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Dopamine/Noradrenaline Reuptake Inhibitor (DNRI) — Smoking Cessation

Bupropion (Smoking Cessation)

Brand names: Zyban

Bupropion is an oral noradrenaline and dopamine reuptake inhibitor licensed as an aid to smoking cessation. Treatment is started while the person is still smoking, before the planned quit date.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

General: Increase dose gradually to reduce seizure risk. ( 2.1 , 5.3 ) Periodically reassess the dose and need for maintenance treatment. ( 2.2 ) Major Depressive Disorder Starting dose: 150 mg once daily. Usual target dose: 300 mg once daily ( 2.2 ) After 4 days, may increase the dose to 300 mg once daily. ( 2.2 ) Seasonal Affective Disorder Initiate treatment in the autumn prior to onset of seasonal depressive symptoms. ( 2.3 ) Starting dose: 150 mg once daily. Usual target dose: 300 mg once daily. ( 2.3 ) After one week, may increase the dose to 300 mg once daily. ( 2.3 ) Continue treatment through the winter season. ( 2.3 ) Hepatic Impairment Moderate to severe hepatic impairment: 150 …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-11-25. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It inhibits the reuptake of noradrenaline and dopamine, which is thought to reduce nicotine cravings and withdrawal symptoms, although the precise mechanism in smoking cessation is not fully understood.

Prescribing in practice

  • It lowers the seizure threshold and is contraindicated in epilepsy or any history of seizures, in eating disorders, and where there is abrupt alcohol or benzodiazepine withdrawal.
  • It has multiple drug interactions, including with medicines that lower the seizure threshold and those metabolised by CYP2D6.
  • Insomnia and dry mouth are common; insomnia is reduced by avoiding doses close to bedtime.

Monitoring

Monitor blood pressure, mood and smoking status; review for any seizure risk factors and for interacting medicines before and during treatment.

Counselling the patient

  • Keep smoking at first and stop on your agreed quit date, usually in the second week of treatment.
  • Avoid taking it too close to bedtime, as it can disturb sleep, and do not take more than prescribed.
  • Tell your prescriber if you have ever had a seizure or fit, or an eating disorder, before starting.

Evidence & guidelines

Recommended as an option for smoking cessation by NICE (NG209).

Reference: NICE PH10 Smoking Cessation; Zyban SPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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