Zyban
Pronounced: ZIGH-ban
Generic name: Bupropion hydrochloride
Why is Zyban prescribed?
Zyban is a nicotine-free quit-smoking aid. Instead of nicotine, it contains
the same active ingredient as the antidepressant medication Wellbutrin.
It works by boosting the levels of several chemical messengers in the
brain. With more of these chemicals at work, you experience a reduction
in nicotine withdrawal symptoms and a weakening of the urge to smoke.
More than a third of the people who take Zyban while participating in
a support program are able to quit smoking for at least 1 month. Zyban
can also prove helpful when people with conditions such as chronic bronchitis
and emphysema decide it's time to quit.
Most important fact about Zyban
About 1 person in 1,000 suffers a seizure while taking Zyban. For this
reason, people with epilepsy and certain other disorders should never
take the drug. Don't share Zyban with friends. Only a doctor can decide
whether it's safe for a particular individual.
How should you take Zyban?
Treatment with Zyban begins while you are still smoking. Zyban needs
about a week to reach an effective level in your body; so to improve
your chance of success, you should not attempt to quit until the second
week of treatment. Set a firm date for quitting. If you are still smoking
after that date, your odds of breaking the habit will be worse. You should
keep taking Zyban for 7 to 12 weeks.
You can use nicotine patches along with Zyban. However, combining the
two treatments can raise your blood pressure, so it's important to tell
your doctor if you plan to use both. Do not smoke while using a patch,
because too much nicotine can cause serious side effects.
Participating in a counseling or support program will make success more
likely. Your doctor can recommend a local program for you.
Swallow Zyban tablets whole. Do not chew, divide, or crush them. Take
them exactly as prescribed.
If you miss a dose...
Do not take an extra tablet to "catch up" for the missed dose.
Skip the dose and take your next tablet at the regularly scheduled time.
Storage instructions...
Store at room temperature in a tightly closed container. Keep out of
direct sunlight.
Zyban side effects
Side effects cannot be anticipated. If any develop or change in intensity,
inform your doctor as soon as possible. Only your doctor can determine
if it is safe for you to continue taking Zyban.
* Side effects include:
Dry mouth and sleeplessness
These are generally mild and usually disappear after a few weeks. If
you have difficulty sleeping, avoid taking Zyban close to bedtime and
ask your doctor about reducing your dosage.
Why should Zyban not be prescribed?
Because Zyban has been known to trigger convulsions, no one with a seizure
disorder should take Zyban. Also avoid Zyban if you are taking Wellbutrin
or any other drug that contains bupropion, Zyban's active ingredient.
The more bupropion you take, the more likely you are to have a seizure.
Zyban's seizure-triggering potential is greater in people with an eating
disorder such as bulimia or anorexia, and in those undergoing abrupt
withdrawal from alcohol, sedatives, and tranquilizers such as Librium
and Valium. If you suffer from one of these problems, never take Zyban.
Avoid it, too, if you are taking a drug classified as an MAO inhibitor,
such as the antidepressants Nardil and Parnate. Allow at least 14 days
to pass between taking one of these drugs and starting your Zyban therapy.
If bupropion or any other ingredient in Zyban has ever given you an
allergic reaction, the drug is not for you.
Special warnings about Zyban
In clinical studies, antidepressants increased the risk of suicidal
thinking and behavior in children and adolescents with depression and
other psychiatric disorders. Because Zyban contains the same ingredient
as the antidepressant Wellbutrin, anyone considering the use of Zyban
or any other antidepressant in a child or adolescent must balance this
risk with the clinical need. Zyban has not been studied in children or
adolescents and is not approved for treating anyone less than 18 years
old.
Additionally, the progression of major depression is associated with
a worsening of symptoms and/or the emergence of suicidal thinking or
behavior in both adults and children, whether or not they are taking
antidepressants. Individuals being treated with Zyban and their caregivers
should watch for any change in symptoms or any new symptoms that appear
suddenly--especially agitation, anxiety, hostility, panic, restlessness,
extreme hyperactivity, and suicidal thinking or behavior--and report
them to the doctor immediately. Be especially observant at the beginning
of treatment or whenever there is a change in dose.
Because the chance of a seizure from Zyban rises with the amount in
your system, never take more than one 150-milligram tablet at a time,
and limit your total daily intake to 2 doses (300 milligrams).
A variety of conditions can predispose you to seizures, including:
Prior head injuries
Prior seizures
Central nervous system tumors
Cirrhosis of the liver
Too much alcohol
Abrupt withdrawal from alcohol, tranquilizers, or sedatives
Addiction to narcotics or cocaine
Use of over-the-counter stimulants or diet pills
Use of diabetes medications
Use of antidepressants, major tranquilizers, steroids, or theophylline
If any of these apply to you, use Zyban with care. If you do have a
seizure while taking Zyban, stop taking the drug and never take it again.
Stop taking Zyban and call your doctor immediately if you have difficulty
breathing or swallowing; notice swelling in your face, lips, tongue,
or throat; develop swollen arms and legs; or break out with itchy eruptions.
These are warning signs of a potentially severe allergic reaction.
If you have a liver or kidney condition, make sure the doctor is aware
of it. Your dosage may need to be reduced. (If you have severe cirrhosis
of the liver, your dosage must be reduced.) Also make certain the doctor
knows about any heart condition you may have.
Zyban can interfere with your driving ability. Don't drive or operate
dangerous machinery until you are certain of the drug's effect on you.
Possible food and drug interactions when taking Zyban
If Zyban is used with certain other drugs, the effects of either could
be increased, decreased, or altered. It is especially important to check
with your doctor before combining Zyban with the following:
Alcohol
Amantadine (Symmetrel)
Antidepressants such as Norpramin, Pamelor, Paxil, Prozac, Tofranil,
and Zoloft
Beta blockers (heart and blood pressure medications) such as Inderal,
Lopressor, and Tenormin
Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Cyclophosphamide (Cytoxan)
Heart-stabilizing drugs such as Rythmol and Tambocor
Levodopa (Dopar, Larodopa, Sinemet)
Major tranquilizers such as Haldol, Risperdal and Thorazine
MAO inhibitors such as the antidepressants Nardil and Parnate
Orphenadrine (Norflex)
Phenobarbital
Phenytoin (Dilantin)
Steroids such as prednisone and hydrocortisone
Theophylline (Theo-Dur, Theolair)
Warfarin (Coumadin)
Quitting smoking, with or without Zyban treatment, could change the
way your body metabolizes certain drugs, for example, theophylline and
warfarin. Make sure your doctor knows all the prescription and over-the-counter
medicines you're taking.
Special information if you are pregnant or breastfeeding
Zyban has not been tested in pregnant women. If you are pregnant or
plan to become pregnant, do your best to quit smoking with the aid of
counseling and support before turning to drug therapy. For the sake of
the baby, you should avoid smoking or taking nicotine in any other form
while pregnant.
Zyban appears in breast milk and could affect a nursing infant. Ask
your doctor whether it will be better to discontinue the medication or
to stop breastfeeding.
Recommended dosage for Zyban
ADULTS
Overdosage
Information on Zyban overdose is limited. However, any medication taken
in excess can have serious consequences. If you suspect an overdose,
seek medical attention immediately.
