Zyban (Bupropion) belongs to the family of medications known as antidepressants. It is used in addition to counselling, as an aid for quitting smoking. It may also be used with Nicotine replacement products. In general, nicotine replacement therapy alone should be tried before using Zyban (Bupropion). Zyban (Bupropion) works by affecting the balance of chemicals that occur naturally in the brain. This helps reduce withdrawal symptoms and the urge to smoke.

Zyban (Bupropion) may be available under multiple brand names and/or in several different forms. Any specific brand name of Zyban (Bupropion) may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Zyban (Bupropion) may not be used for all of the conditions discussed here.

Your doctor may have suggested Zyban (Bupropion) for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking Zyban (Bupropion), speak to your doctor. Do not stop taking Zyban (Bupropion) without consulting your doctor.

Do not give Zyban (Bupropion) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Zyban (Bupropion) if their doctor has not prescribed it.

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The recommended dose as an aid for smoking cessation is 150 mg daily for 3 days, followed by 150 mg twice daily. You should start taking Zyban (Bupropion) at least one week before stopping smoking. Treatment with Zyban (Bupropion) is usually for 7 to 12 weeks.

Multiple daily doses should be taken at least 8 hours apart. It is very important that Zyban (Bupropion) tablets be swallowed whole and not chewed, broken, or crushed. Zyban (Bupropion) may be taken with food or on an empty stomach.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that Zyban (Bupropion) be taken exactly as prescribed by your doctor. If you miss a dose of this skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Zyban (Bupropion) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Zyban (Bupropion). If you are concerned about side effects, discuss the risks and benefits of Zyban (Bupropion) with your doctor.

The following side effects have been reported by at least 1% of people taking Zyban (Bupropion). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• Constipation
• dizziness
• Dry Mouth
• increased appetite
• joint or muscle pain
• nausea or vomiting
• stuffy or runny nose
• trouble concentrating
• trouble sleeping
• weight changes

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• agitation
• anxiety
• extreme distrust
• false beliefs that cannot be changed by facts
• hallucinations
• headache (severe)
• increased blood pressure
• low sodium levels in the blood (e.g., tiredness, weakness, confusion, with achy, stiff, or uncoordinated muscles)
• new or worsened emotional or behavioural problems
• signs of liver problems (e.g., nausea, vomiting, Diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• skin rash, Hives, or itching
• symptoms of Glaucoma (e.g., blurred vision, seeing halos of bright colours around lights, red eyes, increased pressure in your eyes, eye pain or discomfort)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• seizures
• signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with Fever or discomfort
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• symptoms of serotonin syndrome (e.g., confusion, fast heartbeat, hallucinations, restlessness, shaking, shivering, sudden jerking of muscles, sweating)
• thoughts of self-harm or suicide

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Zyban (Bupropion).

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Your privacy is important. That's why we send your medication inside a plain delivery box so no one will know what's inside.

Each purple, round, biconvex, film-coated, sustained-release tablet, printed "ZYBAN 150", contains 150 mg of Zyban (Bupropion) HCl. Nonmedicinal ingredients: carnauba wax, cysteine hydrochloride, edible black ink, FD&C Blue No. 2 Lake, FD&C Red No. 40 Lake, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, and titanium dioxide.

Do not take Zyban (Bupropion) if you:

• are allergic to Zyban (Bupropion) or to any of the ingredients of Zyban (Bupropion)
• are currently taking thioridazine (an antipsychotic medication) or have taken it in the past 2 weeks
• are having abrupt withdrawal issues from alcohol, benzodiazepines (e.g., Diazepam, Clonazepam, Lorazepam), or other sedatives (e.g., Phenobarbital)
• are taking another medication that contains Zyban (Bupropion) (e.g., Wellbutrin XL® or Wellbutrin® SR)
• have a seizure disorder
• have or have had an eating disorder (bulimia or anorexia nervosa)
• have taken a monoamine oxidase inhibitor (MAO inhibitor; e.g., Phenelzine, Tranylcypromine) within the past 2 weeks

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There may be an interaction between Zyban (Bupropion) and any of the following:

• alcohol
• amphetamines (e.g., amphetamine, Dextroamphetamine, Lisdexamfetamine)
• antihistamines (e.g., doxylamine, Diphenhydramine, Hydroxyzine)
• anti-malarial medications (e.g., chloroquine, Mefloquine)
• anti-Parkinson medications (e.g., amantadine, Apomorphine, Bromocriptine, levodopa, Pramipexole, Ropinirole) – dopamine agonists
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Risperidone, thioridazine)
• Atomoxetine
• beta-blockers (e.g., Metoprolol, Propranolol, Timolol)
• caffeine
• Carbamazepine
• Clopidogrel
• Codeine
• Cyclophosphamide
• Dabrafenib
• dexmethylphenidate
• Dextromethorphan
• Digoxin
• Doxorubicin
• Duloxetine
• efavirenz
• Eliglustat
• Fesoterodine
• Flecainide
• Galantamine
• Gefitinib
• Linezolid
• levodopa
• linezolid
• lithium
• lopinavir
• lumacaftor and Ivacaftor
• Methylphenidate
• Metoclopramide
• Mexiletine
• mifepristone
• Mirtazapine
• monoamine oxidase inhibitors (MAO inhibitors; e.g., phenelzine, tranylcypromine, Moclobemide, Selegiline) – Zyban (Bupropion) should not be started until at least 14 days after MAO inhibitors are stopped
• nelfinavir
• phenobarbital
• Phenytoin
• primidone
• Propafenone
• promethazine
• rifampin
• ritonavir
• ropinirole
• Rotigotine
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Escitalopram, Fluoxetine, Paroxetine, Sertraline)
• Tamoxifen
• Tetrabenazine
• theophylline
• Ticlopidine
• Tolterodine
• Tramadol
• tricyclic antidepressants (e.g., Nortriptyline, Imipramine, Desipramine)
• Venlafaxine
• Vilazodone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Zyban (Bupropion). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Zyban (Bupropion). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Zyban (Bupropion).

Drowsiness/reduced alertness: Zyban (Bupropion) may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how Zyban (Bupropion) affects you.

Glaucoma: Zyban (Bupropion) may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how Zyban (Bupropion) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zyban (Bupropion), and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking Zyban (Bupropion).

Heart disease: It is not known whether Zyban (Bupropion) is safe for use by people with a recent history of Heart Attack or unstable heart disease. If you have heart problems, discuss with your doctor how Zyban (Bupropion) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zyban (Bupropion), and whether any special monitoring is needed.

Zyban (Bupropion) can cause increased blood pressure, making some heart conditions worse. If you have high blood pressure, or are taking medication for high blood pressure, make sure your doctor is aware.

Identical medications: Wellbutrin®, Zyban®, and several other medications contain the same active ingredient (Zyban (Bupropion)). If you are taking one of these medications, do not take any other product containing Zyban (Bupropion), as the risk of seizures increases with an increased dosage. To reduce the risk of seizures, the total daily dose of Zyban (Bupropion) should not be greater than 300 mg.

Kidney function: Zyban (Bupropion) is removed from the body by the kidneys. Decreased kidney function can cause Zyban (Bupropion) to build up in the body, causing side effects. If you have Kidney Disease, discuss with your doctor how Zyban (Bupropion) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zyban (Bupropion), and whether any special monitoring is needed.

Liver function: Zyban (Bupropion) is removed from the body by the liver. Decreased liver function can cause Zyban (Bupropion) to build up in the body, causing side effects. If you have liver disease, discuss with your doctor how Zyban (Bupropion) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zyban (Bupropion), and whether any special monitoring is needed.

Zyban (Bupropion) may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Mental health: Zyban (Bupropion) may cause behavior and thought disturbances to worsen for people who have psychotic conditions. It may also cause symptoms of psychosis and mania to develop for people who have not had these symptoms before. If you experience symptoms such as hallucinations, mania (feeling unusually over-excited or uninhibited), or delusional thinking, or notice them in a family member who is taking Zyban (Bupropion), contact your doctor as soon as possible.

Seizure risk: Zyban (Bupropion) may increase the risk of seizures.  If you are at risk of seizures, discuss with your doctor how Zyban (Bupropion) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zyban (Bupropion), and whether any special monitoring is needed.

Things which increase the risk of seizures include:

• addiction to cocaine, stimulants, or opiates (such as Morphine)
• Diabetes treated with oral medications or insulin
• excessive alcohol use
• history of head trauma or seizures (including Epilepsy)
• severe liver problems
• tumours of the brain or spinal cord
• use of other medications that make seizures more likely (e.g., antipsychotics, antidepressants, lithium, Theophylline, steroids)
• use of over-the-counter stimulants or appetite suppressants

Serotonin syndrome: Severe reactions are possible when Zyban (Bupropion) is combined with other medications that act on serotonin, such as tricyclic antidepressants and serotonin reuptake inhibitors – other medications used to treat Depression. Similar effects occur when too much Zyban (Bupropion) is taken or is allowed to build up in the body. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. These reactions should be treated as a medical emergency and immediate medical treatment should be obtained as coma and death are possible.

Suicidal or agitated behaviour, or other behaviour changes: Adults and children taking Zyban (Bupropion) may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after people start taking Zyban (Bupropion). If you experience these side effects or notice them in a family member who is taking Zyban (Bupropion), contact your doctor immediately. Your doctor will monitor you for emotional and behavioural changes while you are taking Zyban (Bupropion).

Pregnancy: The safety of Zyban (Bupropion) during pregnancy has not been established. It has been reported that babies born to pregnant women who have taken medications of this kind during the last trimester of pregnancy may be adversely affected. Physicians and pregnant women should carefully consider the benefits and the risks of all treatment options. If you become pregnant while taking Zyban (Bupropion), contact your doctor immediately.

Breast-feeding: Zyban (Bupropion) passes into breast milk. Because Zyban (Bupropion) presents risks to breast-feeding infants, a decision should be made whether to discontinue breast-feeding or to discontinue Zyban (Bupropion), taking into account the importance of the medication to the mother. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Zyban (Bupropion) have not been established for children and adolescents under 18 years old. The use of Zyban (Bupropion) in children below the age of 18 may cause behavioural and emotional changes, such as suicidal thoughts and behaviour.

Seniors: Because Zyban (Bupropion) is removed from the body by the kidney and liver, seniors may be at an increased risk of side effects, including seizures, if they use Zyban (Bupropion). If you are over 65, discuss with your doctor whether any special monitoring is required.

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