Varenicline

Varenicline is a medicine that can be prescribed to help people quit smoking. It is different from other smoking cessation medications in that it does not contain any nicotine. The drug comes in tablet form and is generally taken once or twice a day for 12 weeks. Side effects that have been reported with varenicline include headache, insomnia, nausea, and abnormal dreams.

 

What Is Varenicline?

Varenicline tartrate (Chantix™) is a prescription medication that is used to help people stop smoking. Unlike many other medications used for this purpose, varenicline does not contain nicotine.
 
(Click What Is Varenicline Used For? for more information, including possible off-label uses.)
 

Varenicline: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking varenicline if you have:
 
  • Kidney disease, such as kidney failure (renal failure)
  • Any mental illness
  • A history of suicidal behavior
  • Any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 
(Click Precautions and Warnings With Varenicline to learn more, including information on who should not take the drug.)
 

Varenicline Side Effects

As with any medicine, side effects are possible with varenicline. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
 
Common side effects of varenicline include but are not limited to:
 
(Click Side Effects of Varenicline to learn more, including potentially serious side effects that you should report immediately to your healthcare provider.)
 
You can learn more about a few specific side effects of varenicline in the following eMedTV articles:
 

 

How Does Varenicline Work?

Varenicline works in a unique manner. Although the drug does not contain nicotine, it binds to nicotine receptors in the brain. This helps people quit smoking in two different ways. First, when varenicline binds to the nicotine receptor, it blocks nicotine from binding, which prevents some of the pleasurable effects of smoking. Second, varenicline acts a little like nicotine when it binds to the receptor, which helps to decrease the effects of nicotine withdrawal.
 

Effects of Varenicline

Studies have shown varenicline to be effective in helping people stop smoking. One study evaluated whether people were still smoking during the last month of treatment (weeks 9 through 12). Up to 51 percent of people taking varenicline did not smoke at all during this time, compared to only 12 percent of those not taking the drug.
 
Two studies compared varenicline to Zyban® (bupropion SR), another smoking cessation medication. These studies also evaluated whether people were still smoking during weeks 9 through 12 of treatment. Up to 44 percent of those taking varenicline did not smoke during this period, compared to just 30 percent of those taking Zyban.
 
Even though varenicline was only used for 12 weeks, some of these studies observed people for an entire year to see if they started smoking again. Up to 23 percent of those who took varenicline had quit and had not started again, compared to just 16 percent of those who took Zyban and only 8 percent of people who received no treatment.
 

When and How to Take Varenicline

General considerations for when and how to take varenicline include the following:
 
  • The medication comes in tablet form. It is taken by mouth twice a day (although for the first three days, it is usually taken just once a day).
     
  • The medication is taken for 12 weeks. If you successfully stop smoking, your healthcare provider may recommend an additional 12 weeks of varenicline to decrease your chances of starting smoking again.
     
  • Varenicline should be taken with a full glass of water after eating.
     
  • You should set a "quit date" and start taking varenicline one week before this time to give the medicine a chance to start working before you try to quit.
     
  • Varenicline should be taken at the same times each day in order to maintain an even level in your blood.
     
  • For the medication to work properly, it must be taken as prescribed. Varenicline will not work if you stop taking it.
     

Dosage Information for Varenicline

The dose of varenicline that your healthcare provider recommends will vary, depending on a number of factors, including:
 
  • How you respond to varenicline
  • Other medications you may be taking
  • Other medical conditions you may have.
     
As is always the case, do not adjust your varenicline dose unless your healthcare provider specifically instructs you to do so.
 
(Click Varenicline Dosing for more information.)
  

Varenicline Drug Interactions

Varenicline is unlikely to interact with other medications (see Drug Interactions With Varenicline).
 

Alternatives to Varenicline

For many people, varenicline is effective in helping with smoking cessation. It is also generally well tolerated. However, side effects can occur or the medicine may not work as well as needed. In these cases, your healthcare provider may recommend an alternative to varenicline. Some examples of other medications used for smoking cessation include:
 
Various forms of counseling are also used to help people stop smoking. In fact, smoking cessation counseling can be beneficial for anyone who is trying to quit smoking, even if they are receiving other treatments.
 
(Click Chantix Alternatives to learn more.)
 

What If I Take an Overdose of Varenicline?

It is not known exactly what to expect from a varenicline overdose. If you happen to overdose on the medication, seek medical attention immediately (see Chantix Overdose).
 

How Should Varenicline Be Stored?

Varenicline should be stored at room temperature, away from moisture and heat. The tablets should be stored in an airtight container.
 
Keep varenicline and all other medications out of the reach of children.
 

What Should I Do If I Miss a Dose of Varenicline?

If you do not take your varenicline as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
 

Strengths of Varenicline

Varenicline tablets come in the following strengths:
 
  • Varenicline 0.5 mg
  • Varenicline 1 mg.
     
The medication is also available in a first-month "starter pack" that contains 11 tablets of varenicline 0.5 mg and 42 tablets of varenicline 1 mg. This starter pack eliminates the need for two different prescriptions for the two different strengths needed to start varenicline, since it is started at a low dose and gradually increased.
 

Is There a Generic Version of Varenicline?

Currently, there is no generic varenicline licensed for sale (see Generic Chantix).
 

Who Makes Varenicline?

Varenicline is made by Pfizer, Inc.
 
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;