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Bupropion Hydrochloride (ZYBAN® Sustained-Release Tablets)
What Is It?
Bupropion is the generic name for the drug marketed as Zyban®, a prescription extended-release medication that reduces symptoms of nicotine withdrawal.
It acts on chemicals in the brain that are related to nicotine craving, but it does not contain nicotine. This medication, originally developed as an
anti-depressant, has been shown to work equally well for quitting smoking in people with and without a history of depression. Bupropion, under the trade
name Zyban®, has been available by prescription since 1998. It approximately doubles the likelihood of successfully quitting smoking compared to using no quit medication.
How do I use bupropion?
Treatment with bupropion begins while the user is still smoking, one week prior to the quit date. Treatment is then continued for 7 to 12 weeks.
Length of treatment should be based on the relative benefits and risks for each individual, and should be discussed with a physician. People
who have not made significant progress towards abstinence by the seventh week of therapy are unlikely to successfully quit during this attempt,
and bupropion treatment should be discontinued. Dose tapering is not required when discontinuing treatment.
One advantage of bupropion is that users begin taking the medication prior to quitting smoking, thereby priming his/her body to deal with the
stress of quitting. Some patients may lose their desire to smoke prior to their quit date or reduce the amount they smoke. Bupropion may be a
good choice for people who prefer an alternative to nicotine replacement, or who have not succeeded on traditional nicotine replacement therapies.
It is effective for both genders and has been shown to aide cessation in depressed patients. Heavily-addicted smokers may benefit from using bupropion
along with a nicotine patch and/or a short-acting form of NRT (such as gum or lozenges). Weight gain is delayed while taking it, not after stopping.
Bupropion is generally well tolerated in persons with cardiovascular disease.
What is the dose?
- Treatment with bupropion should be initiated while the person is still smoking. Approximately one week of treatment is required to achieve steady blood levels of the medication.
- Dosing should begin at 150 mg/day, given every morning for the first 3 days, followed by a dose increase for most people to the recommended dose of 300 mg/day.
- The maximum recommended dose is 300 mg/day, given as 150 mg twice daily. Some persons do well on 150 mg once a day and have fewer side effects.
- An interval of at least 8 hours between successive doses is advised.
- The quit attempt should occur during second week of treatment.
To help you determine if bupropion is right for you, consider using the QuitNet Medication Wizard.
If you decide to try Bupropion/Zyban®, see your doctor about a prescription.
More medically specific information ...
Alan S. Peters, CTTS-M
Ann Wendling, MD, MPH, April 2013