Zyban

Zyban was originally created as a medicine to treat depression. However, it has since been found to help people stop smoking. Zyban is a brand name of bupropion which is the active ingredient. Another brand name for bupropion, used in other countries, is Wellbutrin.

Although it is not exactly clear how Zyban works, it is thought to influence the areas of the brain involved in addictive behaviour. When you stop smoking, you may struggle with withdrawal symptoms. The medicine in Zyban (bupropion) may reduce withdrawal symptoms, like headaches, cravings, and anxiety.

Zyban is considered safe for most people to take. However, there are some instances when it is not recommended.

Zyban is not suitable for:

• children under the age of 18
• women who are breastfeeding or pregnant
• people with certain other health conditions, including bipolar disorder, epilepsy, or an eating disorder (like bulimia or anorexia nervosa)

Zyban belongs to a class of medications called antidepressants. Zyban is a norepinephrine-dopamine reuptake inhibitor (NDRI).

You should begin taking Zyban while you are still smoking. For days 1 to 6, you should take 1 150 mg tablet once a day. On day 7, you should increase your dose to 1 tablet, twice each day. Make sure that you spread these at least 8 hours apart, and do not take them near to your bedtime as you may have difficulty sleeping.

For the second week, you should continue taking 1 tablet, twice each day. This should be the week you stop smoking. For weeks 3 to 9, you should continue taking one tablet, twice each day, for a maximum of 9 weeks. If you have not stopped smoking after 7 weeks, you should speak to your doctor. They may recommend you stop taking Zyban. Most people can stop bupropion easily at the end of the course, but you may be told to reduce the dose slowly if you notice any withdrawal effects.

If you take too many Zyban tablets, you are at a higher risk of having a fit or getting other side effects. Should you forget to take Zyban, you should wait and take the next tablet at the usual time. Never take a double dose to make up for the one you have forgotten. Ask your doctor or pharmacist for advice if you have any further questions about Zyban.

Some people find they are more sensitive to alcohol when using Zyban. Your doctor or pharmacist may advise you to not drink alcohol while you are taking Zyban, or to limit how much you drink.

You may get side effects of Zyban like feeling lightheaded or dizzy which can affect your concentration. Therefore, if you get these, do not drive, or operate machinery.

You can take Zyban with or without food.

Like with any medicine, taking Zyban can cause side effects. However, not everyone will get them.

Common side effects of Zyban include:

• difficulty concentrating
• feeling depressed, agitated, or anxious
• feeling shaky (tremor)
• headache
• dry mouth
• constipation
• nausea or vomiting

Uncommon side effects of Zyban include:

• loss of appetite
• increase in blood pressure
• ringing in the ears
• chest pain
• feeling weak
• feeling confused

Although rare, roughly 1 in every 1,000 people who take Zyban is at risk of having a fit (seizure). You may potentially have a serious allergic reaction to Zyban. If you get any of the below signs, you must visit A&E immediately:

• swollen lips, eyelids, or tongue
• skin rash
• difficulty breathing
• unusual wheezing
• pains in joints or muscles

You should not take Zyban if you:

• are allergic to bupropion or any other ingredients of this medicine
• take any other medicines that contain bupropion
• have a condition that causes fits (seizures), like epilepsy
• have severe liver problems (like cirrhosis)
• have a brain tumour
• have or have had an eating disorder in the past, such as bulimia or anorexia nervosa
• have or have had bipolar disorder

Some medicines can affect how Zyban works. You may be at a higher risk of getting side effects if you take medicines for:

• depression (like paroxetine or desipramine)
• Parkinson’s disease (like amantadine or levodopa)
• cancer (like cyclophosphamide)
• heart disease or stroke (like clopidogrel or ticlopidine)

Other side effects and medicines can interact with how Zyban works. For a full list, see your patient information leaflet. You should also talk to your doctor or pharmacist about this medicine, as they will weigh up the pros and cons of taking Zyban and may decide to alter the dose of the other medicine you are taking.

If you want to quit smoking, there are several types of treatment available from pharmacies, shops, and on prescription to reduce withdrawal symptoms and beat your addiction.

Nicotine replacement therapy (NRT) is a medication that delivers you a low amount of nicotine, without the poisonous chemicals and tar that are found in tobacco smoke.

NRT is available as:

• chewing gum
• skin patches
• mouth and nasal spray
• oral strips, tablets, and lozenges
• inhalators (which resemble plastic cigarettes)

Champix is a brand name for varenicline. This is a medicine that works in two ways. It blocks the reinforcing and rewarding effects of smoking while reducing cravings for nicotine. Evidence indicates that Champix is one of the most effective medicines to help you stop smoking.

There have been clinical trials with promising results that show Zyban is an effective treatment for helping people to stop smoking. Although, you are more likely to get side effects if you take Zyban and stop taking the medicine when compared to people who take a placebo (a ‘dummy’ tablet).

Another study showed that while the proportion of smokers who benefit from using smoking cessation medication like Zyban decreases during the course of the first year, there is still a net benefit that remains at 12 months.

Zyban is only effective if you are motivated to stop smoking, you will need to want to stop smoking for it to work.

No. Zyban and Champix are both taken as part of a smoking cessation programme. However, while the two medicines have the same desired end result, they are not the same.

The two medicines have different active ingredients. The active ingredient of Zyban is bupropion hydrochloride, whereas the active ingredient of Champix is varenicline. Bupropion and varenicline are not defined in medical terms as an NRT, although they do function in a similar way.

Yes. However, Zyban is not sold over the counter. Instead, you must see your doctor or pharmacist for a prescription.

No. Zyban is not a controlled substance under the Controlled Substances Act (CSA).

Zyban is not addictive. Some people might notice symptoms, such as irritability when stopping Zyban, in which case your doctor may advise that you reduce the dose slowly before stopping.

Stopping smoking takes real determination and we recommend taking Zyban as part of a wider stop smoking package. This can include support groups like the following:

• Action on Smoking and Health (ash.org.uk)
• Supporting smokers to stop smoking | Help giving up smoking | QUIT