Zyban

Generic Name: bupropion (oral) (byoo PRO pee on)
Brand Names: Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban SR
Manufacturer: GlaxoSmithKline

Page Contents About Zyban Zyban Alternatives Warnings / Recalls Consumer Information Professional Information Zyban Drug Images History of Zyban Trade Names More Zyban Resources

About Zyban

Zyban is a tablet used to help quit smoking. Zyban contains a medicine called Bupropion. Bupropion is also the medicine in Wellbutrin, which is used for depression. Zyban is started before quitting smoking, with a target date usually in the second week of taking Zyban¹. Zyban is only available on a doctor’s prescription.

How does Zyban help in quitting smoking?

Zyban has an antidepressant action. However, its effect on quitting smoking may not be directly related to its antidepressant effects ². Possible theories for how it works include blocking the effects of nicotine, reducing withdrawal or helping depressed mood ². However, in a trial of people who didn’t want to stop smoking, Zyban was no more effective than placebo ².

How effective is Zyban?

Zyban approximately doubles the chances of quitting smoking at 3 months from quit date³. This drops back a little at 1 year from stopping. Zyban is less effective than Chantix ². In trials, Zyban had around a 14% quit rate versus 21% for Chantix.

Zyban may reduce weight gain from stopping smoking, while it is being taken, although weight gain can occur when Zyban is stopped ⁴.

TopZyban and smoking cessation alternatives compared ^{2,3,5,6,7,8,9}

Treatment	How effective
Zyban (bupropion) Prescription only	Quitting with Zyban is about twice as likely as with placebo at 3 months About 1.5 times success rate than with placebo at 1 year Bupropion has similar success to nicotine replacement, and lower than varenicline
Chantix (varenicline) Prescription only.	3 times more successful than with placebo at 1 year About 60% more successful than with bupropion (Zyban) at 1 year
Nicotine replacement Non-prescription (e.g. Nicorette gum, Nicoderm patches) Prescription (e.g. Nicotrol nasal spray)	About 2 times more likely to have quit than with placebo at 3 months About 70% more successful than with placebo at one year Similar in effectiveness to bupropion (Zyban)
More in depth information on how to Quit Smoking

TopWarnings / Recalls (FDA)

• Public Health Advisory: Antidepressant Use in Children, Adolescents, and Adults
  March 22, 2004 - Audience: Neuropsychiatric healthcare professionals and consumers

TopConsumer Information for Zyban

What is Zyban?

Bupropion is an antidepressant medication.

Bupropion is used to treat major depressive disorder and seasonal affective disorder. At least one brand of bupropion (Zyban) is used to help people stop smoking by reducing cravings and other withdrawal effects.

Zyban may also be used for purposes other than those listed in this medication guide.

Important information about Zyban

You should not take Zyban if you have epilepsy or a seizure disorder, an eating disorder such as anorexia or bulimia, if you are using Wellbutrin, or if you have suddenly stopped using alcohol or sedatives. Do not take Zyban if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms 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.

Avoid using Zyban to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking. Too much Zyban can increase your risk of a seizure.

Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects. Avoid drinking alcohol while taking Zyban. Alcohol may increase your risk of a seizure while you are taking Zyban. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Zyban can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.

Before taking Zyban

Do not take Zyban if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days. You should not take Zyban if you have:

• epilepsy or a seizure disorder;

• an eating disorder such as anorexia or bulimia;

• if you are using a second form of bupropion; or

• if you have suddenly stopped using alcohol or sedatives (such as Valium).

Zyban may cause seizures, especially in people with certain medical conditions or when using certain drugs. Tell your doctor about all of your medical conditions and the drugs you use.

Before taking Zyban, tell your doctor if you have:

• heart disease or high blood pressure;

• head injury, brain or spinal cord tumor;

• kidney disease;

• liver disease (especially cirrhosis);

• bipolar disorder (manic depression);

• diabetes for which you use insulin or take oral medication;

• if you currently use steroids, theophylline (Theo-Dur, Slo-Bid, Bronkodyl Theolair, Respbid), or medicine to treat depression or mental illness; or

• if you recently used alcohol, sedatives (such as Valium), narcotic pain medicines, diet pills, or street drugs such as "speed" or cocaine.

If you have any of these conditions, you may not be able to use Zyban, or you may need a dosage adjustment or special tests during treatment.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. Zyban may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Zyban passes into breast milk and could be harmful to a nursing baby. Do not take Zyban without telling your doctor if you are breast-feeding a baby. Do not give Zyban to anyone younger than 18 years old without the advice of a doctor.

How should I take Zyban?

Take Zyban exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Follow the directions on your prescription label.

Zyban can be taken with or without food.

Do not crush, chew, or break the extended-release tablet (Wellbutrin SR, Wellbutrin XL, Zyban SR). Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

If you take Zyban to help you stop smoking, you may continue to smoke for about 1 week after you start the medicine. Set a date to quit smoking during the second week of Zyban treatment. By that time you will have enough of the medicine in your blood stream to help you quit smoking. Talk to your doctor if you are having trouble quitting after you have used Zyban for at least 7 weeks.

Your doctor may prescribe nicotine patches or gum to help support your smoking cessation treatment. Be sure you read all directions and safety information for the nicotine product. Using nicotine with Zyban may raise your blood pressure and your doctor may want to check your blood pressure regularly. Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.

Do not stop taking Zyban without first talking to your doctor. You may have unpleasant side effects if you stop taking Zyban suddenly. Store Zyban at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much Zyban. Symptoms of a Zyban overdose may include seizures, muscle stiffness, hallucinations, fainting, fast or uneven heartbeat, shallow breathing, heart failure, or coma.

What should I avoid while taking Zyban?

Avoid drinking alcohol while taking Zyban. Alcohol may increase your risk of a seizure while you are taking Zyban. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Zyban can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.

Avoid using bupropion to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking. Too much Zyban can increase your risk of a seizure.

Zyban can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Zyban side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms 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 a seizure (convulsions) or fast, uneven heartbeats.

Less serious side effects may be more likely to occur, such as:

• headache or migraine;

• nausea, vomiting, constipation, dry mouth;

• confusion, dizziness, tremors (shaking);

• appetite changes, weight loss or gain;

• mild itching or skin rash, increased sweating; or

• loss of interest in sex.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Zyban?

Do not take Zyban if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.

There are many other drugs that can affect Zyban. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has information about Zyban written for health professionals that you may read.

What does my medication look like?

Bupropion is available with a prescription under the brand names Wellbutrin, Wellbutrin SR, Wellbutrin XL, and Zyban. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about Zyban, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zyban only for the indication prescribed
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
• Click here for more information on Zyban from the manufacturer.

Copyright 1996-2006 Cerner Multum, Inc. Version: 9.02. Revision Date: 05/22/2007 12:24:31 PM.

Professional Information for Zyban

Systematic (IUPAC) name
(±)-1-(3-chlorophenyl)-2-[(1,1-dimethylethyl)amino]- 1-propanone
Chemical data
Formula	C13H18ClNO
Mol. mass	239.74 g/mol
Pharmacokinetic data
Bioavailability	5 to 20% in animals; no studies in humans
Metabolism	Hepatic
Half life	20 hours
Excretion	Renal (87%), fecal (10%)
Therapeutic considerations
Legal status	POM(UK) ℞-only(US)
Routes	Oral

Zyban (bupropion hydrochloride) Sustained-Release Tablets are a non-nicotine aid to smoking cessation. Zyban is chemically unrelated to nicotine or other agents currently used in the treatment of nicotine addiction. Initially developed and marketed as an antidepressant (WELLBUTRIN [bupropion hydrochloride] Tablets and WELLBUTRIN SR [bupropion hydrochloride] Sustained-Release Tablets), Zyban is also 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. It is (±)-1-(3-chlorophenyl)-2-[(1, 1-dimethylethyl)amino]-1-propanone hydrochloride. The molecular weight is 276.2. The molecular formula is C13H18ClNO•HCl. Bupropion hydrochloride powder is white, crystalline, and highly soluble in water. It has a bitter taste and produces the sensation of local anesthesia on the oral mucosa. The structural formula is:

Zyban Tablets are supplied for oral administration as 150-mg (purple), film-coated, sustained-release tablets. Each tablet contains the labeled amount of bupropion hydrochloride and the inactive ingredients carnauba wax, cysteine hydrochloride, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80 and titanium dioxide and is printed with edible black ink. In addition, the 150-mg tablet contains FD&C Blue No. 2 Lake and FD&C Red No. 40 Lake.

More Professional Information for Zyban...

TopZyban Drug Images

	Drug Name Zyban Strength(s) 150 MG Imprint(s) ZYBAN 150 Manufacturer / Distributor GSK Pharm
	Drug Name Zyban SR Strength(s) 150 mg Imprint(s) ZYBAN 150 Manufacturer / Distributor GlaxoSmithKline
	Drug Name Zyban SR Refill Strength(s) 150 mg Imprint(s) ZYBAN 150 Manufacturer / Distributor GlaxoSmithKline

TopHistory of Zyban (Bupropion)

Bupropion was first synthesized by Burroughs Research in 1966, and patented by Burroughs-Wellcome (later Glaxo-Wellcome, and, as of 2000, GlaxoSmithKline) in 1974. It was approved by the Food and Drug Administration (FDA) as an antidepressant in 1984 and marketed under the name Wellbutrin. However, a significant incidence of seizures at the originally recommended dosage (400-600 mg) caused in 1986 the removal of the drug from the market. It was shown that the risk of seizures increases from 0.1% at 100-300 mg/day to 0.3-0.4% at 450 mg/day to 2% at 600 mg/day. Reflecting this experience, bupropion was re-introduced to the market in 1989 with the maximum dose of 450 mg/day.

In 1996 the FDA approved sustained-release (SR) and in 2003 extended release (XL) formulations of Wellbutrin that release bupropion at a slower rate. Wellbutrin SR and XL are now available in generic form. In 1997, bupropion was approved by the FDA for use as a smoking cessation aid under the name Zyban. In late 2006, Wellbutrin XL was approved for use by the FDA as treatment for seasonal affective disorder.

In the UK, bupropion was approved in 2000 as a smoking cessation aid, and has not been approved for the treatment of depression.

Source: Wikipedia

TopInternational Trade Names for Zyban

• Elontril (Germany)
• Odranal (Colombia)
• Quomen (Thailand)
• Well (Korea)
• Wellbutrin (United States, Canada)
• Zetron (Brazil)
• Zyban LP (France)
• Zyban Sustained Release (Australia)
• Zyban SR (Poland, United Kingdom)
• Zylexx SR (Pakistan)

TopMore Zyban Resources

Zyban (for Smoking Cessation);

Zyban Sustained-Release Tablets

Zyban - Includes detailed dosage instructions.

Zyban

Zyban Images

Zyban Drug Interactions

Zyban contains the ingredient(s) Buproprion;

Bupropion

Bupropion

Bupropion Drug Interactions

Buproprion is also an ingredient of Wellbutrin (for Depression, Seasonal Affective Disorder, Attention Deficit Disorder);

Wellbutrin

Wellbutrin

Wellbutrin XL Extended-Release Tablets

Wellbutrin SR Sustained-Release Tablets

Wellbutrin SR

Wellbutrin

Wellbutrin Images

Wellbutrin Drug Interactions

Top

References

1. http://www.drugs.com/pro/zyban.html
2. Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD000031. DOI: 10.1002/14651858.CD000031.pub3.
3. Wu P, Wilson K, Dimoulas P, et al. Effectiveness of smoking cessation therapies: a systematic review and meta-analysis. BMC Public Health 2006; 6: 300.
4. Ebbert JO, Sood A, Hays JT, Dale LC, et al. Treating tobacco dependence: review of the best and latest treatment options. J Thor Oncol 2007; 2: 249-56.
5. Fiore MC, Bailey WC, Cohen SJ, et al. Treating Tobacco Use and Dependence. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. June 2000.
6. Lancaster T, Stead LF. Self-help interventions for smoking cessation. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD001118. DOI:10.1002/14651858.CD001118.pub2.
7. Cahill K, Stead LF, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD006103. DOI: 10.1002/14651858.CD006103.pub2.
8. Crane R. The most addictive drug, the most deadly substance: smoking cessation tactics for the busy clinician. Prim Care Clin Office Pract 2007; 34: 117-35.
9. GlaxoSmithKline. Zyban SR Prescribing Information. May 2007. http://us.gsk.com/products/assets/us_zyban.pdf. Last accessed 25 June 07

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Every effort has been made to ensure that the information provided by Multum, Micromedex and Drugs.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This drug information does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2007 Multum Information Services, Inc. The information in contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.