ZYBAN Rx

Indications for ZYBAN:

Aid in smoking cessation.

Adult Dose for ZYBAN:

Swallow whole. Set target quit date within 1–2 weeks after start. Treat for 7–12 weeks; reevaluate if no significant progress by week 7; up to 6 months' therapy has been shown to be effective. Avoid bedtime dosing. ≥18yrs: initially 150mg once daily for 3 days, then 150mg twice daily at least 8 hrs apart; max 300mg/day in divided doses. Severe hepatic cirrhosis: max 150mg every other day. Mild-moderate hepatic cirrhosis, renal impairment: may give less often.

Children's Dose for ZYBAN:

<18yrs: not recommended.

Pharmacological Class:

Aminoketone.

Contraindications:

Seizure disorders. Bulimia. Anorexia nervosa. Within 14 days of MAOIs. Abrupt withdrawal of sedatives or alcohol. Other forms of bupropion (eg, Wellbutrin).

Warnings/Precautions:

Psychiatric disorders (monitor). History or risk of seizures; discontinue if seizure occurs: do not restart. Depression: clinical worsening or suicidal risk (monitor). Bipolar disorder. Psychosis. Hypertension. Unstable heart disease. Recent MI. CHF. Hepatic or renal impairment (monitor closely). Elderly. Labor & delivery. Pregnancy (Cat.C): not recommended, attempt nondrug treatment first. Nursing mothers: not recommended.

Interactions:

See Contraindications. Avoid alcohol. May use with transdermal nicotine (monitor for hypertension). MAOIs, levodopa, amantadine may increase toxicity. Caution with drugs that lower seizure threshold (eg, quinolones, theophylline, antidiabetics, anorectics, CNS stimulants, systemic steroids, antidepressants, antipsychotics), or factors that lower seizure threshold (eg, opiate or cocaine addiction, excessive use of alcohol or sedatives). Caution with drugs metabolized by CYP2B6 (eg, orphenadrine, cyclophosphamide) or CYP2D6 including tricyclic antidepressants, SSRIs (eg, paroxetine, fluoxetine, sertraline), antipsychotics (eg, haloperidol, risperidone, thioridazine), β-blockers (eg, metoprolol), Class 1C antiarrhythmics (eg, propafenone, flecainide); consider dose reduction. May be affected by metabolic enzyme inducers (eg, carbamazepine, phenobarbital, phenytoin) or inhibitors (eg, cimetidine). Smoking cessation potentiates theophylline, warfarin, insulin, β-blockers, pentazocine, oxazepam, tricyclics (eg, imipramine), caffeine, acetaminophen, adrenergic antagonists (eg, prazosin, labetolol), others. Smoking cessation antagonizes adrenergic agonists (eg, isoproterenol, phenylephrine), others.

Adverse Reactions:

Dry mouth, insomnia, dizziness, rash (rarely may be serious, eg, erythema multiforme, Stevens-Johnson syndrome), pruritus, constipation, asthenia, fever, headache, palpitations, sweating, visual changes, anorexia, GI effects, urinary frequency; serious neuropsychiatric symptoms (eg, behavioral changes, agitation, depression, suicidal ideation, hallucinations), cardiovascular effects.

How Supplied:

Tabs—60; Advantage Pack (1x60 tabs)—1