A combination of bupropion with counselling can increase your chance of successfully stopping smoking.
Start taking the tablets at least a week before your target stop date.
The most common side-effect is difficulty sleeping - the risk of this is less if you avoid taking doses near bedtime.
|Type of medicine||A smoking cessation aid|
|Used for||Helping people to stop smoking|
Nicotine is a drug that is inhaled from the tobacco in cigarettes. It gets into the bloodstream, and stimulates the brain. Most regular smokers are addicted to nicotine. Even though you want to quit smoking, it can be difficult to succeed, because nicotine addiction is strong and hard to break. This is where bupropion can help.
Stopping smoking in somebody who smokes regularly causes a reduction of some chemicals in the brain. This leads to withdrawal symptoms such as cravings, anxiety, irritability and other symptoms associated with 'giving up'. Bupropion alters the levels of some of these chemicals and this is possibly how it relieves the withdrawal symptoms.
Bupropion does not 'make' you stop smoking. You still need determination to succeed and to break the smoking habit. A combination of bupropion with counselling from a nurse, doctor, pharmacist, or other health professional increases your chance of successfully stopping smoking. Therefore, most doctors will only prescribe bupropion to people who really want to stop smoking as part of a 'stopping smoking' programme.
Bupropion is also available as a combination product to support weight loss. If you are taking bupropion for this purpose and you need additional information, ask your pharmacist or doctor for advice.
Before taking bupropion
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking bupropion it is important that your doctor knows:
- If you are under 18 years of age, or over 65 years old.
- If you are pregnant or breastfeeding.
- If you have any problems with the way your liver works, or any problems with the way your kidneys work.
- If you have diabetes (diabetes mellitus).
- If for any reason you are at risk of having a seizure.
- If you have ever had an eating disorder, such as anorexia nervosa or bulimia.
- If you have bipolar disorder.
- If you regularly drink a lot of alcohol or if you have a drug problem.
- If you have been told you have a tumour of the brain or spinal cord, or if you have ever had a serious head injury.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines. This is particularly important if you are taking digoxin for a heart condition. Your dose of digoxin may need to be adjusted before or after treatment with bupropion.
- If you have ever had an allergic reaction to a medicine.
How to take bupropion
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about bupropion and stopping smoking. It will also provide you with a full list of the side-effects which can be associated with bupropion.
- Take bupropion exactly as your doctor tells you to. You will be asked to set yourself a date on which to stop smoking. Your doctor will then ask you to start taking bupropion tablets at least a week before this 'quit' date. The aim is to build up the dose so that your body gets used to the medicine before your quit date.
- Start by taking one tablet (150 mg) each day for the first six days. Then from day seven onwards, take one tablet twice a day (unless you are told otherwise by your doctor). Make sure that you leave at least eight hours between the doses. Ideally, take one tablet in the morning and one early evening. Remember to stop smoking on the day you have set as your quit date.
- It is not important whether you take bupropion tablets before or after food, but it is best if you try to take your doses at the same time(s) each day. This will help you to remember to take the tablets regularly.
- Swallow the tablets whole with a glass of water - do not chew or break the tablets before you swallow.
- If you forget to take a dose, leave out the missed dose but make sure that you remember to take your next dose when it is due. Do not take two doses together to make up for the forgotten dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor or nurse. This is so that you can be given counselling and encouragement, and also so that a check can be kept on your progress. You will also need to have your blood pressure measured regularly, as this can increase in some people.
- Make sure that your doctor or healthcare professional knows if you are taking any other medicines. This is because stopping smoking can change the way your body breaks down certain medicines. So, as a result of quitting, the dose of some prescribed medicines may need to be adjusted.
- A full course of treatment with bupropion will last for 7-9 weeks in total. If you are still smoking after seven weeks, let your doctor know about this so that you can discuss the options that are available to you.
- After your course of treatment, your doctor may suggest that you gradually reduce the dose over a few days before you finally stop taking the tablets.
- If you buy any medicines, always check with a pharmacist that they are safe to take with your other medicines.
Can bupropion cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with bupropion. You will find a full list in the manufacturer's information leaflet supplied with your medicine. Some of the symptoms may also occur as a result of stopping smoking.
|Common bupropion side-effects||What can I do if I experience this?|
|Difficulty sleeping||Try to avoid taking your last dose near to bedtime|
|Feeling dizzy, difficulty concentrating||If this happens, do not drive and do not use tools or machines until you feel better|
|Headache||Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets|
|Feeling sick (nausea) or being sick (vomiting), stomach upset||Keep to simple foods. Try taking the tablets after meals|
|Constipation||Eat a well-balanced diet and drink plenty of water each day|
|Mood changes, changes to the way things taste, feeling shaky, itchy rash, sweating, high temperature (fever)||If troublesome, speak with your doctor|
Important: if you feel depressed or start having thoughts about harming yourself, you must let your doctor know straightaway. Depression can occur as a symptom of nicotine withdrawal and it can also on occasion occur as a result of taking bupropion.
On rare occasions, medicines that affect the level of serotonin in the brain can cause it to go too high and cause problems. The risk is higher if you are taking more than one medicine with this effect. Seek medical attention if you develop any combination of the following:
- Stiff muscles or 'jerky' movements.
- Unusually fast heartbeat.
- High temperature (fever), feeling sick (nausea) or being sick (vomiting), diarrhoea.
- Feeling delirious or seeing visions (hallucinating).
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store bupropion
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Do not give it to others, even if their condition appears to be the same as yours.
Further reading and references
Manufacturer's PIL, Zyban® 150 mg prolonged-release film-coated tablets; GlaxoSmithKline UK, The electronic Medicines Compendium, November 2019.
British National Formulary, 80th Edition (Sep 2020); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.