Treatment

Bupropion SR
Zyban®
generic SR

Wellbutrin SR®

Begin treatment
1-2 weeks before
quit date:

• 150mg every morning for 3 days, then 150mg twice daily

7-12 weeks, maintenance up to 6 months

• History of taking another form of bupropion
• History of using an MAO inhibitor in the past 14 days
• History of seizure
• History of eating disorder
  
• Observe for serious neuropsychiatric symptoms: changes in behavior, agitation, depressed mood, suicidal ideation and suicidal behavior.

• Insomnia
• Dry mouth

FDA Black Box Warning: Monitor for changes in behavior: hostility, agitation, depressed mood, suicidal thoughts or actions; Elicit psychiatric history.

150mg - 1box of 60 tablets:

• brand name: $197-210/month
• generic SR: $97/month

Medicaid,
Medicare Part D*
Zyban® requires a prior authorization; Bupropion SR does not; Wellbutrin SR® is not covered

Begin treatment
1 week before
quit date:

• Days 1-3: 0.5mg tablet every morning
• Days 4-7: 0.5mg tablet twice daily
• Days 8-end of treatment: 1mg tablet twice daily

• Significant renal impairment
  
• Patient undergoing dialysis
  
• Observe for serious neuropsychiatric symptoms: changes in behavior, agitation, depressed mood, suicidal ideation and suicidal behavior.

• May impair ability to drive or operate heavy machinery
• Nausea
• Insomnia
• Abnormal dreams

FDA Black Box Warning: Monitor for changes in behavior: hostility, agitation, depressed mood, suicidal thoughts or actions; Elicit psychiatric history.

Approximately $131/month

Medicaid,
Medicare Part D*

• Particular cardiovascular patient groups

• Local irritation of mouth and throat
• Coughing, rhinitis

• Particular cardiovascular patient groups
• High dependence potential

• Nasal irritation

1-24 cigs/day:
2mg gum (up to 24 pieces/day)

25+ cigs/day:
4mg gum (up to 24 pieces/day)

Up to 12 weeks

• Particular cardiovascular patient groups

• Mouth soreness
• Dyspepsia
• Hiccups
• Jaw ache

2mg box of 100-170 pieces: $48

4mg box of 100-110 pieces: $63

Medicaid, requires a fiscal order

Patient smokes 1st cigarette more than 30 min. after waking: 2mg (up to 20 per day)

Patient smokes 2nd cigarette within 30 min. after waking: 4mg (up to 20 per day)

Up to 12 weeks

• Particular cardiovascular patient groups

• Nausea
• Hiccups
• Heartburn

2mg box of 72 lozenges:
$34

4mg box of 72 lozenges:
$39

Nicotine Patch
Nicoderm CQ®
generic

Prescription-only: generic (legend)

(Step down)

• 21mg/24 hours
• 14mg/24 hours
• 7mg/24 hours

• 4 weeks
• then 2 weeks
• then 2 weeks

• Particular cardiovascular patient groups

• Local skin reaction
• Insomnia
• Vivid dreams

7mg box: $37

14mg box: $47

21mg box : $48

OTC:
Medicaid
Requires a
fiscal order

Prescription-only:
Medicare Part D*

Counseling Coverage is Available:
• NYS Medicaid covers cessation counseling for pregnant and postpartum women, and children/adolescents aged 10-21. For more information, contact (518) 474-5187.
• Medicare Part B covers cessation counseling for people with a disease caused or exacerbated by smoking; and those taking a therapeutic agent whose metabolism or dosing is affected by tobacco use.
  
  *Medicare coverage varies depending on the individual's drug plan.