About Zyban
Bupropion is prescribed under the brand name Zyban to help
individuals quit smoking. Bupropion increases levels of
the neurotransmitters dopamine and norepinephrine, working
differently than other antidepressants. It is unclear how
it works to help people quit smoking.
It is important that this medication be taken only in the
quantities recommended by your doctor, and that it be taken
only as often as suggested. When you stop taking Zyban, step
off your dose slowly, according to the plan offered by your
doctor in order to minimize the possibility of side effects.
Zyban is only available by prescription. Use only as directed.
Zyban Side Effects
Common Zyban side effects: Anxiety, confusion, insomnia,
nervousness, or weight loss (individuals who are underweight
may want to consider another treatment, as their weight may
drop further on this medication).
Possible Zyban side effects: Agitation, constipation, dizziness,
dry mouth, frequent urination, heart palpitations, indigestion,
nausea or vomiting, ringing in the ears, severe headaches,
sweating, swelling, tremor. Consult your physician as soon
as possible if any of these conditions develop. While not
all of them are serious, your doctor should make that determination,
and may be able to help alleviate temporary discomfort.
Rare Zyban side effects: Altered white blood cell or platelet
counts, liver poisoning, mania in patients with manic depression,
psychosis in patients with psychotic tendencies, or drug-related
seizures (increased likelihood with higher doses). Seek medical
attention immediately if any of these effects occur. If you
have had a medical history of any of these conditions, your
doctor should monitor your treatment closely or may decide
on a different medication. In very rare cases, weight gain
has been reported with treatment, though weight loss is far
more common. Speak to your doctor if this occurs.
Cautions: Before taking Zyban, inform your doctor of any
of the following conditions, or a history of them. Some of
these conditions are contraindications for treatment, and
you should try another medication. Some conditions may require
more careful monitoring, or dosage adjustments.
- Alcoholism or drug abuse: Bupropion does not react well
with alcohol or street drugs. You could be at increased
risk for seizure, psychosis, or a fatal drug interaction.
- Allergies: If you have had an allergic reaction
to Wellbutrin or Zyban in the past, this medication is not
right for you. If you experience any swelling of the face
or extremities, or break out in a rash, contact your doctor
immediately. Also be sure to inform your doctor of any other
allergies you may have had, either to prescription medication,
or food and dyes.
- Brain disease, mental illness, or head injury:
A doctor must consider treatment carefully, on a case by
case basis.
- Eating disorder: If you have, or had in the past,
either anorexia nervosa or bulimia, you may be at an increased
risk for seizure. Also, underweight individuals may find
that their weight drops further with bupropion treatment,
and this could be dangerous for some people. Consult with
your doctor about possible risks.
- Heart problems: If you have heart disease or have
had a recent heart attack, your doctor may be very cautious
in prescribing treatment. Also, bupropion may interact with
certain prescription treatments for heart disease or high
blood pressure.
- Kidney or liver problems: Your doctor may adjust
your dosage and monitor you more carefully.
- Other medicines: Inform your doctor of any medications
you are currently taking, especially if they increase the
likelihood of seizure. Discuss any reactions to medication
you have had in the past, especially to other antidepressants.
Do not take bupropion within 14 days of stopping an MAO
inhibitor.
- Pregnancy or an intention to become pregnant may
indicate that you should not take Wellbutrin or Zyban. Doctors
do not generally recommend taking bupropion while breastfeeding.
- Seizure disorders: Individuals with seizure disorders
of any kind should not take bupropion either as Wellbutrin
or Zyban, for any reason. This medication increases the
risk of seizure.
Zyban Interactions
If you are planning to take Zyban, be sure that the prescribing
physician is aware of all other medications you are using,
especially if you see multiple doctors. Some medications should
not be mixed with bupropion at all, and with others, your
doctor may want to adjust the dosage of one or the other prescription.
Ask your doctor before starting any medication while you are
being treated with bupropion.
Wellbutrin and Zyban should not be taken together, as higher doses
of bupropion increase the risk of serious side effects, such as
seizures.
- Alcohol can increase the risk of seizure in combination with
bupropion. Do not drink while you are being treated with this
medication, it is not safe.
- Ambien (zolpidem) may
increase the risk of hallucination.
- Anticonvulsants such as Dilantin
(phenytoin) or Cerebyx (fosphenytoin) may be less effective
when taken with Zyban.
- Barbiturates such as Phenobarbitol may lower levels of bupropion
in the body.
- Beta Blockers (blood pressure, heart disease, migraine prevention
medication) such as Inderal
(propranolol), Lopressor
(metoprolol), or Tenormin (atenolol) should be taken with
care during bupropion treatment
- Bronchodilators of the xanthine (thioxanthine) class (Aminophylline, Dyphylline,
Oxtriphylline, Somophyllin, Theo-Dur, etc...) may increase your risk of seizure.
- Clozaril (clozapine) may increase the risk of seizure from Zyban.
- Cytoxan (cyclophosphamide)
- Desyrel (trazodone)may increase
the risk of seizure.
- Ginseng - Do not take this herb while using bupropion in any
form.
- Haldol (haloperidol) may increase the risk of seizure from Zyban.
- Lithium may increase the risk
of seizure from Zyban.
- Loxitane (loxapine) may increase the risk of seizure from
Zyban.
- Ludiomil (maprotiline) may increase the risk of seizure
from Zyban.
- Ma Huang - Do not take this herb while using bupropion in any
form.
- MAO inhibitors - Zyban should not be mixed with MAO (monoamine
oxidase) inhibitors, a class of antidepressants and antisenility
drugs, such as Eldepryl (selegiline), Furoxone (furazolidone),
Nardil (phenelzine), Marplan (isocarboxazid), or Parnate
(tranylcypromine). Wait 2 weeks after stopping an MAO inhibitor
before taking bupropion, this drug reaction could be very
dangerous.
- Marijuana - There is a risk of psychotic behavior if marijuana
usage is combined with Zyban treatment. Avoid this combination.
- Moban (molindone) may increase the risk of seizure from
Zyban.
- Nicotine gum or patches - If you plan to use nicotine replacement
in addition to Zyban while you are trying to quit smoking, consult
your doctor about the best plan of action. Combining these two
treatments may not work for you.
- Norgesic/Norflex (orphenadrine)
- Protease inhibitors such as Norvir (ritonavir) may lead to toxic
levels of bupropion in the body. This drug combination is dangerous,
and these treatments should not be used at the same time.
- Provigil (modafinil) -
May increase CNS stimulation.
- Risperdal (risperdone) may build up to toxic levels in the body
if taken with bupropion.
- Ritalin (methylphenidate)
- Rythmol (propafenone) should be taken in lower doses, as it
may build up to toxic levels in the body if taken with bupropion.
- Selective serotonin reuptake inhibitors (SSRIs) like Celexa
(citalopram), Paxil
(paroxetine), Prozac
(fluoxetine), Luvox
(fluvoxamine), or Zoloft
(sertraline) may increase the risk of seizure from Zyban.
- Sinemet (carbidopa, levodopa) - Increases risk of side effects.
- St. John's Wort - Do not take this herb while using bupropion
in any form.
- Steroids like Prednisone or Hydrocortisone - Consult your doctor
before combining treatment.
- Stimulants and certain prescription diet pills may increase
the risk of seizure with bupropion, this combination is
not advised. Consult your doctor about the safety of any
stimulant medication while you are being treated with Zyban.
- Tagamet (cimetidene) may raise levels of bupropion.
- Tambocor (flecainide) - Bupropion may increase levels of this
medication, and it is recommended that your doctor lower your
Tambocor dosage to avoid toxicity.
- Tegretol (carbamazepine) - Bupropion may lower levels of this
medication.
- Tranquilizers and antipsychotics of the phenothiazine class,
such as Mellaril (thioridazine), Trilafon (perphenazine),
and Thorazine (chlorpromazine) may increase the risk of
seizure from Zyban.
- Tricyclic antidepressants such as Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor
(nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine),
may increase the risk of seizure from Zyban.
- Yohimbe - Do not take this herb while using bupropion in any
form.
Zyban Directions
Zyban is commonly started with 150 mg once a day, for three days.
After this, it may be increased to 150 mg twice per day for up to
12 weeks. You should have made progress with stopping your smoking
habit by 7 weeks, or your doctor should reevaluate your treatment.
Bupropion dosage should never exceed a total of 450 mg per day,
as this would greatly increase the risk of seizure. Never take double
doses of this medication, or take it more often than your doctor
has suggested. Only a doctor with access to your full medical history
can determine if Wellbutrin or Zyban are safe treatments for you.
Never allow anyone else to use your prescription, as this could
be very dangerous.
Zyban comes in 150 mg sustained release tablets.
Zyban tablets should never be crushed or broken as
it could result in a dangerously high dosage of bupropion.
The tablets may be taken with food or milk to reduce stomach
upset, there are no restrictions on taking bupropion with
food.
If you miss a dose: For regular Wellbutrin tablets, take it as
soon as you remember, unless it is close to the time for your next
dose. If it is almost time for the next tablet, skip the missed
dose. If you are taking Zyban or sustained release Wellbutrin, simply
wait until the next day and resume your regular schedule, ignoring
missed doses. Never take double doses of bupropion, or take doses
too close together, as it increases the risk of seizure. Dosage
should never exceed 450 mg per day, or be taken closer together
than your doctor suggests is safe.
If you are using Zyban to quit smoking: Begin treatment at least
a week before you plan to quit, and set a specific date in the second
week of treatment. Plan a support program with the help of your
doctor, as this will greatly increase the likelihood of success.
Store bupropion away from direct light and heat. Store in a dry
location; avoid storing it in the bathroom, near sinks, or other
areas where it may become damp. Do not use after the expiration
date.
Keep bupropion away from children; both when storing it, and when
discarding any unused medication.
Bupropion may cause drowsiness, disorientation, or seizure. Be
cautious if you plan to drive or operate heavy machinery, avoid
these activities if you find yourself feeling tired or experience
slowed reactions.
Zyban is a trademark of Glaxo Wellcome
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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