How does Zyban Work?
Zyban is the first non-nicotine, FDA-approved oral medication
(a pill) for smoking cessation. Zyban has proven to be
twice as effective as the nicotine patch in keeping patients
smoke free in the long term. It also has the potential
to minimize the weight gain associated with smoking cessation.
Your chances of quitting with Zyban greatly depend on
your commitment to quitting. In both short-term and long-term
clinical studies, Zyban was significantly more effective
than sugar pills in helping patients stop smoking. It
is important to participate in the behavioral program,
counseling, or other support program that your healthcare
professional recommends.
Initially developed and marketed as an antidepressant
(Wellbutrin [bupropion hydrochloride] Tablets and Wellbutrin
SR [sustained release tablets], Zyban is chemically unrelated
to tricyclic, tetracyclic, selective serotonin re-uptake
inhibitor, or other known antidepressant agents. Its structure
closely resembles that of diethylpropion; it is related
to phenylethylamines. Zyban is a relatively weak inhibitor
of the neuronal uptake of norepinephrine, serotonin, and
dopamine, and does not inhibit monoamine oxidase. The
mechanism by which ZYBAN enhances the ability of patients
to abstain from smoking is unknown. However, it is presumed
that this action is mediated by noradrenergic and/or dopaminergic
mechanisms.
What is the appropriate dosing of Zyban?
Individuals should take Zyban as directed by your physician.
The usual recommended dosage is to take one 150-mg tablet
in the morning for the first 3 days. On the fourth day,
begin taking one 150-mg tablet in the morning and one
150-mg tablet in the early evening. Doses should be taken
at least 8 hours apart. The safety and efficacy of Zyban
have not been established in children under 18.
When is Zyban Contraindicated?
Zyban may trigger seizure activity particularly in individuals
with a prior history of eating disorder i.e. bulimia or
anorexia. If you suffer from one of these problems, you
should not take Zyban. Individuals who are taking a medication
classified as an MAO inhibitor, such as the antidepressants
Nardil and Parnate should not take Zyban. If you are taking
these medication please consult with your physicians and
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. In addition, the following
medications a
Additional Warnings:
The chance of a seizure from Zyban rises with the amount
in your system, therefore, individuals should not 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 also 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
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 physician knows
about any heart condition you may have.
Zyban can also interfere with your driving ability. Don't
drive or operate dangerous machinery until you are certain
of the drug's effect on you.
Are there any medication or food interactions associated
with 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
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)
How long should individuals remain on Zyban?
For most patients, healthcare professionals will recommend
staying on Zyban for at least 7 to 12 weeks to help support
long-term success. It may be necessary to stay on Zyban
for a longer period, depending on your healthcare professional's
recommendation. You've probably been smoking for some
time, and your body has become accustomed to it. Zyban
helps reduce withdrawal symptoms as you remove cigarettes
from your life. It's important to remain on Zyban for
at least 7 to 12 weeks and possibly up to 6 months depending
on your healthcare professional's instructions.
What if an overdose of Zyban occurs?
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.
Symptoms of Zyban overdose may include:
Blurred vision, confusion, grogginess, jitteriness, light-headedness,
nausea, seizure, sluggishness, visual hallucinations
Missed Doses:. If you forget to take a dose, do not take
an extra tablet to "catch up" for the dose you forgot.
Wait and take your next tablet at the regular time. Do
not take more tablets than your healthcare professional
prescribed. This is important so you do not increase your
chance of having a seizure. It is important to swallow
Zyban tablets whole. Do not chew, divide, or crush tablets.
You may take Zyban with or without food.
What are the most common side effects associate
with taking Zyban?
The most common side effects that caused people to stop
taking Zyban during clinical studies were shakiness and
skin rash. Individuals should stop taking Zyban and contact
your healthcare professional if you have signs of an allergic
reaction such as a rash, hives, or difficulty in breathing.
Discuss any troublesome side effects with your physician.
If you have trouble sleeping, try not to take your medication
too close to bedtime. If you're taking two tablets each
day, take one early in the day and the second one in the
late afternoon or very early evening. Be sure that you
take them at least 8 hours apart. Also, try to avoid drinking
any beverages that contain caffeine in the late afternoon
or evening. This includes coffee, tea, and many sodas.
If you are still troubled by difficulty sleeping, speak
with your healthcare professional.
Keep in mind your reasons for quitting smoking. Consider
the effects years of smoking cigarettes have on your body;
then weigh this against any short-term discomfort you
might experience while quitting. Remember to reward yourself
for each day you're smoke free!
Can Zyban be used at the same time as nicotine
patches?
Yes, Zyban and nicotine patches can be used at the same
time but should only be used together under the supervision
of your healthcare professional. Using Zyban and nicotine
patches together may raise your blood pressure. Your healthcare
professional will probably want to check your blood pressure
regularly to make sure that it stays within acceptable
levels. DO NOT SMOKE AT ANY TIME if you are using the
nicotine patch or any other nicotine product in combination
with Zyban. It is possible to get too much nicotine and
experience serious side effects.
Can individuals drink alcohol or smoke while taking
Zyban?
Individuals should not to drink alcohol at all, or to
drink very little, while taking Zyban. People who drink
a lot of alcohol and then suddenly stop drinking, may
increase their risk of seizure. Be sure to discuss this
matter with your healthcare professional before you begin
taking Zyban.
It is not physically dangerous to smoke and use Zyban
at the same time. However, continuing to smoke after the
date you set to stop smoking will seriously reduce your
chance of breaking the smoking habit.
Can individuals take Zyban if they have mild-to-moderate
chronic bronchitis and/or emphysema (also called Chronic
Obstructive Pulmonary Disease or COPD)?
Yes, Zyban combined with a behavior modification program
has been shown to help people with COPD quit smoking.
It is important to participate in the behavior program,
counseling, or other support program that your healthcare
professional recommends.
Are there any concerns for patients with liver or kidney
problems?
If you have liver or kidney problems, tell your doctor
before taking Zyban. Depending on the severity of your
condition, your physician may need to adjust your dosage.
Should Zyban be taken if you are pregnant or breast-feeding?
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.