Focus on Zyban (bupropion sustained release) and Champix (varenicline)
Efficacy:
Champix has a higher abstience rate than Zyban.
Dosing:
-Begin 1 to 2 weeks before quit date
Zyban: 150 mg once daily for 3 days, then 150 mg BID
Champix: 0.5 mg once daily for 3 days, then 0.5 mg BID for 4 days, then 1 mg twice daily (alternatively patients may continue 0.5 mg BID)
Adverse Effects:
Zyban: insomnia, dry mouth, GI changes (constipation), seizure risk, anxiety. Contraindicated in patients with anorexia and epilepsy.
Champix: upset stomach (take with food), taste changes, sleep changes (vivid dreams), ?cardiovascular risk, ?psychiatric risk
Drug Interactions:
Zyban is a CYP 2D6 inhibitor, so careful with CYP2D6 substrates such as fluoxetine, aripiprazole, paroxetine etc. Also, it can interact with MAOI inhibitors which increases the risk of serotonin syndrome.
Champix has no significant drug interactions.