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The Pharmaceutical Journal Vol 266 No 7149 p718-722
May 26, 2001


  Disillusioned youth
  Travel medicine
  Seprate register
  Code of Ethics

Letters to the Editor


Take care with Zyban

From Mr Anthony Cox, MRPharmS, Mr Christopher Anton, MA MEng, and Dr Robin Ferner, MD FRCP

The summary of product characteristics for amfebutamone (bupropion, Zyban), marketed by GlaxoSmithKline, advises that caution should be taken when using amfebutamone with certain other groups of medication. These are:

  • Drugs that lower seizure threshold or have been associated with seizures.
  • Drugs that affect cytochrome P450 isoenzyme CYP 2B6 (the major enzyme responsible for the metabolism of amfebutamone).
  • Enzyme inhibitors.
  • Enzyme inducers.
  • Drugs that are metabolised by cytochrome P450 isoenzyme CYP 2D6 (which amfebutamone inhibits).

At a recent inquest into the death of a patient prescribed amfebutamone in combination with chloroquine and diphenhydramine, the coroner said that advice given when prescribing amfebutamone should be improved. In order to help prescribers and pharmacists to avoid potential interactions with amfebutamone and drugs seen in the community, we have made a provisional list of those drugs that might interact (PDF *). Amfebutamone has potentially serious interactions with many drugs. Co-prescription with those which lower the seizure threshold is a relative contra-indication, and care is also needed when metabolic interactions are possible.

Anthony Cox
Christopher Anton
Robin Ferner

West Midlands Centre for Adverse Drug Reaction Reporting


* PDFs require Acrobat Reader 4 or later. Click here for the latest version

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