There are two types of smoking cessation products, some contain nicotine, and some don’t.
One type of these are nicotine replacement therapy (NRT) products, such as gums, lozenges, sprays, and inhalers, work by giving you a small dose of nicotine without all the other dangerous chemicals found in cigarettes. That way, you can wean yourself off nicotine and withdrawal isn’t so bad. They don’t stop the cravings, though. Most nicotine replacement products are available over-the-counter. is
The other smoking cessation products are prescription drugs that don’t use nicotine. They change the way your brain works to ease withdrawal symptoms and make you not want to smoke as much or at all. The Food and Drug Administration (FDA) has approved two of these products: Bupropion (brand name: Zyban) and Varenicline (brand name: Chantix). Let’s take a look at Bupropion in this article, to tell you what you should know about the drug.
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Bupropion is the generic (common or non-branded) name for bupropion hydrochloride, the active ingredient in the branded drug, Zyban.
Originally marketed as an antidepressant drug under the brand name of Wellbutrin, it became apparent that Bupropion was an effective quit-aid, because smokers using it to treat depression also lost interest in smoking. People not planning to quit smoking found themselves stopping with relative ease.
Later, bupropion hydrochloride was given the brand name of Zyban and in 1997, the FDA approved it as a quit-smoking aid. When used in combination with nicotine replacement therapies (NRTs), the chance for long-term success with smoking cessation increases.
It is important to be monitored by your doctor if you're using both Bupropion and an NRT, as high blood pressure can be a concern.
How it works
It isn't completely understood how Bupropion works, but it’s known that the drug alters brain chemistry in such a way that nicotine is made less effective. The result is a reduced interest in smoking, and nicotine cravings and withdrawal are minimal.
While this medication was developed as an anti-depressant, you do not need to suffer from depression for it to work as a quit aid. That said, if you develop quit-related depression, Bupropion may help to offset the symptoms.
Bupropion is not sold over the counter, so you must see your doctor for a prescription.
To begin with, you take the drug while you're still smoking, as follows:
Days 1 - 3: One 150 mg tablet once a day.
Days 4 - 7: One 150 mg tablet twice a day, at least 8 hours apart.
It's a good idea to space your pills out so that the second pill of the day is several hours before bedtime as bupropion can make it hard to get to sleep.
Week 2: Continue to take one pill twice a day, at least 8 hours apart. Stop smoking during week two, on the day you picked to quit.
Week 3 and beyond: Continue as with week 2. The recommended course of treatment is 7 weeks, but it can be taken for a longer period of time. Your doctor will help you decide when you should stop treatment.
If you're unable to stop smoking by the end of week 3, your doctor may discontinue this medication, as it might not be a good fit for you as a quit aid. If that happens, don't worry. There are several other options on the market today that could work better for you.
Very Important: If you miss a dose and it's close to time for the next one, skip that pill. Never take a double dose to catch up as this could increase the risk for seizures.
If you take too much Bupropion accidentally, call your doctor, poison control or go to an emergency room at your local hospital immediately, even if you're not experiencing anything out of the ordinary.
Also, never stop taking this drug abruptly, unless you have one of the side effects in the section below where that is recommended. Consult with your doctor immediately if this happens.
Who should not use Bupropion
Bupropion isn't suitable for everyone. Avoid it if:
- You use any other drug containing bupropion hydrochloride
- You have or have had a seizure disorder
- You have or have had an eating disorder
- You are taking or have recently taken a monoamine oxidase inhibitor (MAOI)
- You are pregnant or nursing
- You are allergic to bupropion hydrochloride
- You are abruptly discontinuing alcohol or sedatives(including benzodiazepines)
Bupropion has many side effects, ranging from the common, those you should seek immediate medical attention for, to those that warrant stopping the drug immediately.
In 2009, the U.S. Food and Drug Administration required the makers of Zyban and Chantix, a similar quit aid to post a warning on product packaging about potentially severe side effects.
If you have any problems not listed below that are troublesome and you're concerned about whether they might be related to Bupropion, check in with your doctor as soon as possible.
Common side effects
- Dry mouth
- Change in appetite
- Change in sense of taste
- Weight loss
- Stomach pain
- Stuffy nose
- Uncontrollable shaking in a part of the body
- Ringing in the ears
- Sore throat
- Excessive sweating
- Frequent urination
If any of the above side effects become severe or don't go away, see your doctor.
Side effects you should seek immediate medical attention for
- irrational fears
- rapid, pounding or irregular heart rate
- muscle or joint pain
Side effects that warrant stopping Bupropion immediately
- Rash or blisters
- Swelling of the face, throat, tongue, lips, eyes, hands, lower legs
- Difficulty breathing or swallowing
- Chest pain
If you experience any of these side effects, discontinue Bupropion and see your doctor or go to an emergency room right away.
Of the small number of studies done on the effectiveness of Bupropion over the years, success rates seem to be in the 30% range for people who are smoke-free at the one year mark. However, the figures for people who have not smoked any cigarettes during the entire year drop to about 18%, or about one in five. When used with NRTs, the rate climbs slightly to approximately 22% for those who didn't smoke at all during the first year.
More importantly, perhaps, is how effective Bupropion can be when you couple it with a good support group of like-minded individuals for smoking cessation. Whether online or in person, support may be the single most important quit tool you can use.
- WebMD, What Are the Medicines for Nicotine Withdrawal? [website] 2019, https://www.webmd.com/smoking-cessation/understanding-nicotine-withdrawal-treatment#1, (accessed November 2, 2019).
- verywellmind, How Zyban Can Help With Quitting Smoking, [website] 2019, https://www.verywellmind.com/what-should-i-know-about-zyban-as-a-quit-aid-2825342, (accessed November 2, 2019).
- NIH, Chantix & Bupropion for Smoking Cessation (ChanBan), [website] 2013, https://clinicaltrials.gov/ct2/show/NCT00587769, (accessed November 2, 2019).
- Thomas A. Barringer, TA, Weaver EM, Does long-term bupropion (Zyban) use prevent smoking relapse after initial success at quitting smoking? [website] 2002, https://www.mdedge.com/familymedicine/article/59979/addiction-medicine/does-long-term-bupropion-zyban-use-prevent-smoking, (accessed November 2, 2019).