| Zyban Information (frequently asked questions)
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.
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.
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