Zyban
Zyban
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                                                   ZYBAN

Zyban also known by its chemical name bupropion is a drug which is widely used to help in quitting the smoking habit by reducing the cravings and other withdrawal symptoms. There are various other purposes which are not listed in the medicine guide.

Product Description

Zyban sustained tablets are basically non nicotine aid for smoking cessation. The drug is not chemically related to nicotine or any other agents which are currently used for the treatment of addiction to nicotine. Initially the drug was developed as an anti depressant and was marketed as Wellbutrin tablet. Zyban is also chemically unrelated to tetracyclic, tricyclic inhibitor or some other known antidepressant agents. The molecular formula of Zyban is C13H18ClNO&bul. Bupropion hydrochloride (Zyban) powder is crystalline, white and shows highly soluble propeties in water. The medicine is known to have bitter taste and also produces sensation of anaesthesia on mucosa.

ZYBAN is mostly supplied  for oral administration in the form of 150-mg, purple film-coated, release tablets. Each tablet includes the label of bupropion hydrochloride and also the inactive ingredients cysteine hydrochloride, magnesium stearate, polysorbate  80, polyethene glycol, microcrystalline cellulose, and titanium dioxide which is printed with black ink.

Mechanism of Action

Mechanism with which Zyban helps in enhancing the overall ability of patients to completely abstain from smoking in not yet know, but it is presumed that there is some relation to dopaminergic mechanisms. It is a comparatively a weak inhibitor of neuronal uptake of dopamine and do not inhibit the update of serotonin.

Dosage Pattern

-      Zyban treatment can be initiated before the plan of quitting because the process and effect of medicine will take nearly one week to achieve steady blood levels of bupropion. The patient should keep a target date for quitting the smoke within initial first two weeks of treatment.

-      To minimise the risk of seizure: Start the dose with one tablet of 150 mg per day for first three days. Then increase the dose to almost 300 mg per day with 150 mg tablet twice with the interval of almost 8 hours between each dose. The dose should increase more than 300 mg per day.

-      The medicine should be taken as whole without crushing, driving and chewing as this could cause an increased risk of seizure.

The drug can be taken with or without food.

Duration of Treatment

The treatment with Zyban should be continued till 12 weeks. If the patient has not quit his smoking  habits within these 7 to 2 weeks that means the patient will not quit and this would require complete re analysis of the treatment. The goal of therapy is to achieve complete abstinence.

Dose for Patients with Hepatic Impairment

-      Moderate to Severe Impairment: Dose should not exceed more than 150 mg per day.

-      Mild hepatic impairment: Consider decreasing the dose or frequency of dose.

Dose Adjustment in Patients with Renal Impairment

- Reduce the dose or the frequency of dose in patients suffering from renal impairment.

Storage

-      Always store the medicine at normal room temperature between 20-25 degree celsius

-      Always keep the medicine away from direct sunlight

-      Keep the medicine away from moisture

-      Canadian product needs to be stored between 15 to 25-degree celsius.

-      The tablets have a strange odour which is quite normal. The medicine is still very safe to use.

-      Do not store the medicine in the bathroom

-      Keep all the medicines always from children

-      Keep it off the reach from the pets

-      Do not flush the drug into toilet to pour them into drain

-      Follow the instructions carefully as mentioned on the instruction leaflet

-      Properly discard the medicine when no longer needed or expired.

-      Consult the local pharmacy or waste disposal management company for more details how to safely discard the product.

PRECAUTIONS

-      General: Allergic Reactions:   There is post marketing symptoms of the syndrome known as Stevens-Johnson and also anaphylactic shock which is also associated with zyban intake.

-      In such cases, patients should stop taking Zyban and immediately consult a doctor if there is any allergic action like skin rash, chest pain, hives, shortness of breathe and deem during the treatment.

-      Fever with the rash, delayed hypersensitivity have also been reported in relation to bupropion.

-      Insomnia: Symptoms of insomnia can be reduced by avoiding the dose during the bedtime and if required, there should be a reduction in dose.

-      Neuropsychiatric Phenomena: As the study of clinical trials, Zyban conducted non-depressed smokers and the incidence of different neurotic side effects. A depressed patient, when treated with bupropion, can lead to depression trails and also shows a variety of signs such as delusion, psychosis, hallucinations, concentration disturbance, confusion and paranoia. These symptoms in some cases can be abated once the dose is reduced or with the withdrawal of treatment.

-      Activation of Neuro-psychosis: Almost all the antidepressants can lead to maniac episodes through bipolar disorders during the depressed phase of illness and can activate latent psychosis among susceptible individuals. The sustained formulation of Zyban is expected with similar risk.

-      Nicotine Withdrawal:  Patients with the withdrawal of nicotine are prone to depressed mood. Depression, rarely have a chance of  suicidal ideation and has been widely reported in patients who is undergoing smoking cessation attempt.

-      Cardiovascular Effects:  There have been reported cases of acute treatment, hypertension in the clinical studies

-      With no clinical experience ensuring the safety of Zyban among patients with myocardial infarction.

-      Zyban has been associated with an immediate rise in supine blood pressure resulting in discontinuation of treatment for patients suffering from baseline hypertension.

-      Hepatic Impairment:  The medicine should handle with extreme caution among patients suffering from hepatic cirrhosis.These patients have a reduced frequency due to the dose.

-      All patients suffering from hepatic impairment needs to be closely monitored for possible side effects due to high drug level.

-      Renal Impairment:   There are no clinical study conducted on the patients suffering from renal impairment. Zyban is metabolised in live to start activating the metabolites.

-      Zyban is not used in the treatment of depression any longer but it contains some active ingredients like WellbutrinXL which are also found in active antidepressant medicines.

Side Effects

-       Commonly known side effects includes: weight loss, insomnia, xerostomia, nausea, dizziness.

-       Other effects are chest pain, skin rash, hypertension, palpitations, tremor, migraine, anxiety, dysgeusia and diaphoresis.

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