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Chantix (varenicline)- an aid to stop smoking

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read
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Chantix was a product containing varenicline, a medicine to help you in the initial stages of quitting smoking. The manufacturer has fully discontinued the brand name Chantix due to unacceptable levels of nitrosamines. Generic versions are still available.

Varenicline 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, while 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.

Doctor’s advice

How is varenicline used?

The usual treatment course of varenicline 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 reduce each day. From the quit date onwards, you continue to take the tablets for the remainder of the course.

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

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

For weeks 2 to 12: One 1 mg strength tablet is taken twice daily. 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 will have broken the habit and behavioral cues that keep people smoking.

If you are not able to quit smoking right away, you should have been able to reduce smoking during the first 12 weeks of treatment. If you have not quit smoking 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 varenicline

Like all medicines, varenicline 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 varenicline or stopping smoking, including severe agitation, depression, or changes to behavour. You should see your doctor urgently if this occurs.

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

Is varenicline 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 varenicline. It makes some people less tolerant of alcohol, so be cautious in alcohol consumption when first starting varenicline, and speak to your doctor if you have an alcohol dependency, as there may be a better option for you.

Varenicline 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 after a discussion with your doctor or midwife.

Varenicline tablets are licensed for adults over 18 years only.

When should I see my doctor?

If any of the common side effects are intolerable or not subsiding 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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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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