Oral medication to help quit smoking

There is no one miraculous drug treatments to guarantee success with giving up smoking, but there are 2 licensed prescription only medications that can increase your chance of quitting.

Bupropion (Zyban)

Bupropion is classified as an antidepressant and has been used for many years to help with depression. However, it was discovered that a lot of people taking Bupropion were successfully quitting smoking. It is unclear as to exactly how it works, but it helps relieve the withdrawal symptoms when quitting smoking.
  • It can only be prescribed by a doctor or nurse prescriber who will assess your suitability for taking it.
  • It is advised for smokers that smoke more than 15 cigarettes a day and are motivated to give up smoking.
  • Approximately 1 in 5 smokers motivated to quit smoking will succeed with the help of Bupropion.

How to take Bupropion

  • Take on 150 mg tablet every day for the first 6 days, then increase the dose to 150mg twice a day 8 hours apart.
  • You continue to smoke during this time and aim to stop within 10 days of taking the medication.
  • Continue taking 1 tablet twice a day for 7 more weeks (8 weeks in total).

If elderly or have liver or kidney problems the dose will be reduced for you.

Side effects of Bupropion

Many take Bupropion without any side effects, but your doctor will inform you of the possible side effects: among the most common are:
  • Insomnia
  • Dry mouth
  • Taste disturbances
  • Headaches

More serious side effects include:
  • Drowsiness - therefore do no drive or operate machinery.
  • High Blood pressure (BP) - you will need to have your blood pressure checked before commencing Bupropion and regularly after and some people may have a rise in BP.
  • A fit or convulsion (seizure) - this is uncommon but approximately 1 in 1000 people will have one. It is therefore not suitable for some people - see list below.

Bupropion is not suitable for all people

Do not take if you;
  • Are under the age of 18
  • Are pregnant or breast feeding
  • Have a history or seizures and or are epileptic
  • Have ever had anorexia nervosa or bulimia nervosa
  • Have a history of bipolar disorder (manic depression)
  • Are taking antidepressants or antipsychotics
  • Taking antimlarials such as mefloquine and chloroquine
  • Abuse of alcohol
  • History of head trauma or tumour

Varenicline (Champix®)

Varenicline mimics the effects of nicotine on the body reducing the urge to smoke. It acts on receptors in the brain that the nicotine would normally stimulate. It blocks these receptors and therefore the effects of nicotine, reducing the withdrawal symptoms you get when quitting smoking.

You need to be motivated to quit smoking and must seek help from a health care professional, this will increase you success of quitting.
  • This medicine is only available on prescription
  • It is advised for those who smoke more than 15 cigarettes a day.
  • Success rate at 12 months is of approximately of 22%.

How to take Varenicline

  • You must set a date that you will stop smoking.
  • One week before your quit date you start taking one 0.5mg tablet for 3 days . You then increase to 0.5mg twice a day for 4 days then increase to 1 mg twice a day for 11 weeks.
  • Take preferably after food with a glass of water.

Side effects of Varenicline

  • Nausea appears to be the most common side effect.
  • Headaches, sleep disorders, abnormal dreams.

People who should no take Varenicline

  • This drug is contraindicated for pregnant and breast feeding women.
  • People with under lying psychiatric illness and all patients must be warned if they develop any suicidal thoughts or behaviour to discontinue the medication immediately and seek medical help.

A study was carried out on 746 smokers who had smoked an average of 23 cigarettes a day for 25 years. All the smokers had tried to quit at least once. They all achieved cessation of smoking and It was revealed that after one year of stopping smoking, 26,1% of the smokers who took champix were still non smokers whereas only 20% were still quit after using a NRT patch. (February 2008)

This medicine should not be taken with NRT (Nicotine Replacement Therapy).

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