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Champix (varenicline)- an aid to stop smoking

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 4 minutes read

Champix is a product containing varenicline, a medicine to help you in the initial stages of quitting smoking. Champix acts on the nicotine receptors in the brain, but doesn't reward you with dopamine, the feel-good hormone that nicotine produces. It therefore blocks nicotine from having its effect, breaking that pleasure-reward association, whilst at the same reducing cravings and withdrawal symptoms. This all works towards reducing the pleasurable effects of smoking and nicotine.

This hopefully breaks the cycle to urge you to smoke again, and avoids feelings of depression, irritability and sleeplessness that can accompany nicotine cravings.

For the maximum chance of success, most people prefer to engage the NHS Stop Smoking service, which is free and will provide prescriptions for stop smoking aids, including Champix, and help you find strategies to break the behavioural habit of smoking. Together you will set a stop smoking date, and they will help you prepare for that.

Doctor’s advice

How is Champix used?

The usual treatment course of Champix tablets is 12 weeks, starting one week before the date you intend to quit. You can continue to smoke and gradually wean down during this week, and you should notice that the cravings for cigarettes reduces each day. From the quit date onwards, you continue to take the tablets for the remainder of the course.

The initiation pack of Champix contains 25 tablets, with doses varying between 0.5mg and 1mg. There is a maintenance pack containing only 1mg tablets.

For week 1: The dosage is one 0.5mg tablet daily for the first 3 days, then increased to one 0.5mg tablet twice a day (morning and evening) for the remainder of the week.

For weeks 2 to 12: One 1mg strength tablet is taken twice a day. After completing the course, you will have stopped smoking for at least 11 weeks. The theory is that you will no longer have nicotine cravings or withdrawal symptoms, and you have broken the habit and behavioural cues that keep people smoking.

If you are not able to quit smoking straight away, you should reduce smoking during the first 12 weeks of treatment and quit by the end of that treatment period. Discuss with your pharmacist or stop smoking adviser on what to do after this.

Common side effects of Champix

Like all medicines, Champix can cause side effects in some people. Giving up smoking with or without treatment can cause various symptoms, including feeling depressed, irritable, frustrated or anxious, sleeplessness, difficulty concentrating, decreased heart rate and increased appetite or weight gain. Rarely severe mental health symptoms can arise, either from Champix or stopping smoking, including severe agitation, depression or changes to behaviour. You should see your doctor urgently if this occurs.

It can be difficult to tease apart whether Champix or stopping smoking is to blame for some symptoms. Champix often causes inflammation in the nose and throat, vivid dreams, difficulty sleeping, dry mouth, constipation or diarrhoea, dizziness, headaches and nausea. A full list of possible side effects is available in your medicine pack.

Is Champix for everyone?

It suits most people, but caution should be added in those with a kidney or heart problem, or certain mental health conditions, as your doctor may suggest a more suitable alternative. Those with severe kidney problems should not take Champix. It makes some people less tolerant of alcohol, so be cautious in alcohol consumption when first starting Champix, and speak to your doctor if you have an alcohol dependency, as there may be a better option for you.

Champix is not recommended in pregnancy or breastfeeding, as there is too little research to say whether it is safe. However, smoking during pregnancy carries significant risks to your baby, so it’s worth choosing this time to quit: nicotine replacement therapy (NRT) is an option alongside willpower, after discussion with your doctor or midwife.

Champix tablets are licensed for adults over 18 years only.

When should I see my doctor?

If any of the common side effects are unbearable or not settling after a few weeks, speak to your stop smoking adviser, doctor or pharmacist, and consider together any alternative methods to help you stop smoking. Additionally, any of these professionals may be able to help with a continuation course or alternative if you have relapsed or continue to feel the urge to smoke after your 12 week treatment course.

You should also speak to your doctor urgently if you feel severely agitated, anxious, depressed or have thoughts about hurting yourself.

Seek immediate medical attention for any of the rare but serious adverse effects listed in your product information, such as chest pain, difficulty breathing, mouth or throat swelling, a blistering or peeling skin rash or a suspected seizure.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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