Zyban Information

An individual may be addicted to cigarettes if he/she experience one or more of the following signs:

You continue to smoke despite the desire to quit.

• You have made a serious, but unsuccessful, attempt to stop using tobacco or permanently reduce the amount you use.
  
• Your attempts to stop smoking have led to physical withdrawal symptoms, including a craving for tobacco, anxiety, irritability, restlessness, difficulty concentrating, headaches, drowsiness, and stomach upset.
  
• You develop a "tolerance" for tobacco. Smoking the same number of cigarettes produces less effect over time, making it necessary to increase the number of cigarettes you smoke to achieve the desired sensation.
  
• You have continued to use tobacco even when you have a serious physical problem (such as cardiovascular or respiratory disease) that you know is worsened by tobacco.

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.