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Brand name: Zyban

Generic name: Bupropion Hydrochloride

Bupropion is a nicotine-free quit-smoking aid. Instead of nicotine, it contains the same active ingredient as the antidepressant medication Wellbutrin. It works by boosting the levels of several chemical messengers in the brain. With more of these chemicals at work, you experience a reduction in nicotine withdrawal symptoms and a weakening of the urge to smoke. More than a third of the people who take Bupropion while participating in a support program are able to quit smoking for at least 1 month. Bupropion can also prove helpful when people with conditions such as chronic bronchitis and emphysema decide it's time to quit.

Most important fact about Bupropion

About 1 person in 1,000 suffers a seizure while taking Bupropion. For this reason, people with epilepsy and certain other disorders should never take Bupropion. Don't share Bupropion with friends. Only a doctor can decide whether it's safe for a particular individual.

How should you take Bupropion?

Treatment with Bupropion begins while you are still smoking. Bupropion needs about a week to reach an effective level in your body; so to improve your chance of success, you should not attempt to quit until the second week of treatment. Set a firm date for quitting. If you are still smoking after that date, your odds of breaking the habit will be worse. You should keep taking Bupropion for 7 to 12 weeks.

You can use nicotine patches along with Bupropion. However, combining the two treatments can raise your blood pressure, so it's important to tell your doctor if you plan to use both. Do not smoke while using a patch, because too much nicotine can cause serious side effects.

Participating in a counseling or support program will make success more likely. Your doctor can recommend a local program for you.

Swallow Bupropion tablets whole. Do not chew, divide, or crush them. Take them exactly as prescribed.

If you miss a dose of Bupropion

Do not take an extra tablet of Bupropion to "catch up" for the missed dose. Skip the dose and take your next Bupropion tablet at the regularly scheduled time.

Storage instructions for Bupropion

Store at room temperature in a tightly closed container. Keep out of direct sunlight.

What side effects when taking Bupropion may occur ?

Side effects of Bupropion cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Bupropion.

The most common side effects when taking Bupropion are:

Dry mouth and sleeplessness
These are generally mild and usually disappear after a few weeks. If you have difficulty sleeping, avoid taking Bupropion close to bedtime and ask your doctor about reducing your dosage.

More common side effects when taking Bupropion may include:

Abdominal pain, abnormal dreams, anxiety, constipation, diarrhea, disturbed concentration, dizziness, joint pain, increased cough, itching, nasal inflammation, nausea, nervousness, rash, sore throat.

Less common side effects when taking Bupropion may include:

Abnormal thinking, allergic reaction, bronchitis, changes in taste, difficulty breathing, dry skin, fever, hives, hot flashes, increased appetite or loss of appetite, increased blood pressure, migraine, mouth ulcers, muscle pain, neck pain, nosebleed, ringing in the ears, shakiness, sinus inflammation, sleepiness, throbbing heartbeat.

Rare side effects when taking Bupropion may include:

Chest pain, feeling of unhappiness, thirst, swelling of the face.

Why should Bupropion not be prescribed ?

Because Bupropion has been known to trigger convulsions, no one with a seizure disorder should take Bupropion. Also avoid Bupropion if you are taking Wellbutrin or any other drug that contains bupropion, Bupropion's active ingredient. The more bupropion you take, the more likely you are to have a seizure.

Bupropion's seizure-triggering potential is greater in people with an eating disorder such as bulimia or anorexia, and in those undergoing abrupt withdrawal from alcohol, sedatives, and tranquilizers such as Librium and Valium. If you suffer from one of these problems, never take Bupropion. Avoid it, too, if you are taking a drug classified as an MAO inhibitor, such as the antidepressants Nardil and Parnate. Allow at least 14 days to pass between taking one of these drugs and starting your Bupropion therapy.

If Bupropion or any other ingredient in Bupropion has ever given you an allergic reaction, Bupropion is not for you.

Special warnings about Bupropion

Because the chance of a seizure from Bupropion rises with the amount in your system, never 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 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

If any of these apply to you, use Bupropion with care. If you do have a seizure while taking Bupropion, stop taking Bupropion and never take it again.

Stop taking Bupropion 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 of Bupropion may need to be reduced. (If you have severe cirrhosis of the liver, your dosage must be reduced.) Also make certain the doctor knows about any heart condition you may have.

Bupropion can interfere with your driving ability. Don't drive or operate dangerous machinery until you are certain of the Bupropion´s effect on you.

Possible food and drug interactions when taking Bupropion

If Bupropion 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 Bupropion with the following:

Alcohol
Amantadine (Symmetrel)
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)

Quitting smoking, with or without Bupropion treatment, could change the way your body metabolizes certain drugs, for example, theophylline and warfarin (Coumadin). Make sure your doctor knows all the prescription and over-the-counter medicines you're taking.

Special information if you are pregnant or breastfeeding

Bupropion 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 Bupropion therapy. For the sake of the baby, you should avoid smoking or taking nicotine in any other form while pregnant.

Bupropion appears in breast milk and could affect a nursing infant. Ask your doctor whether it will be better to discontinue the Bupropion or to stop breastfeeding.

Recommended dosages for Bupropion

ADULTS

The usual starting dose of Bupropion is one 150-milligram tablet in the morning for the first 3 days. After that, take one 150-milligram tablet in the morning and another in the early evening. Keep doses at least 8 hours apart.

The maximum recommended dose is 300 milligrams daily.
Continue taking Bupropion for 7 to 12 weeks. Your doctor may recommend continuing treatment for up to 6 months.

Kidney and Liver Disease

Your doctor may reduce the frequency of your doses to avoid high blood levels of Bupropion. If you have severe cirrhosis of the liver, you should take no more than 150 milligrams every other day.

CHILDREN

The safety and efficacy of Bupropion have not been established in children under 18.

Overdosage with Bupropion

Information on Bupropion overdose is limited. However, any medication taken in excess can have serious consequences. If you suspect an overdose of Bupropion, seek medical attention immediately.

Symptoms of Bupropion overdose may include:

Blurred vision, confusion, grogginess, jitteriness, light-headedness, nausea, seizure, sluggishness, visual hallucinations.

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