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You may have nicotine withdrawal symptoms when you stop smokingincludingincreased appetiteweight gaintrouble sleepingtrouble concentratingslower heart ratehaving the urge to smokeand feeling anxiousrestlessdepressedangryfrustratedor irritatedThese symptoms may occur with or without using medication such as Zyban.

This drug passes into breast milk and may have undesirable effects on a nursing infantConsult your doctor before breast-feeding.

The functioning agent in Champix is a nicotinic receptor partial agonistThis means that it stimulates some of the receptors in the brain which are susceptible to nicotinenamelythe acetylcholine receptors.

Your doctor will start you on a 150 mg tablet in the morningand may or may not increase this to twice a dayEvidence suggests that once-daily dosing is as effective as taking it twicewith fewer side effects.

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This medication may interfere with certain medical/laboratory testsincluding brain scan for Parkinson’s diseaseurine screening for amphetaminespossibly causing false resultsTell laboratory personnel and all your doctors you use this drug.

The initial dose is 150mg to be taken daily for six daysincreasing on day seven to 150mg twice daily.

What to doPatients should be warned of the risks of potential serious adverse effects of these medicationsincluding seizures and allergic reactionsZyban and Wellbutrin SR should not be administered concurrentlynor should they be prescribed to patients with a seizure disorderFurthermorebupropion should not be administered to patients with conditions altering the seizure thresholdincluding anorexia nervosa or bulimiapatients with potential benzodiazepine or alcohol withdrawalthose with head trauma or central nervous system pathologyor patients taking antipsychotic drugssystemic steroidsquinolone antibiotics or antimalarial drugsDoses should be limited to no more than 150 mg per single dose and to no more than 300 mg per dayIf a seizure or allergic reaction occursthe medication should be discontinued and appropriate medical attention soughtTo avoid prolonged QT intervals and ventricle arrhythmias secondary to thioridazine toxicitybupropion should not be administered if a monoamine oxidase inhibitor or thioridazine antipsychotic drug has been given within the past 14 daysBupropion is contraindicated in patients with severe hepatic impairmentA patient information sheet is now available online4.

Patients with hepatic impairmentBupropion is extensively metabolised in the liver to active metaboliteswhich are further metabolisedNo statistically significant differences in the pharmacokinetics of bupropion were observed in patients with mild to moderate hepatic cirrhosis compared with healthy volunteersbut bupropion plasma levels showed a higher variability between individual patientsTherefore Zyban should be used with caution in patients with mild to moderate hepatic impairment and 150 mg once a day is the recommended dose in these patients.

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