Auvelity is taken as one tablet by mouth once daily for the first three days, then increased to one tablet twice daily from day four onward. Each tablet contains a fixed combination of dextromethorphan and bupropion, and the dosing schedule is straightforward once you get past that brief startup period.
The Dosing Schedule
For the first three days, you take one tablet in the morning. On day four, you increase to one tablet twice a day. That twice-daily dose is the full therapeutic dose, and it stays the same from that point forward. Your two daily doses should be spaced at least eight hours apart, and you should never take more than two tablets in a single day.
There’s no further titration after that. Unlike some antidepressants that require weeks of gradual dose increases, Auvelity reaches its target dose within the first week.
How to Take Each Tablet
You can take Auvelity with or without food. Swallow the tablet whole. Do not crush, split, or chew it. The tablet has a layered, extended-release design, and breaking it would release both ingredients too quickly, which could increase side effects and reduce how well the medication works throughout the day.
What to Do If You Miss a Dose
If you miss a dose, skip it entirely. Do not double up or take an extra tablet to compensate. Just wait until your next regularly scheduled dose and continue as normal. Taking two doses close together raises the risk of side effects, particularly seizures, which is why the label specifically warns against it.
When You Might Notice a Difference
Auvelity works faster than most traditional antidepressants. In the main clinical trial, patients showed statistically significant improvement in depression scores as early as one week, with further gains at week two. By week six, the average improvement was meaningfully greater than placebo. This is notably quicker than the four-to-six-week window typical of SSRIs and SNRIs, though individual responses vary.
The speed comes partly from how the two ingredients work together. One component acts on a brain signaling system called NMDA, which is the same pathway targeted by ketamine-based treatments. The other component, bupropion, serves a dual role: it has its own antidepressant activity and it also slows the breakdown of dextromethorphan in your body, keeping blood levels high enough to be effective.
Who Should Not Take Auvelity
Auvelity is not safe for everyone. You should not take it if you have a seizure disorder, or if you have a current or past eating disorder such as anorexia or bulimia. Both of these conditions lower the seizure threshold, and bupropion (one of Auvelity’s ingredients) carries a known seizure risk.
You also cannot take Auvelity if you recently stopped using alcohol heavily, benzodiazepines, barbiturates, or anti-seizure medications. Sudden withdrawal from any of these substances raises seizure risk on its own, and adding Auvelity compounds the danger.
There’s a strict rule around a class of older antidepressants called MAOIs. You must wait at least 14 days after stopping an MAOI before starting Auvelity, and at least 14 days after stopping Auvelity before starting an MAOI. The combination can trigger a dangerous spike in serotonin levels. The same 14-day washout applies to the antibiotic linezolid and intravenous methylene blue, which have MAOI-like effects.
Dose Adjustments for Kidney or Liver Problems
If you have moderate kidney impairment, the recommended dose is one tablet once daily in the morning, with no increase to twice daily. Auvelity is not recommended at all for people with severe kidney impairment, because the body can’t clear the drug efficiently enough.
For liver function, mild or moderate impairment doesn’t require a dose change. Severe liver impairment is a different story: Auvelity is not recommended in that case either.
How to Stop Taking Auvelity
Don’t stop Auvelity abruptly. Like most antidepressants, suddenly discontinuing it can cause withdrawal symptoms, which may include headache, diarrhea, sweating, and flu-like feelings. Your prescriber will typically taper the dose down gradually to minimize these effects. If you want to stop taking Auvelity, plan it with your prescriber rather than quitting on your own.