Initial uptake and evidence of safe prescribing practice with Buproprion (Zyban)

To study the effect of safety concerns and the introduction of freely available nicotine replacement therapy (NRT) on the prescribing of Buproprion within the General Medical Services (GMS) scheme in Ireland.

Using the state-supported GMS prescription database in Ireland, we identified 8166 patients who were prescribed Buproprion and 18,450 patients who were prescribed NRT over a 12-month-period.

A decline in the prescribing of Buproprion was noted which coincided with concerns regarding the safety of the drug but which preceded the introduction of NRT to the GMS. Furthermore, patients who were prescribed Buproprion were less likely to be co-prescribed potentially interacting drugs (odds ratio (OR): 0.48, 95% confidence intervals (CI): 0.42, 0.54) or drugs known to reduce seizure threshold (OR: 0.63, 95% CI: 0.6, 0.67) indicating good prescribing practice. Patients aged 65 years or more were less likely to be prescribed any form of smoking cessation therapy compared with those aged <65 years (OR: 0.23, 95% CI: 0.22-0.24) indicating that such therapy was targeted at those most likely to benefit.

We provide evidence that prescribers exercised caution in the prescription of Buproprion and were likely to have been influenced both by the safety concerns and the introduction of freely available NRT to the GMS population.