Varenicline

Varenicline is a selective nicotine-receptor partial agonist, specifically designed to target the nicotine receptors in the brain, which are integral to addiction and cravings.

Varenicline works by partially stimulating these receptors, mimicking some of the effects of nicotine but at a much lower intensity.

This helps to reduce cravings for cigarettes and alleviate withdrawal symptoms commonly experienced when an individual stops smoking.

In addition to reducing cravings, Varenicline blocks nicotine from accessing these receptors.

When nicotine from a cigarette enters the brain, it normally binds to nicotinic receptors, triggering the release of dopamine, a neurotransmitter associated with short-term pleasure and reward.

By preventing nicotine from binding to these receptors, Varenicline counteracts the pleasurable effects of smoking.

Start the treatment 1 to 2 weeks before your planned quit-smoking date. Take Varenicline tablets whole with water, with or without food, beginning with one 0.5mg tablet per day for the first three days.

From days 4 to 7, take two 0.5mg tablets per day, one in the morning and one in the evening.

From day 8 until the end of treatment, take two 1mg tablets per day, one in the morning and one in the evening.

Varenicline treatment typically lasts for 12 weeks. For individuals who successfully quit smoking during this initial period, an additional 12-week course at a dose of 1mg twice daily is recommended to help prevent relapse, extending the total treatment duration to 24 weeks.

If you miss a dose, skip it and continue with your regular schedule. Do not take an extra dose to make up for the missed one.

Research has shown that Varenicline is significantly more effective than other smoking cessation treatments, such as bupropion (commonly known as Zyban 150mg).

In a comparative study, 44% of participants who used Varenicline successfully quit smoking after 9 to 12 weeks of treatment. This was significantly higher than the success rate of 29.7% for those using bupropion and 17.7% for those given a placebo.

Individuals taking the following types of medication cannot take Varenicline unless they are advised to do so by a pharmacist or doctor.

Antidepressants and anti-anxiety medications

Varenicline can interact with these medications, potentially intensifying side effects such as mood changes or dizziness.

Blood thinners such as Warfarin

Individuals taking blood thinners may need to adjust the dosage of the blood thinning medication as Varenicline can affect blood clotting times. Additionally, individuals taking any medication for cardiovascular issues should consult a doctor before taking Varenicline.

Other smoking cessation treatments

Combining Varenicline with nicotine replacement treatments, such as nicotine patches and/or gum, may increase the side effects of treatment.

Varenicline may also interact with medications for other conditions, such as Theophylline (an asthma treatment) and insulin (a diabetes medication).

You should speak to our pharmacy team or consult your GP before taking Varenicline if you are currently on any type of medication.

If you miss a dose of Varenicline, take it as soon as you remember unless it is within 3 to 4 hours of your next dose. If the missed dose is within 3 to 4 hours of the next dose, skip the missed dose and continue treatment as normal.

Varenicline is a partial nicotine receptor agonist, which means it binds to and partially activates nicotine receptors, mimicking the effects of nicotine.

Therefore, it is not advisable to combine Varenicline with smoking cessation aids that contain nicotine, as doing so can lead to excessive stimulation of nicotine receptors in the brain. This can lead to side effects such as nausea, headaches, and dizziness.

Speak to our pharmacy team or your GP before taking any type of smoking cessation treatment.

Some individuals may experience increased sensitivity to alcohol while taking Varenicline.

Alcohol consumption can affect the central nervous system, and Varenicline may enhance this effect by altering the brain's neurotransmitter response, potentially increasing the effects of alcohol on the brain and body.

This means that even a small amount of alcohol could lead to stronger-than-expected symptoms. It is advisable to limit alcohol consumption and monitor how you respond.

We recommend discussing your alcohol use with your healthcare provider before taking Varenicline to stop smoking.

Varenicline is medically identical to Champix. It contains the same active ingredient (varenicline tartrate) and works in the same way. It is equally effective at helping people quit smoking as Champix.

The only difference is that Champix is a branded treatment while Varenicline is a generic version.

Varenicline was reintroduced to the UK at the end of 2024 after being approved as safe by the Medicines and Healthcare Regulatory Agency.

Varenicline is not available over the counter, as it's a prescription-only medication. If you wish to buy Varenicline, you can complete our free online consultation to see if you're eligible for the treatment. Our pharmacy team will assess your suitability for treatment and advise you on your options.

The medical assessment we conduct as part of our online consultation helps maximise patient safety by accounting for key factors that can affect treatment, including the interaction between Varenicline and a patient’s existing health conditions, the medication they are currently using, and more.

The standard treatment course for Varenicline lasts for 12 weeks, which is enough time for most individuals to quit smoking successfully.

It is recommended to start taking Varenicline between 1 and 2 weeks before the planned quit-smoking date, as this ensures there is sufficient time for the medication to start working and gradually reduce nicotine cravings.

The starting course of treatment for Varenicline consists of lower initial doses at 0.5mg, followed by a higher dose of 1mg after the first week, lasting for up to 12 weeks.

Individuals who successfully quit smoking after 12 weeks are recommended to take a follow-up 12-week course to help reduce the probability of relapse.

The time taken to stop smoking using Varenicline also depends on the individual’s personal willpower to quit smoking. Individuals who are more motivated to quit will stop smoking with Varenicline sooner.

Many people permanently quit smoking by the time they have completed the recommended 12-week full course of Varenicline, followed by the 12-week follow-up course.

However, some people may feel the urge to resume smoking once they stop taking Varenicline, as the medication is no longer acting on nicotine receptors in the brain to prevent cravings.

Individuals who still feel the urge to smoke after stopping treatment are recommended to speak to our pharmacy team or their GP about the next steps.

You can still smoke while taking Varenicline, but it’s not advisable. Varenicline reduces the enjoyment of nicotine products such as cigarettes, so smoking will not be as pleasurable.

If you continue to smoke while using Varenicline, the nicotine from cigarettes can overstimulate nicotine receptors, increasing the risk of experiencing side effects such as nausea.

Varenicline is only prescribed to patients who understand that willpower and motivation to quit smoking are needed to stop smoking successfully and reduce the risk of relapse.

Varenicline contains the active ingredient varenicline tartrate. It partially stimulates nicotine receptors in the brain, mimicking the effects of nicotine, but at a much lower intensity than the nicotine found in smoking products.

In contrast, nicotine replacement treatments such as patches and gums contain nicotine, which can make them addictive.

If you relapse during a Varenicline course and begin smoking again, don't be discouraged or discontinue your treatment altogether. Update our pharmacy team or your GP so they can help adjust your treatment plan and continue your course of treatment as prescribed.

Varenicline differs from Zyban in its active ingredient and mechanism.

Varenicline contains the active ingredient varenicline tartrate, which stimulates nicotine receptors in the brain while blocking nicotine from fully activating them.

Zyban contains the active ingredient bupropion, which blocks transporters from removing dopamine and noradrenaline from synaptic clefts in the brain.

Clinical studies show that Varenicline is more successful than alternatives at helping patients to quit smoking^[1].

Varenicline is different from Cytisine in its unique active ingredient.

The active ingredient in Varenicline is varenicline tartrate, which partially stimulates nicotine receptors while also blocking nicotine’s full effect, reducing cravings and making smoking less rewarding.

Cytisine, on the other hand, is a natural plant alkaloid that also binds to nicotine receptors, but not as effectively as Varenicline.

Varenicline was found to be the more effective medication in clinical trials^[2].

1. Benli et al. (2017) A Comparison of the Efficacy of Varenicline and Bupropion and an Evaluation of the Effect of the Medications in the Context of the Smoking Cessation Programme. Tobacco Induced Diseases, 15, pp. 10. Available at: https://doi.org/10.1186/s12971-017-0116-0

2. Oreskovic et al. (2023) Cytisine Versus Varenicline for Smoking Cessation in a Primary Care Setting: A Randomized Non-inferiority Trial. Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco, 25(9), pp.1547–1555. Available at: https://doi.org/10.1093/ntr/ntad065