From the FDA Drug Label
Based on varenicline characteristics and clinical experience to date, varenicline has no clinically meaningful pharmacokinetic drug interactions [see Clinical Pharmacology(12.3)]. 7. 1 Use with Other Drugs for Smoking Cessation Safety and efficacy of varenicline in combination with other smoking cessation therapies have not been studied. Bupropion Varenicline (1 mg twice daily) did not alterthe steady-state pharmacokinetics of bupropion (150 mg twice daily) in 46 smokers. The safety of the combination of bupropion and varenicline has not been established
The safety of using Chantix (varenicline) and Wellbutrin (bupropion) together has not been established, although varenicline does not alter the steady-state pharmacokinetics of bupropion 1. It is recommended to exercise caution when considering combination therapy.
- Key points:
- No clinically meaningful pharmacokinetic drug interactions between varenicline and bupropion
- Safety and efficacy of combination therapy not studied
- Combination use not established 1
From the Research
Yes, Chantix (varenicline) and Wellbutrin (bupropion) can be used together for smoking cessation, and this combination is sometimes prescribed by healthcare providers. Both medications work differently to help people quit smoking - Chantix partially activates nicotine receptors while blocking nicotine's effects, and Wellbutrin affects brain chemicals like dopamine and norepinephrine that are involved in nicotine addiction. The combination may be more effective than either medication alone for some people who have had difficulty quitting with a single medication. However, this combination should only be used under medical supervision as both medications can have side effects including mood changes, sleep disturbances, and nausea. Patients with certain medical conditions like seizure disorders, eating disorders, or those taking certain other medications may not be suitable candidates for this combination therapy.
Key Considerations
- The most recent and highest quality study, 2, suggests that varenicline plus counseling may be the best treatment for individuals with past or current major depressive disorder, given its greater efficacy, similar risk of adverse events, and reductions in anxiety and depression while trying to quit smoking.
- Another study, 3, found that varenicline, bupropion, and nicotine patch are well tolerated and effective in adults with psychotic, anxiety, and mood disorders, with varenicline showing superior abstinence rates compared to bupropion, NRT, and placebo.
- A systematic review, 4, assessed the efficacy and safety of combination varenicline and bupropion, and found that combination therapy yielded greater efficacy than varenicline monotherapy in two randomized controlled trials and one retrospective outcomes study.
Dosage and Administration
The typical dosing would be Chantix starting at 0.5mg once daily for days 1-3, then 0.5mg twice daily for days 4-7, then 1mg twice daily thereafter, alongside Wellbutrin SR 150mg once daily for 3 days, then 150mg twice daily. Always consult with your healthcare provider before starting, stopping, or combining these medications.