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.
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.
Aug 22, 2022- Wellbutrin XL commonly leaves hollow tablet shells in your stool because of how the medication is designed to release slowly through your digestive tract.
- Seeing these ghost tablets does not mean your medication isn't working or being absorbed into your body, as the active drug has already been released before the empty shell is eliminated.
- The prescribing information for Wellbutrin XL specifically warns about this possibility, and many other extended-release medications can cause the same thing.
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 & sources
- 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
Glossary — Terms in This Answer
- Extended-release
- A medication formulation designed to release the drug slowly over a long period of time rather than all at once.
- Bupropion
- The active pharmaceutical ingredient in Wellbutrin that is responsible for the medication's therapeutic effect.
- Diffusion-style release mechanism
- A method where medication passes through small openings in a tablet's outer coating at a controlled rate over time.
- Gastrointestinal transit
- The process of food and medications passing through the stomach and intestines in the digestive system.
- Feces
- Waste material eliminated from the body through bowel movements.
- Membrane
- A thin outer layer that controls what substances can pass through it.
- Unabsorbed
- Material that the body has not taken in or processed through the intestinal walls into the bloodstream.
- Insoluble
- Unable to dissolve or break down in liquid.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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