Zyban dosage altered, just to be safe

By MARTIN JOHNSTON health reporter

Controls on the use of the quit-smoking pill Zyban have been tightened in New Zealand, in line with British changes that followed the deaths of 37 people taking the drug.

Patients on Zyban here will start on one pill a day, increasing to two a day (taken separately) after a week. Previously they went on to the higher dose on day four.

New Zealand's drug regulation authority, Medsafe, will also remind doctors not to prescribe Zyban to patients with epilepsy, head-injury victims, or those taking other medicines that increase seizure risk.

GlaxoSmithKline, which makes Zyban, said it had received reports of 152 patients in New Zealand suffering adverse reactions with a suspected link to the drug. This was out of 23,000 who have been prescribed it since its launch last July.

Three people have suffered seizures, two have had heart palpatations and one has died, but that was a suicide.

In Australia, where Zyban is subsidised (it is not in New Zealand), health authorities are investigating the deaths of nine patients to see if their use of the drug was a factor.

Australia has experienced unprecedented demand for the drug, but almost 800 adverse reactions were reported between February and mid-May.

A British coroner, after investigating the death of a 21-year-old woman who was taking Zyban with other medicines, said in April that she died of natural causes, but he believed Zyban was implicated.

Medsafe's senior medical adviser, Dr Stewart Jessamine, said yesterday that it was hard to see what difference to the "side-effect profile" delaying the increased dose would make. But the committee on adverse drug reactions had decided to follow the British changes because it was unlikely to harm patients and could be beneficial.

* Customs officials said yesterday that they were on alert for a new mint-flavoured candy, containing as much nicotine as a cigarette, which critics say could encourage children to start smoking.

The lolly-sized "cigalett" is designed for smokers who are banned from lighting up in the workplace. Customs will seize the product, soon to be tested in the United States, it if it is imported.