taken but hollowed out as the drug has been released while it goes through your digestive system.

Some drugs may also appear as a wet, powdery mass in your stool as well. This too, is simply what is left of the pill or tablet after the medication has been released and moved through your digestive tract. 

Wellbutrin XL Tablets In The Stool

Wellbutrin XL (bupropion extended-release) is well known to leave ghost tablets in the stool. In fact, the prescribing information for Wellbutrin XL warns of this possibility:

"The insoluble shell of the extended-release tablet may remain intact during gastrointestinal transit and is eliminated in the feces."

Wellbutrin XL Release Mechanism

Wellbutrin XL uses a diffusion-style release mechanism. These tablets have multiple layers of coating, with the inner coating containing the active drug (i.e. bupropion) and the outer coating controlling the release of the drug.

After taking by mouth, the drug is diffused over time through small openings in an outer membrane. After all of the inner contents of the tablet have been released, an empty shell of the original tablet remains and is eliminated from the body. The remaining tablet is simply the unabsorbed/undigested portion of your medication.

It is important to remember that if you see a ghost tablet, it doesn’t mean your medication isn't working or being absorbed. A common analogy regarding ghost tablets is to think of them like sponges that have been wrung out. The medicine has been released as it moves through your digestive tract but the tablet, like a sponge, stays intact.

Other Drugs That Leave 'Ghost Tablets'

In addition to Wellbutrin XL, below are some other medications that can leave ghost tablets in the stool:

  •  Adalat CC
  • Asacol
  • Cardura XL
  • Concerta
  • Ditropan XL
  • Dynacirc
  • Exalgo
  • Fortamet
  • Glucophage XR
  • Glucotrol XL
  • Glumetza
  • OxyContin
  • Pristiq
  • Procardia XL
  • Sudafed 24 Hour
  • Tegretol XR

References

  • Wellbutrin XL Prescribing Information, AccessFDA
  • Curse of the ghost pills: the role of oral controlled-release formulations in the passage of empty intact shells in faeces. Two case reports and a literature review relevant to psychiatry, PubMed
  • Formulation and Evaluation of Sustained Release Tablets of Bupropion HCl, Research Gate

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

Recent Questions