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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Williams
D
D
Department of Clinical Pharmacology, Aberdeen Royal Infirmary, Foresterhill Aberdeen, Scotland UK. David.J.Williams@arh.grampian.scot.nhs.uk
Bennett
K
K
Heery
A
A
Feely
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016642:Bupropion / Q000009:adverse effects / Q000627:therapeutic use*; D016208:Databases, Factual; D018765:Dopamine Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D004347:Drug Interactions; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D005194:Family Practice / Q000592:standards*; D005260:Female; D006801:Humans; D007494:Ireland; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D009538:Nicotine / Q000627:therapeutic use; D012449:Safety; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000188:drug therapy*
D018765:Dopamine Uptake Inhibitors; D016642:Bupropion; D009538:Nicotine