What should I do if I experience swallowing difficulty while taking Zyban (bupropion)?

Managing Swallowing Difficulty While Taking Zyban (Bupropion)

If you experience swallowing difficulty while taking Zyban (bupropion), you should contact your healthcare provider immediately as this may require medication adjustment or alternative treatment options.

Understanding the Issue

Swallowing difficulties (dysphagia) can occur as a side effect of medications or may be related to underlying conditions. When occurring with Zyban (bupropion):

• Bupropion is available as extended-release tablets that should be swallowed whole
• The FDA drug label specifically states: "Swallow bupropion hydrochloride extended-release tablets (XL) whole. Do not chew, cut, or crush bupropion hydrochloride extended-release tablets (XL)" 1
• Altering the tablet can release the medication too quickly, increasing the risk of side effects including seizures 1

Immediate Steps to Take

1. Contact your healthcare provider immediately

   • Do not attempt to modify the medication on your own
   • Do not stop taking the medication without medical advice

2. While awaiting medical advice:

   • Try taking the medication with plenty of water
   • Sit upright when taking medication (90-degree angle)
   • Take one pill at a time if you're on multiple medications

Medical Management Options

Your healthcare provider may recommend one of the following approaches:

1. Medication Adjustment

• Dose adjustment: Your provider may consider adjusting the dosage 2
• Formulation change: If available, a different formulation might be considered
• Alternative medication: Your provider may switch you to a different smoking cessation aid, such as nicotine replacement therapy 2

2. Dysphagia Assessment

• Your provider may refer you to a healthcare professional with expertise in swallowing assessments 2
• This could include a speech-language pathologist who can perform a comprehensive evaluation

3. Diagnostic Evaluation

• If swallowing difficulties persist, your provider might recommend:
  • Videofluoroscopic swallow study (VSS)
  • Fiberoptic endoscopic examination of swallowing (FEES) 2

Important Cautions

• Never crush, cut, or open Zyban tablets - this can lead to rapid drug release and increased risk of seizures 1
• Do not stop taking your medication without consulting your healthcare provider - abrupt discontinuation may lead to withdrawal symptoms
• Avoid self-adjusting your medication - studies show 16.9% of patients with swallowing difficulties inappropriately cut or crush their solid dosage forms 3
• Do not skip doses - research shows 34.6% of patients with swallowing difficulties sometimes skip doses, which can compromise treatment effectiveness 3

Prevention Strategies

• Take medication with sufficient water (at least 150 ml)
• Maintain proper posture (upright) when swallowing medication
• Focus on relaxing throat muscles before attempting to swallow
• Consider using a "chin tuck" technique if recommended by a healthcare professional 2

When to Seek Emergency Care

Seek immediate medical attention if you experience:

• Severe difficulty swallowing
• Inability to swallow
• Choking sensation
• Signs of allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing)

Remember that swallowing difficulties with medication are relatively common (affecting approximately 9-13% of patients taking multiple medications) 4, but require proper medical management to ensure both safety and treatment effectiveness.