Zyban (bupropion)

How does it work?

Zyban tablets contain the active ingredient bupropion hydrochloride, which is a medicine used to help people who are dependant on nicotine to give up smoking. It acts in the brain but is not the same as nicotine replacement therapy.

It is not fully understood how this medicine works to help people give up smoking, but it is known that bupropion affects neurotransmitters in the brain. Neurotransmitters are chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells.

Neurotransmitters are released from nerve cells as a message is transmitted. Once the message has been transmitted, the nerve cells then reabsorb the neurotransmitter.

Bupropion prevents two of these neurotransmitters, noradrenaline and dopamine, from being reabsorbed back into the nerve cells. Noradrenaline and dopamine are responsible for moderating mood and various other processes in the brain. It is thought that bupropion helps people to quit smoking by increasing the amount of noradrenaline and dopamine free to act in the brain.

Bupropion is used in combination with motivational support techniques. You should seek help and support as much as possible while giving up smoking, even while taking this medicine, as this will increase your chance of success.

You should start taking this medicine while you are still smoking and set a 'target stop date' for within the first two weeks of treatment, preferably in the second week. This is because the medicine needs time to start working.

The starting dose is one tablet once a day for six days, increasing on day seven to one tablet twice a day. There should be an interval of at least eight hours between doses. It is best to take your first dose when you get up in the morning and your second dose at least eight hours later. Try to avoid taking your second dose at bedtime, as difficulty sleeping (insomnia) is a common side effect of the medicine.

If you have not managed to stop smoking by the seventh week of treatment, your doctor will ask you to stop taking this medicine.

What is it used for?

Aid for giving up smoking, in combination with motivational support.

Warning!

Zyban tablets should be swallowed whole with water - do not chew, crush or break them.

This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.

You should minimise your consumption of alcohol or avoid it entirely while you are taking this medicine. This is because there have been rare reports of reduced tolerance to alcohol, or adverse psychiatric reactions in people who drank alcohol while taking this medicine.

Stop taking this medicine and inform your doctor if you get any of the following symptoms during treatment: skin rash, blistering of the skin, itching, fever, chest pain, collapse, swelling of any part of the body, shortness of breath or pain in the muscles or joints. These are symptoms of allergy to this medicine.

Do not exceed the prescribed dose of this medicine. Doing so increases the risk of fits (seizures), which is a rare side effect of this medicine.

If you have a fit (seizure) while taking this medicine, treatment should be stopped and not restarted.

Your blood pressure should be monitored while you are taking this medicine.

Consult your doctor before using nicotine replacement therapy, such as nicotine patches or gum, in combination with this medicine. If you do use nicotine replacement therapy at the same time, your blood pressure should be monitored every week.

Certain medicines should not be taken with Zyban. Tell your doctor or pharmacist if you are taking any other medicines before you start Zyban. It is also important to tell your doctor or pharmacist that you are taking Zyban before you take any new medicines, including those bought without a prescription. See below for more details.

Use with caution in

Elderly people

Decreased kidney function

Decreased liver function

Alcohol abuse

People who have had a head injury

People taking medicines known to increase the risk of seizures (see below)

History of psychiatric illness

Diabetes

High blood pressure.

Not to be used in

Seizure disorders, eg due to brain injury or epilepsy

History of fits (seizures), eg epilepsy

Tumours of the brain or spinal cord (central nervous system)

People undergoing abrupt withdrawal from alcohol or benzodiazepines (eg diazepam, temazepam)

People with a history of anorexia nervosa

People with a history of bulimia nervosa

People with a history of bipolar disorder (manic depression)

People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days

Severe cirrhosis of the liver

Pregnancy

Breastfeeding

People taking any other medicinal product that contains bupropion.

This medicine is not recommended for children and adolescents under 18 years of age, as there is no information regarding its safety and efficacy in this age group.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine during pregnancy has not been established, therefore it should not be used by pregnant women. Talk to your doctor or pharmacist for advice on giving up smoking if you are pregnant.

This medicine passes into breast milk. Women taking this medicine should not breastfeed. Seek medical advice from your doctor.

Label warnings

This medication is to be swallowed whole, not chewed.

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