Zyban (Bupropion) Dosage and Side Effects
ZYBAN is an oral prescription medication which is used in combination with a support program such as counseling to help motivated adults quit smoking. ZYBAN can be used in combination with nicotine replacement therapy (patches, gum, lozenges, etc.).
Warnings and Precautions
IMPORTANT WARNINGS ABOUT THE RISK OF SEIZURES FOR PATIENTS TAKING ZYBAN:
There is a risk of having a seizure with ZYBAN: At the maximum recommended dose of 300 mg per day, ZYBAN has been shown to cause seizures in about 1 out of every 1000 people.
For this reason, ZYBAN is not right for everyone.
If the decision is to try ZYBAN, there are precautions to be aware of to help reduce the chances of a seizure.
Do NOT take other drugs with the same medicinal ingredient (bupropion) that is in ZYBAN, such as WELLBUTRIN SR or WELLBUTRIN XL tablets (used to treat depression).
Never take more than one tablet (150 mg) of ZYBAN at one time, and never take more than two tablets total (300 mg) in a day.
BEFORE you use ZYBAN tell your doctor or pharmacist if you:
have ever had any seizures in the past
take other medications that may increase your chance of a seizure, including drugs for depression and some antibiotics
are taking, or planning on taking, any prescription or over-the-counter medications, or diet aids during your therapy
have had a serious head injury
have kidney or liver problems
have had a heart attack, heart problems, or high blood pressure
are pregnant or trying to become pregnant, or if you think that you might be pregnant
are breast feeding
have diabetes which is treated with insulin or other medications
regularly drink a lot of alcohol. If you are a heavy drinker and suddenly stop drinking while taking ZYBAN, you increase the chances of having a seizure.
If You Experience a Seizure:
If you experience a seizure while taking ZYBAN, contact your doctor or go to a hospital emergency ward immediately. Stop taking ZYBAN, and do not start the medication at any later time, as you may suffer more seizures. In addition, you should not take any other medications that contain bupropion, such as the antidepressants WELLBUTRIN XL and WELLBUTRIN SR, due to the risk of more seizures.
ZYBAN can cause an acute attack of glaucoma. Having your eyes examined before you take ZYBAN could help identify if you are at risk of having angle-closure glaucoma. Seek immediate medical attention if you experience:
changes in vision
swelling or redness in or around the eye.
New or Worsened Emotional or Behavioural Problems:
Particularly in the first weeks, or when doses are adjusted, a small number of people taking drugs of this type may experience unusual feelings of agitation, hostility or anxiety, or have impulsive or disturbing thoughts such as thoughts of self-harm, or harm to others. Your doctor should be informed of such changes immediately. Close observation by a doctor is necessary in this situation.
These symptoms can develop during treatment with ZYBAN or after stopping treatment. They can also be associated with trying to quit smoking, with or without medications to help quit.
If you, your family, or friends notice mental health changes that are unusual for you while in ZYBAN, stop taking the drug and talk to your doctor. If the symptoms are severe, seek immediate emergency help.
Pregnancy and Breastfeeding:
Because of the possibility of harm to the baby, ZYBAN should only be taken during pregnancy or while breastfeeding if you and your doctor decide that the potential benefits outweigh the potential harms.
Taking ZYBAN during the first trimester is associated with a risk of heart defect in the baby. As well, some newborns whose mother took drugs of the same type as bupropion during the third trimester of pregnancy have developed complications at birth including: feeding and/or breathing difficulties, seizures, tense or floppy muscles, jitteriness, constant crying.
If you are pregnant or planning on becoming pregnant, or are breastfeeding, talk with your doctor about the risks and benefits of different anti-smoking treatment options.
Driving or Using Heavy Machinery:
Do not drive a car or use heavy machinery until you know how ZYBAN affects you. ZYBAN can affect your ability to do these things safely.
ZYBAN is not recommended for use in children under 18 years of age.
Whether you are taking medication to stop smoking or not, the following are symptoms you may feel: depressed, short-tempered, frustrated or angry, nervous, impatient; have difficulty concentrating. Your appetite may increase, and you may gain some weight.
Like all medications, ZYBAN can cause some side effects, although not everybody gets them.
The common side effects are mostly mild to moderate and these usually occur in the first weeks of treatment.
Common side effects of ZYBAN can include:
stuffy or runny nose
If you think you have these side effects, it is important that you seek medical advice from your doctor straight away.
Interactions with this medication
You should tell your doctor if you are taking or have recently taken any medications (prescription, non-prescription or natural herbal) especially:
medicines for Parkinson’s disease such as levodopa, amantadine or orphenadrine
medicines used for epilepsy (such as carbamazepine, phenytoin, or phenobarbitone)
the antipsychotic thioridazine
other medications for mental illness such as haloperidol and risperidone
antidepressants such as citalopram, paroxetine, venlafaxine
cyclophosphamide or ifosfamide, drugs mainly used to treat cancer
drugs called beta blockers to treat heart conditions
medicines to regulate heart rhythm
clopidogrel or ticlopidine, drugs used to reduce blood clots
tamoxifen, a drug to treat breast cancer
ritonavir or efavirenz, drugs to treat HIV infection
sedatives or tranquilizers
digoxin used to treat congestive heart failure and a fast heart rate or irregular heart rhythm such as atrial fibrillation sometimes called “a-fib”.
In general, drinking alcoholic beverages should be kept to a minimum or avoided completely while taking ZYBAN. Alcohol may trigger or worsen the allergic reactions. Be sure to discuss your use of alcohol with your doctor before you begin taking ZYBAN.
Proper Use of this medication
Never take an “extra” dose of ZYBAN.
Never take more than one tablet at a time, or more than 2 tablets in one day.
It takes about 1 week for ZYBAN to reach the right levels in your body to be effective. So, to maximize your chance of quitting, you should not stop smoking until you have taken ZYBAN for 1 week.
Your target date to stop smoking should be during the second week of taking ZYBAN.
Take ZYBAN with or without food. If you have difficulty sleeping, take the second tablet earlier in the evening (but at least 8 hours after the first tablet).
Be sure to swallow ZYBAN tablets whole. Do not crush, cut or chew the tablets—doing so may increase the chance of side effects.
ZYBAN tablets may have a distinctive odour; this is normal.
ZYBAN is usually prescribed for 7-12 weeks.
You may need to take ZYBAN for a longer period of time to prevent you from returning to previous smoking behaviour. You and your doctor will determine how long you should take it according to your individual needs.
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 doctor. Using ZYBAN and nicotine patches together may raise your blood pressure, sometimes severely. Tell your doctor if you are planning to use nicotine replacement therapy so that your blood pressure can be checked regularly.
Can I smoke while taking ZYBAN?
It is not dangerous to smoke and take ZYBAN at the same time. But your chances of success in breaking your smoking habit are lowered if you smoke after the date you set to quit.
If you take too many tablets, you may increase the risk of a seizure, or other serious effects.
If you miss a dose of ZYBAN, do NOT double the next dose. Wait and take your next tablet at the regular time.
Remember: This medicine has been prescribed only for you. Do not give it to anybody else, as they may experience undesirable effects, which may be serious.