bupropion (Zyban)
Bupropion extended-release (SR), brand name Zyban, is an atypical antidepressant. It's taken by adults for smoking cessation (quitting smoking) only. It works by easing symptoms of nicotine withdrawal and lowering your cravings for nicotine. Bupropion (Zyban) isn't interchangeable with other forms of bupropion that are prescribed for mental health conditions. It comes as 150-mg tablets that are taken by mouth, typically twice per day. Side effects include trouble sleeping, dry mouth, and dizziness. This medication is only available as a generic; brand name Zyban has been discontinued.
What is Bupropion (Zyban)?
What is Bupropion (Zyban) used for?
- Smoking cessation (quitting smoking) in adults
How Bupropion (Zyban) works
Bupropion (Zyban) is an atypical antidepressant. This form of the medication is specifically used to help you quit smoking.
The exact way bupropion (Zyban) works in smoking cessation isn't well-understood. But it's thought to raise the levels of certain chemicals in the brain to ease symptoms of nicotine withdrawal. It also blocks nicotine receptors in the brain, which can curb cravings for cigarettes.
Drug facts
Side effects of Bupropion (Zyban)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Trouble sleeping (40%)
- Runny nose (12%)
- Dry mouth (11%)
- Dizziness (10%)
- Nausea (9%)
- Trouble concentrating (9%)
- Anxiety (8%)
- Constipation (8%)
- Joint pain (5%)
- Strange dreams (5%)
Less Common Side Effects
- Nervousness
- Rash
- Itching
- Stomach pain
- Diarrhea
- Not feeling hungry
- Cough
- Sore throat
- Muscle pain
- Change in taste
Bupropion (Zyban) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts or behaviors
- Serious allergic reaction or skin reaction: sore throat, fever, fatigue, rash, hives, painful blisters, skin reddening, skin peeling, swollen lymph nodes, swelling of the face, trouble breathing
- Seizures
The following Bupropion (Zyban) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Increase in blood pressure
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Seizures
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Constipation
- Dizziness
- Dry mouth
- Loss of appetite
- Nausea
- Tremors or shaking
- Trouble sleeping
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Pros and cons of Bupropion (Zyban)
Pros
- Taken by mouth
- Can take with or without food
- Can be combined with nicotine patch (Nicoderm CQ) for better results
Cons
- Taken twice per day
- Drinking alcohol at the same time can raise the risk of seizures and mood changes
- Commonly causes trouble sleeping
Pharmacist tips for Bupropion (Zyban)
- Swallow bupropion (Zyban) tablets whole. Don't crush, cut, or chew the tablets because this can damage the special coating that releases the medication into your body slowly over time. Damaging this special coating can raise your risk of side effects.
- It takes about a week for bupropion (Zyban) to start working. Schedule a smoking quit date within the first 2 weeks of starting bupropion (Zyban).
- Most people need to take bupropion (Zyban) for 7 to 12 weeks. But some people might need to take it longer. Follow up with your prescriber throughout treatment so they can see how you're doing. Let your prescriber know if you're unable to quit smoking after 12 weeks. They can review your treatment plan or help you find other options.
- Bupropion (Zyban) can cause dry mouth. To help with dry mouth, try staying hydrated and chewing sugar-free gum.
- People who take bupropion (Zyban) sometimes experience worsening mental health problems, such as depression. Let your prescriber know right away if you or your loved ones notice any sudden changes in your mood, behavior, or thoughts.
- Make sure to tell your care team about all of the medications you're taking and planning to take. Bupropion, the active ingredient in Zyban, can interact with other medications, including clopidogrel (Plavix) and other antidepressants. Your care team can check that all your medications are safe to take together.
- Speak with your prescriber if you become pregnant while you're taking bupropion (Zyban). It's not clear whether the medication is safe to take while pregnant, but some studies suggest it can cause harm. Because it's important to stop smoking during pregnancy, have a conversation with your care team about your options for treatment.
- Let your prescriber know if you're breastfeeding. Bupropion (Zyban) can get into breast milk, which might be harmful for nursing babies. But smoking while breastfeeding can also raise the risk of harm to your baby. Your care team can discuss options to help you quit smoking during breastfeeding.
Common questions about Bupropion (Zyban)
The FDA didn't specify why brand name Zyban was discontinued. But it did state that the reason isn't related to concerns for safety or how well it works. The generic form of Zyban, bupropion extended-release (SR), is still available in the market.
No, Zyban and Wellbutrin aren't interchangeable. They both contain the same active ingredient, bupropion. But Zyban is FDA-approved as an aid to help you quit smoking, while Wellbutrin is approved to treat depression. Brand-name Zyban has been discontinued, but it's available as generics. Wellbutrin is available as both brand name and generic medications. Talk with your healthcare team if you have more questions about Zyban and Wellbutrin.
No, bupropion (Zyban) is only FDA-approved as an aid to help you quit smoking. Bupropion comes in other formulations that are approved for depression. If you have or think you might have depression, talk with your healthcare team. They can talk with next-steps and your treatment options.
A study showed about 20% of people who took bupropion (Zyban) were able to quit smoking and continue to not smoke after receiving treatment for a year, compared to 10% of people who took placebo. If you're thinking about quitting smoking, talk with your healthcare team. They can talk with you about what to expect with bupropion (Zyban) treatment, as well as about a holistic plan that involves medications, behavioral therapy, and ways to avoid triggers.
No, bupropion (Zyban) is only available by a prescription from a healthcare professional. If you're looking for smoking cessation treatment that's available over the counter, there are some nicotine replacement products available, such as nicotine gum (Nicorette) and nicotine patches (Nicoderm CQ).
No, it's best to avoid alcohol while taking bupropion (Zyban). Drinking alcohol can raise your risk for bupropion (Zyban) side effects, such as depression and seizures. Also, taking bupropion (Zyban) can make you more sensitive to the effects of alcohol and put you at higher risk for alcohol poisoning.
People who took bupropion (Zyban) in clinical studies for smoking cessation didn't report weight gain as a side effect. But in general, people who try to quit smoking can experience some weight gain. This is because stopping nicotine can cause changes in the body, such as making you feel more hungry or slowing down your metabolism. If your concerned about possible weight gain, talk with your healthcare team. They can work with you to lower your risk of weight gain, such as planning healthy and well-balanced meals and an exercise routine that's appropriate for you.
Most people don't feel sleepiness or tiredness from taking bupropion (Zyban). But this medication commonly causes insomnia (trouble sleeping) as a side effect. If you have trouble sleeping at night, you're more likely to feel tired the next day. Contact your prescriber if bupropion (Zyban) is affecting your sleep.
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Risks and warnings for Bupropion (Zyban)
Bupropion (Zyban) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Suicidal thoughts or behavior and mood changes
- Risk factors: Ages 24 years or younger | History of depression or any mental health condition | Drinking alcohol
Bupropion (Zyban), like other antidepressants, can raise the risk of thoughts of suicide or harming yourself. The risk is higher for younger adults. Get medical help right away if you or anyone around you notices that you have signs of worsening depression or changes in mood. Call 911 if you have suicidal thoughts or behaviors.
Bupropion (Zyban) can also cause other mental health changes, like hallucinations, getting lost from reality (psychosis), paranoia, and delusions. These changes can occur in people with or without a history of mood problems. It's not clear whether they are caused by bupropion (Zyban) or whether some might be symptoms of nicotine withdrawal. It's important that you, your caregiver, and the people around you watch for depressed mood, feelings of uneasiness, and any changes of behavior, thoughts, or feelings while you're taking bupropion (Zyban). Stop taking the medication right away and talk to your prescriber if you have any concerning changes to your mental health.
Not for use alone in bipolar disorder
Before you start bupropion (Zyban), your prescriber will check whether you have or are at risk for bipolar disorder. Bupropion (Zyban) isn't approved to treat bipolar depression. Taking antidepressants can sometimes cause a manic episode to happen. The risk is higher for those with or at risk for bipolar disorder. Talk to your care team right away if you or your loved ones notice symptoms of a bipolar manic episode, such as racing thoughts, restlessness, getting easily distracted, or unusual talkativeness.
Seizures
- Risk factors: Taking a higher dose than recommended | Past seizures | Eating disorder | Head injury or medical conditions that can raise the risk for seizures | Taking other medications that raise the risk for seizures | Taking insulin or diabetes medications | Recently quitting alcohol or stopping treatment with certain medications | Alcohol or substance use disorder
Bupropion (Zyban) can raise your risk of having a seizure. Be sure to take the medication exactly as prescribed. Stop taking bupropion (Zyban) and tell your prescriber right away if you think you've had a seizure during treatment.
Don't take bupropion (Zyban) if you have a history of seizures or medical conditions that raise your risk for seizures, like head injury, stroke, or eating disorder. Also don't take bupropion (Zyban) if you've recently stopped drinking alcohol regularly or recently stopped taking benzodiazepines, barbiturates, or seizure medications.
High blood pressure
- Risk factors: History of high blood pressure | Taking other medications that can raise blood pressure
Bupropion (Zyban) can cause high blood pressure, especially in people who have or are at risk for high blood pressure. Your prescriber will check your blood pressure before you start this medication and also during your follow-up visits. They r might recommend that you check your blood pressure at home often. Tell your healthcare team if your blood pressure rises more than usual or if you feel dizzy or lightheaded.
Glaucoma
- Risk factors: History of angle-closure glaucoma
Bupropion (Zyban) can cause or worsen angle-closure glaucoma in some people. Tell your prescriber about your full medical history before you start this medication to make sure it's safe for you to take. Visit your optometrist or ophthalmologist right away if you have sudden symptoms of angle-closure glaucoma like severe headache, eye pain, nausea, and seeing halos around lights.
Severe allergic reaction and skin reaction
Severe allergic reactions to bupropion (Zyban) are possible, including life-threatening reactions like facial swelling and anaphylaxis (e.g., closing of the throat). Bupropion (Zyban) can also cause rare but serious skin reactions, like Stevens-Johnson syndrome.
Stop taking bupropion (Zyban) and get medical attention right away. if you notice unusual changes in your skin, like rash, painful blisters, skin reddening, or skin peeling, that can happen with or without sore throat, fever, and fatigue. Call 911 if you experience swelling in your face or if you have trouble breathing.
Bupropion (Zyban) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 150mg | 60 tablets | $24.26 | $0.40 |
Typical dosage for Bupropion (Zyban)
Your healthcare team will ask you to start bupropion (Zyban) when you're ready to quit smoking. Treatment starts after you've chosen a target quit day, while you're still smoking. Typically, the target quit day is set within the first 2 weeks after you begin taking the medication.
Adults: The typical starting dose is 150 mg by mouth once per day for 3 days, then 150 mg by mouth twice per day (separated by at least 8 hours). Treatment usually lasts 7 to 12 weeks.
Your dose might differ if you have liver or kidney problems.
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Bupropion (Zyban) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Bupropion (Zyban) will not be safe for you to take.
- Seizures
- Currently have or have had a eating disorder (e.g., bulimia, anorexia)
- Stopping alcohol, benzodiazepines, barbiturates, or antiepileptic (anti-seizure) medications suddenly
- Currently take, have recently taken within the last 14 days, or plan to take within the next 14 days medications called monoamine oxidase inhibitors (MAOIs) (e.g., phenelzine, linezolid (Zyvox), and methylene blue).
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