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Auvelity (dextromethorphan hydrobromide/bupropion hydrochloride) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with agitation linked with dementia due to Alzheimer’s disease.
Auvelity is a combination medicine that affects N-methyl-D-aspartate (NMDA) and sigma-1 receptors, which are involved in brain signaling. It also changes levels of certain brain chemicals that may help reduce agitation associated with dementia due to Alzheimer’s disease. The exact way it works is not fully known.
Doctors prescribe Auvelity for adults with agitation associated with dementia due to Alzheimer’s disease.
Auvelity is given as a tablet by mouth, typically once daily at first, then increased to twice daily based on tolerability. The doses should be taken at least eight hours apart.
The recommended starting dose of Auvelity for agitation associated with dementia due to Alzheimer’s disease in adults is 30 milligrams/105 milligrams once daily in the morning.
On day 8, the dose may be increased to 30 milligrams/105 milligrams twice daily based on tolerability. On day 15, the dose may be increased to the maximum recommended dose of 45 milligrams/105 milligrams twice daily.
Do not take more than two doses in the same day.
For people with moderate kidney problems, people taking a strong CYP2D6 inhibitor, or known CYP2D6 poor metabolizers, treatment starts at 30 milligrams/105 milligrams once daily in the morning. On day 8, the dose may be increased to a maximum of 45 milligrams/105 milligrams once daily based on tolerability.
This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
In clinical studies of Auvelity for agitation associated with dementia due to Alzheimer’s disease in adults, the most common side effects occurred in about 5 percent to 9 percent of people. These were:
Auvelity can cause serious side effects that require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Axsome Therapeutics, the manufacturer of Auvelity, offers the Auvelity OnMySide Savings & Support Program. Eligible people with commercial insurance may pay as little as $10 for up to a 90-day prescription.
The Auvelity OnMySide Savings & Support Program also offers helpful information and resources when getting started, prescription refill reminders, and live Nurse Navigators to help answer treatment questions. The savings offer is not available to people with Medicare, Medicaid, or other government-funded insurance.
To learn more, visit the Auvelity OnMySide Savings & Support Program, or call 800-805-8621.
Before starting Auvelity, your doctor will check your blood pressure, screen for a personal or family history of bipolar disorder, mania, or hypomania, and review whether you take any other medicines that contain bupropion or dextromethorphan.
Tell your doctor if you have any allergies to dextromethorphan hydrobromide/bupropion hydrochloride or any ingredients in Auvelity.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Do not take Auvelity if you:
Before taking Auvelity, tell your doctor if you have high blood pressure, bipolar disorder, glaucoma, liver problems, kidney problems, or a history of psychosis or other mental health conditions. Also tell your doctor if you drink alcohol regularly or take medicines that may increase the risk of seizures or serotonin syndrome.
Auvelity is also FDA approved to treat major depressive disorder (MDD) in adults.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Auvelity, talk with your doctor about the risks and benefits. Auvelity is not recommended during pregnancy, and breastfeeding is not recommended during treatment and for five days after the final dose.
These answers are fact-checked by our editorial staff.
How effective is Auvelity?
In a five-week study of adults with agitation associated with dementia due to Alzheimer’s disease, people taking Auvelity had a 14.9-point average improvement on the Cohen-Mansfield Agitation Inventory (CMAI), compared with an 11.6-point improvement in people taking placebo (an inactive treatment).
This study showed that agitation symptoms improved more in people taking Auvelity than in those taking placebo over five weeks.
In a longer-term study, people who continued taking Auvelity had a longer time before agitation symptoms returned compared with people who were switched to placebo.
How long does Auvelity take to work for Alzheimer’s disease?
In a clinical study of adults with agitation associated with dementia due to Alzheimer’s disease, improvement with Auvelity was measured over five weeks.
The clinical study results did not report the exact time when people first noticed improvement.
What tests or monitoring are needed with Auvelity for Alzheimer’s disease?
Before starting Auvelity, healthcare providers should check blood pressure, review whether the person takes other medicines containing bupropion or dextromethorphan, and screen for a personal or family history of bipolar disorder, mania, or hypomania.
Blood pressure should also be monitored from time to time during treatment.
Older adults may have a greater risk of low sodium levels while taking Auvelity.
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