What is the most important information I should know about Zyban?

• You should not take Zyban if you have epilepsy or a seizure disorder, an eating disorder such as anorexia or bulimia, if you are using a second form of Zyban, or if you have suddenly stopped using alcohol or sedatives. Do not take Zyban if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.
• You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are 18 years of age or younger. Talk with your doctor about this risk. While you are taking this medication you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
• Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), or thoughts of suicide or hurting yourself.
• Do not stop taking Zyban without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.
• Avoid using Zyban to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking. Too much of this medicine can increase your risk of a seizure.
• Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.
• Avoid drinking alcohol while taking Zyban. Alcohol may increase your risk of a seizure while you are taking Zyban. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Zyban can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.
• There are many other drugs that can affect Zyban. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What is Zyban?

• Zyban is an antidepressant medication.
• Zyban is used to treat major depressive disorder and seasonal affective disorder.
• At least one brand of Zyban (Zyban) is used to help people stop smoking by reducing cravings and other withdrawal effects.
• Zyban may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Zyban?

• Do not take Zyban if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.
• You should not take Zyban if you have:
  • epilepsy or a seizure disorder;
  • an eating disorder such as anorexia or bulimia;
  • if you are using a second form of Zyban; or
  • if you have suddenly stopped using alcohol or sedatives (such as Valium).
• Zyban may cause seizures, especially if you have any of the following conditions:
  • head injury, brain or spinal cord tumor;
  • bipolar disorder (manic depression);
  • diabetes for which you use insulin or take oral medication;
  • current use of steroids, theophylline (Theo-Dur, Slo-Bid, Bronkodyl Theolair, Respbid), or medicine to treat depression or mental illness; or
  • recent use of alcohol, sedatives (such as Valium), narcotic pain medicines, diet pills, or street drugs such as “speed” or cocaine.
• Before taking Zyban, tell your doctor if you have high blood pressure, heart disease, liver disease, kidney disease, or severe liver disease (especially cirrhosis).
• You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. While you are taking Zyban, you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
• Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), or thoughts of suicide or hurting yourself.
• FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
• Zyban passes into breast milk and could be harmful to a nursing baby. Do not take Zyban without telling your doctor if you are breast-feeding a baby.
• You should not smoke if you use inhaled insulin (Exubera) to treat diabetes. Smoking may cause you to have low blood sugar (hypoglycemia) while using Exubera. Do not use Exubera unless you have been smoke-free for at least 6 months. Do not start smoking again or you will have to stop using Exubera.

How should I take Zyban?

• Take Zyban exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.
• Zyban can be taken with or without food.
• Take each dose with a full glass of water.
• Do not crush, chew, or break the extended-release tablet (Wellbutrin SR, Wellbutrin XL, Zyban SR). Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.
• If you take Zyban to help you stop smoking, you may continue to smoke for about 1 week after you start the medicine. Set a date to quit smoking during the second week of Zyban treatment. By that time you will have enough of the medicine in your blood stream to help you quit smoking. Talk to your doctor if you are having trouble quitting after you have used Zyban for at least 7 weeks.
• Your doctor may prescribe nicotine patches or gum to help support your smoking cessation treatment. Be sure you read all directions and safety information for the nicotine product. Using nicotine with Zyban may raise your blood pressure and your doctor may want to check your blood pressure regularly. Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.
• Do not stop taking Zyban without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.
• If you use the Zyban extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.
• Store Zyban at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

• Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a Zyban overdose may include seizures, muscle stiffness, hallucinations, fainting, fast or uneven heartbeat, shallow breathing, heart failure, or coma.

What should I avoid while taking Zyban?

• Avoid drinking alcohol while taking Zyban. Alcohol may increase your risk of a seizure while you are taking Zyban. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Zyban can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.
• Avoid using Zyban to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking. Too much of this medicine can increase your risk of a seizure.
• Zyban can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
• You should not smoke if you use inhaled insulin (Exubera) to treat diabetes. Smoking may cause you to have low blood sugar (hypoglycemia) while using Exubera. Do not use Exubera unless you have been smoke-free for at least 6 months. Do not start smoking again or you will have to stop using Exubera.

What are the possible side effects of Zyban?

• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Stop using Zyban and call your doctor at once if you have a seizure (convulsions) or fast, uneven heartbeats.
• Continue taking Zyban and talk to your doctor if you have any of these less serious side effects:
  • headache or migraine;
  • sleep problems (insomnia);
  • nausea, vomiting, constipation, dry mouth;
  • confusion, dizziness, agitation, tremors (shaking);
  • appetite changes, weight loss or gain;
  • mild itching or skin rash, increased sweating; or
  • loss of interest in sex.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Zyban?

• Do not take Zyban if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.
• There are many other drugs that can affect Zyban. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.