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NDRI (smoking cessation aid)

Bupropion hydrochloride

Brand names: Zyban

Adult dose

Dose: 150mg OD ×6 days then 150mg BD; treatment 7–9 weeks
Route: Oral
Frequency: BD

Clinical pearls

  • NICE NG209 stop smoking: 2nd/3rd-line option after varenicline / cytisine / NRT
  • Set quit date 1–2 weeks after starting
  • DVLA: warn re seizure risk

Contraindications

  • Seizure disorder
  • Eating disorder (current/history)
  • CNS tumour
  • Acute alcohol/benzodiazepine withdrawal
  • Bipolar disorder
  • Severe hepatic disease
  • Concurrent MAOI
  • Pregnancy/breastfeeding
  • Hypersensitivity

Side effects

  • Insomnia
  • Dry mouth
  • Headache
  • Dizziness
  • Seizures (dose-related)
  • Hypertension
  • Hypersensitivity skin reactions
  • Suicidal ideation (MHRA)

Interactions

  • Strong CYP2D6 substrates
  • SSRIs (lower seizure threshold)
  • MAOIs
  • Antipsychotics

Monitoring

  • BP
  • Mood
  • Seizure history

Reference: BNF; NICE NG209; MHRA Drug Safety Update; https://bnf.nice.org.uk/drugs/bupropion-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.