Champix and Zyban are, at the time of writing this article, the only prescription-only tablet stop smoking medicines. At the same time, these two have a success rate incomparably higher than any other smoking cessation aid available on the modern market. Both of these medicines have the same end-result, namely, successfully quitting smoking, and both are ideally taken as a part of a wider smoking cessation program that includes motivational support.

However, despite all these similarities, Zyban and Champix are vastly different medicines, functioning in different ways and being produced by different companies, based on the different active ingredients. So, let’s take a closer look at the similarities and differences between Champix and Zyban.

What’s on this page?

What is Zyban?

Zyban is a very successful prescription-only stop smoking medicine issued in the form of a tablet. Developed by GlaxoSmithKline pharmaceutical company, this medicine relies on its active ingredient bupropion hydrochloride in order to help smokers give up on their harmful habit with as little unpleasant symptoms as possible.

Zyban appeared on the market back in 1997, almost a whole decade before Champix and has been used for smoking cessation ever since then. However, the active ingredient of Zyban has an even longer history, being released back in 1980s due to its antidepressant qualities. However, high doses of bupropion hydrochloride commonly issued for the treatment of mental health issues were soon discovered to cause severe side effects, leading to its eventual withdrawal from the market. When the medicine made a comeback some time later, it was issued only in a significantly reduced dose.

Despite its antidepressant traits, bupropion hydrochloride isn’t a typical selective serotonin reuptake inhibitor (SSRI). But, in order to get a better understanding of how this substance works to help with stop smoking efforts, we would first need to consider what happens in a smoker’s brain when nicotine is inhaled.

Biochemical basis of nicotine addiction

As is the case with every subjectively experienced phenomenon, nicotine addiction too is rooted in the activity of various neurotransmitters, substances tasked with regulating the mood. Dopamine and noradrenaline are probably the best-known, aside from serotonin. Dopamine is the neurotransmitter that is closely connected to so-called reward centres in the brain. Many addictive substances, including both recreational drugs and nicotine, tend to cause a surge in activity of dopamine, resulting in subjectively experienced feelings of pleasure.

On the other hand, noradrenaline acts as a stimulant, so when its levels rise, the brain is more focused and alert – which is why this compound is closely related to fight-or-flight response that occurs in situations of heightened pressure or danger.

Nicotine acts not only on these two, but also on serotonin, acetylcholine and beta-endorphin. However, the interaction of nicotine with dopamine and noradrenaline receptors explains the capacity of this addictive substance to act both as a pleasure enhancer and a stimulant, making quitting smoking successfully a tough task.

How does Zyban work?

The exact mechanism of action isn’t fully understood, but scientists have deduced that bupropion somehow limits the absorption of both dopamine and noradrenaline, keeping these compounds present in the brain for longer periods of time than they should naturally linger, thus sustaining the sensations of happiness and alertness, reducing the need to smoke.

How is Zyban used?

Patients just starting out the course of Zyban will commence treatment with a rather low dose of one pill every day, over the course of six days. One the seventh day of the treatment, the dose will be increased to two tablets per day and the user should pick a final stop smoking date – ideally timed to fall within the second week of the treatment.

After this, Zyban is to be taken for up to nine weeks and the exact method and time of quitting treatment will be determined by a doctor.

Is Zyban prescription only?

Yes, Zyban can be bought in the UK only following consultations and approval from a certified medical professional.

What is Champix?

Champix is, similarly to Zyban, a very successful stop smoking medicine available in the form of a tablet. Manufactured by Pfizer pharmaceutical company, Champix was based on an active ingredient called varenicline – the root of the exceptional success rates of this medicine. With a unique mechanism of action that makes it stand among the competition, Champix has been approved and released to both European and American markets in 2006.

How does Champix work?

Varenicline, the active ingredient of Champix works as a nicotinic receptor partial agonist, meaning that it stimulates the same receptors in the brain that are susceptible to nicotine, most notably, acetylcholine receptors which are closely linked to heightened subjective experience of perception and reward. The stimulation of these receptors by nicotine molecules is yet another element of the physical aspect of tobacco addiction.

By binding to those same receptors, varenicline serves two purposes – it reduces nicotine withdrawal symptoms by providing stimulation to nicotine receptors, leading to less pronounced cravings. On the other hand, varenicline will also limit the effect of inhaled nicotine on the said receptors. What this means is that if someone who is taking Champix lights a cigarette, that person will experience significantly diminished pleasure from the act.

How is Champix used?

Champix is available in different dosages and different packs. The users just commencing their treatment will first be issued Champix Starter Pack that contains the tablets of two different strengths (0.5mg and 1mg) and covers the first two weeks of the treatment. Over the course of the first three days, the patient should take one 0.5mg tablet daily. On the fourth day, this dose will be doubled (0.5mg tablet two times per day). Finally, on the eighth day of the treatment, the dose will be doubled yet again, switching to 1mg tablets two times per day.

Similarly to Zyban, stop smoking date should be set to take place within the second week of the treatment course. Starting with the eighth day and moving forward, the users will switch to Champix Maintenance Pack. The duration of the treatment will be determined by your doctor, but most commonly it is around 12 weeks.

Can you buy Champix without prescription?

Yes, Champix can be bought only with a valid prescription issued by a certified medical professional.

Champix versus Zyban: Which medicine is the most effective?

Several scientists have shown interest in this question. In fact, numerous trials have been conducted with the goal of comparing the effectiveness of Zyban, Champix and various NRTs. In 2006, Canadian researchers concluded that both bupropion and NRTs were significantly more successful than placebo, but at the same time, varenicline was more successful than any of the other alternatives.1 However, at the time when this study was conducted, Champix was a completely new medicine and studies into its efficiency were significantly limited in number.

However, later study, conducted in 2008 by American experts seem to confirm the original results, stating that the success rate of varenicline was around 44% as opposed to bupropion’s 29.7% and 17.7% when it comes to placebo. But, the exceptional success of Champix was confirmed after yet another large-scale study published in the Cochrane report.2 This study also concludes that while both Zyban and Champix are efficient, Champix does have a measurably higher success rate.

Which medicine of the two should I use?

This is a question that can be answered with certainty only by your doctor. Only after careful examination of your condition and medical history, a professional will be able to properly assess your health profile and issue you a prescription for that medicine which is the most suitable for your specific case.

References:

  1. Effectiveness of Smoking Cessation Therapies – NCBI
  2. Pharmacological Interventions for Smoking Cessation – Cochrane Database