Can Chantix (varenicline) and bupropion be used to help patients quit nicotine vaping?

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From the Guidelines

Both Chantix (varenicline) and bupropion can be used to help patients quit nicotine vaping, as they have been shown to be effective in quitting combustible cigarettes, which shares a similar nicotine addiction mechanism. The effectiveness of these medications in smoking cessation, as outlined in the study by 1, suggests they can be beneficial for vaping cessation as well. Chantix works by partially activating nicotine receptors in the brain, reducing cravings and withdrawal symptoms while blocking the pleasurable effects of nicotine. The typical regimen involves starting with 0.5 mg once daily for days 1-3, then 0.5 mg twice daily for days 4-7, followed by 1 mg twice daily for 12 weeks total. Bupropion (marketed as Zyban for smoking cessation) works by affecting brain chemicals related to nicotine cravings. The standard dose is 150 mg once daily for 3 days, then 150 mg twice daily for 7-12 weeks.

Key points to consider when using these medications for vaping cessation include:

  • Starting the medication 1-2 weeks before the quit date to allow it to reach therapeutic levels
  • Combining the medication with behavioral counseling for enhanced effectiveness, as combining behavioral and pharmacotherapy interventions may increase cessation rates from approximately 8% to 14% compared with usual care or minimal behavioral interventions 1
  • Monitoring for side effects, such as nausea, sleep disturbances, and potential psychiatric symptoms with Chantix, and insomnia, dry mouth, and seizures in susceptible individuals with bupropion
  • Being aware that while clinical trials specifically for vaping cessation are limited, the similar nicotine addiction mechanism suggests these medications can help with vaping cessation as they do with traditional smoking, with evidence suggesting that rates of smoking abstinence may increase from approximately 10% in control groups to 17% in persons using any form of NRT, from roughly 11% in control groups to 19% in those using bupropion SR, and from approximately 12% in control groups to 28% in those using varenicline 1.

Given the information from 1, it's clear that using Chantix or bupropion, potentially in combination with behavioral support, can significantly increase the chances of successfully quitting nicotine vaping, despite the original approval of these medications for quitting combustible cigarettes.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Nicotine Vaping Cessation

  • Chantix, also known as varenicline, and bupropion are medications that can be used to help patients quit nicotine vaping, as they have been shown to be effective in smoking cessation 2, 3, 4, 5, 6.

Mechanism of Action

  • Varenicline works as a partial agonist at nicotinic alpha4beta2 receptors, while bupropion is an inhibitor of the neuronal uptake of noradrenaline and dopamine 2, 4.

Combination Therapy

  • Combination therapy with varenicline and bupropion has been shown to be more effective than varenicline monotherapy in some studies, with greater efficacy in smoking cessation and higher success rates 4, 5.

Efficacy and Safety

  • The efficacy and safety of combination varenicline and bupropion therapy have been assessed in several studies, with results indicating that it may be a viable option for smoking cessation, although further safety analysis is warranted to rule out additive psychiatric adverse effects 4, 5.

Comparative Effects

  • Comparative studies have been conducted to evaluate the effects of varenicline, combination nicotine replacement therapy, and patch monotherapy on candidate mediators of early abstinence in smoking cessation attempts, with results suggesting that varenicline and combination therapy may work through different mechanisms to achieve abstinence 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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