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.
