The Zyban (Bupropion) brand of bupropion is used to help people stop smoking by reducing cravings and other withdrawal effects. Zyban may also be used for purposes not listed in this medication guide. You should not take Zyban if you have seizures, an eating disorder, or if you have suddenly stopped using alcohol, seizure medication, or sedatives.
This medication is used in combination with a stop-smoking program (e.g., support group, counseling) to help you quit smoking. Zyban can decrease your nicotine withdrawal symptoms (e.g., irritability, anxiety, restlessness) and your urge to smoke. Quitting smoking decreases your risk of heart and lung disease, as well as cancer. This medication belongs to a class of medications known as antidepressants. It is not known exactly how bupropion works to reduce smoking urges. It may work by restoring the balance of certain natural chemicals (neurotransmitters) in the brain. Discuss the risks and benefits of this medication, as well as other ways to quit smoking (such as nicotine replacement treatment), with your doctor. OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional. Zyban may also be used to treat other mental/mood disorders such as depression and attention deficit hyperactivity disorder (ADHD). It may be used to prevent autumn-winter seasonal depression (seasonal affective disorder). It is also used with other mood stabilizers to treat bipolar disorder.
Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using bupropion and each time you get a refill. If you have any questions regarding the information, consult your doctor or pharmacist. Take this medication by mouth, usually twice daily with or without food. If stomach upset occurs, take with food. It is important to take your doses at least 8 hours apart or as directed by your doctor to decrease your risk of seizure. You may have trouble sleeping when you start taking this drug. Do not take your evening dose too close to bedtime. Do not crush or chew this medication. Doing so can release all of the drug at once, increasing the risk of side effects, including seizures. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Your dosage is based on your medical condition and response to therapy. Your dose may be slowly increased to limit side effects. Do not take more or less medication than prescribed. Do not take more than 150 milligrams in a single dose. Do not take more than 300 milligrams per day. Taking more than the recommended dose of this medication may increase your risk of having a seizure. It is recommended that you do not try to quit smoking until you have been taking bupropion for 1 week so that the drug can reach a high enough level in your blood. Set a date for quitting, and stop smoking sometime in the second week of taking the drug.
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: seizure (convulsions); fast heartbeats; fever, swollen glands, rash or itching, joint pain, or general ill feeling; confusion, trouble concentrating, hallucinations, unusual thoughts or behavior; or severe skin reaction — fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Less serious side effects may include: dry mouth, nausea, stomach pain; headache, dizziness, ringing in your ears; loss of interest in sex; sore throat, muscle pain; mild itching or skin rash, increased sweating, increased urination; or changes in appetite, weight loss or gain. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
Potential For Other Drugs To Affect ZYBAN Bupropion is primarily metabolized to hydroxybupropion by CYP2B6. Therefore, the potential exists for drug interactions between ZYBAN and drugs that are inhibitors or inducers of CYP2B6. Inhibitors of CYP2B6 Ticlopidine and Clopidogrel: Concomitant treatment with these drugs can increase bupropion exposure but decrease hydroxybupropion exposure. Based on clinical response, dosage adjustment of ZYBAN may be necessary when coadministered with CYP2B6 inhibitors (e.g., ticlopidine or clopidogrel). Inducers of CYP2B6 Ritonavir, Lopinavir, and Efavirenz: Concomitant treatment with these drugs can decrease bupropion and hydroxybupropion exposure. Dosage increase of ZYBAN may be necessary when coadministered with ritonavir, lopinavir, or efavirenz but should not exceed the maximum recommended dose. Carbamazepine, Phenobarbital, Phenytoin: While not systematically studied, these drugs may induce the metabolism of bupropion and may decrease bupropion exposure. If bupropion is used concomitantly with a CYP inducer, it may be necessary to increase the dose of bupropion, but the maximum recommended dose should not be exceeded. Potential for ZYBAN to Affect Other Drugs Drugs Metabolized by CYP2D6 Bupropion and its metabolites (erythrohydrobupropion, threohydrobupropion, hydroxybupropion) are CYP2D6 inhibitors. Therefore, coadministration of ZYBAN with drugs that are metabolized by CYP2D6 can increase the exposures of drugs that are substrates of CYP2D6. Such drugs include certain antidepressants (e.g., venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, and sertraline), antipsychotics (e.g., haloperidol, risperidone, thioridazine), beta-blockers (e.g., metoprolol), and Type 1C antiarrhythmics (e.g., propafenone and flecainide). When used concomitantly with ZYBAN, it may be necessary to decrease the dose of these CYP2D6 substrates, particularly for drugs with a narrow therapeutic index. Drugs that require metabolic activation by CYP2D6 to be effective (e.g., tamoxifen) theoretically could have reduced efficacy when administered concomitantly with inhibitors of CYP2D6 such as bupropion. Patients treated concomitantly with ZYBAN and such drugs may require increased doses of the drug].