Smoking Cessation Drugs: Bupropion
Type of Medication
- Antidepressant
Commonly Used Brand Names
- Wellbutrin
- Zyban
What Bupropion Is Prescribed For
Bupropion is an antidepressant, but it is also prescribed to help people quit smoking . It can be used in combination with a nicotine replacement product.
How Bupropion Works
Bupropion appears to affect two brain chemicals that may be related to nicotine addiction : dopamine and norepinephrine. Bupropion reduces the cravings for cigarettes that smokers experience when they try to quit. It also seems to reduce many of the nicotine withdrawal symptoms, including irritability, frustration, and anger.
Considerations While Taking This Medication
See Your Doctor
Your doctor will determine the appropriate level of bupropion for you and will adjust the dosage as you progress.
Manage Your Medications
Tell your doctor about all the medications you take; some should not be taken with bupropion, while others may require a different dosage level.
Be Cautious With Certain Medical Conditions
The presence of other medical problems may affect the use of bupropion. Tell your doctor if you have any other medical problems, especially
- Anorexia nervosa or bulimia (or history of)
- Brain tumor , disorders, or surgery
- Alcoholism
- Drug abuse
- Head injury (or history of)
- Mental retardation
- Seizure disorders
- Bipolar disorder (manic-depressive illness)
- Psychosis
- High blood pressure
- Heart disease
- Kidney disease
- Liver disease
Report Breastfeeding
Women who are pregnant or breastfeeding should not use bupropion. Talk to your doctor about other options.
Proper Usage
Start taking bupropion one week before you plan to stop smoking. It takes about one week for this medication to reach adequate levels in your system, so plan a specific quit date during the second week that you are taking bupropion.
If you miss a dose, just skip it and stay with your regular dosing schedule.
Note : Do not double doses. Taking too much bupropion at one time can cause seizures.
If all goes well and you are successful in quitting, you should plan to stay on the bupropion for 7-12 weeks. Your primary care provider may recommend a longer course of treatment, however, depending on your circumstances.
Possible Side Effects
Most people do not have side effects from taking bupropion for smoking cessation. If side effects do occur, they can usually be minimized. In addition, side effects are most often temporary, lasting only as long as you are taking the medication.
There are rare, but serious side effects that you should be aware of. Medications like bupropion may cause severe mood and behavior changes in some people, including suicidal thoughts. Young adults may be more at risk for these side effects. Make sure you call your doctor right away if this happens to you.
Other Side Effects
You should also call your doctor right away if any of the following occur:
If these side effects occur frequently and/or become bothersome, call your doctor:
- Abdominal pain
- Constipation
- Decrease in appetite
- Dizziness
- Dry mouth
- Increased sweating
- Nausea or vomiting
- Trembling or shaking
- Insomnia
- Weight loss
Symptoms of an Overdose
Symptoms of an overdose may be more severe than side effects seen at regular doses, or two or more side effects may occur together. Call your doctor right away if you notice any of the following:
- Fast heartbeat
- Hallucinations
- Loss of consciousness
- Nausea and/or vomiting
- Seizures
Drug Interactions
Bupropion should not be combined with other medications that lower the threshold for seizures. These include the following:
- Theophylline
- Antipsychotic medications
- Antidepressants
- Tramadol (Ultram)
- Sibutramine
- Tamoxifen
- Steroids
- Diabetes drugs
- Ritonavir
Smoking Cessation Success
It is very clear from all of the studies on smoking cessation that your chances of long-term success depend a great deal on your motivation and commitment to quitting, regardless of which therapy you choose.
RESOURCES:
American Lung Association
http://www.lungusa.org
Centers for Disease Control and Prevention
http://www.cdc.gov
CANADIAN RESOURCES:
Healthy Living Unit
http://www.phac-aspc.gc.ca/pau-uap/fitness/
The Canadian Lung Association
http://www.lung.ca
References:
Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update. In: Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.
Public health advisory: FDA requires new boxed warnings for the smoking cessation drugs Chantix and Zyban. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm169988.htm . Published July 1, 2009. Accessed July 8, 2009.
Zyban oral. Medscape Drug Reference website. Available at http://www.medscape.com/druginfo/dosage?cid=med&drugid=1609&drugname=Zyban+Oral&monotype=default. Accessed on May 27, 2009.
Last reviewed May 2009 by Janet H. Greenhut, MD, MPH
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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