130. Treatment Recommendations: Medications-Bupropion
Treating Tobacco Use and Dependence: 2008 Update
Patient selection | Appropriate as a first-line medication for treating tobacco use |
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Precautions, warnings, contraindications and side effects (see FDA package insert for complete list) |
Pregnancy-Pregnant smokers should be encouraged to quit without medication. Bupropion has not been shown to be effective for tobacco dependence treatment in pregnant smokers. (Bupropion is an FDA pregnancy Class C agent.) Bupropion has not been evaluated in breast-feeding patients. |
Dosage | Patients should begin bupropion SR treatment 1-2 weeks before they quit smoking. Patients should begin with a dose of 150 mg every morning for 3 days, then increase to 150 mg twice daily. Dosage should not exceed 300 mg per day. Dosing at 150 mg twice daily should continue for 7-12 weeks. For long-term therapy, consider use of bupropion SR 150 mg for up to 6 months post-quit. |
Availability | Prescription only |
Prescribing instructions | Stopping smoking prior to quit date-Recognize that some patients may lose their desire to smoke prior to their quit date, or will spontaneously reduce the amount they smoke. Dosing information-If insomnia is marked, taking the PM dose earlier (in the afternoon, at least 8 hours after the first dose) may provide some relief. Alcohol-Use alcohol only in moderation. |
Costa | 1 box of 60 tablets, 150 mg= $97.00 per month (generic); $197.00 (Brand name) |
a Cost data were established by averaging the retail price of the medication at national chain pharmacies in Atlanta, GA, Los Angeles, CA, Milwaukee, WI, Sunnyside, NY and listed on-line during January, 2008 and may not reflect discounts available to health plans and others.