Information On Zyban

Pronounced: ZIGH-ban
Generic name: Bupropion hydrochloride

Why is Zyban prescribed?

Zyban is a nicotine-free quit-smoking aid. Instead, Zyban has 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 this drug 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.

What are the side effects of Zyban?

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.

The most common side effects are:

• 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.

More common side effects may include:

• abdominal pain
• abnormal dreams
• anxiety
• constipation
• diarrhea
• disturbed concentration
• dizziness
• joint pain
• increased cough
• itching
• nasal inflammation
• nausea
• nervousness
• rash
• sore throat

Less common side effects may include:

• abnormal thinking
• allergic reaction
• bronchitis
• changes in taste
• difficulty breathing
• dry skin
• fever
• hives
• hot flashes
• increased appetite or loss of appetite
• increased blood pressure
• migraine
• mouth ulcers
• muscle pain
• neck pain
• nosebleed
• ringing in the ears
• shakiness
• sinus inflammation
• sleepiness
• throbbing heartbeat

Rare side effects may include:

• chest pain
• feeling of unhappiness
• thirst
• swelling of the face

Why should Zyban not be prescribed?

Because Zyban has been known to trigger convulsions, no one with a seizure disorder should take this drug. 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. 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

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.

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
• 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)

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

ADULTS

The usual starting dose is one 150-milligram tablet in the morning for the first 3 days. After that, take one 150-milligram tablet in the morning and another in the early evening. Keep doses at least 8 hours apart. The maximum recommended dose is 300 milligrams daily.

Continue taking Zyban for 7 to 12 weeks. Your doctor may recommend continuing treatment for up to 6 months.

Kidney and Liver Disease

Your doctor may reduce the frequency of your doses to avoid high blood levels of Zyban. If you have severe cirrhosis of the liver, you should take no more than 150 milligrams every other day.

CHILDREN

The safety and efficacy of Zyban have not been established in children under 18.

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.

Symptoms of Zyban overdose may include:

• blurred vision
• confusion
• grogginess
• jitteriness
• light-headedness
• nausea
• seizure
• sluggishness
• visual hallucinations