What is the correct way to take Chantix (varenicline)?

Correct Way to Take Chantix (Varenicline)

The correct way to take Chantix (varenicline) is to begin dosing one week before your quit date, 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 weeks 2-12, taking each dose after eating and with a full glass of water. 1

Dosing Schedule

Initial Titration (First Week)

• Days 1-3: 0.5 mg once daily
• Days 4-7: 0.5 mg twice daily

Maintenance Dose

• Day 8 to end of treatment: 1 mg twice daily 2, 3, 1

Administration Tips

• Take Chantix orally after eating to minimize nausea (the most common side effect)
• Take with a full glass of water
• Set a quit date and begin Chantix one week before this date
• Alternatively, you can begin Chantix and quit smoking between days 8 and 35 of treatment 1

Treatment Duration

• Standard treatment course is 12 weeks
• For patients who successfully quit smoking after 12 weeks, an additional 12-week course is recommended to increase the likelihood of long-term abstinence 3, 1

Gradual Approach Option

For patients unable or unwilling to quit abruptly, a gradual approach may be used:

• Begin Chantix dosing as described above
• Reduce smoking by 50% from baseline within first 4 weeks
• Reduce by another 50% in the next 4 weeks
• Continue reducing with the goal of complete abstinence by week 12
• Continue treatment for an additional 12 weeks (total 24 weeks) 1

Special Populations

• Renal Impairment:

  • Mild to moderate: No dosage adjustment needed
  • Severe (creatinine clearance <30 mL/min): Start with 0.5 mg once daily, maximum 0.5 mg twice daily
  • End-stage renal disease on hemodialysis: Maximum 0.5 mg once daily 1

• Elderly and Hepatic Impairment:

  • No dosage adjustment necessary for hepatic impairment
  • Elderly patients may need dose adjustment based on renal function 1

Side Effects Management

• Nausea (28-29% of patients): Taking after meals helps minimize this side effect
• Insomnia (14%) and abnormal dreams (10-13%): Common but usually transient
• If side effects are persistent and troublesome, contact your healthcare provider for possible dose reduction 3, 1

Important Precautions

• Patients with a history of psychiatric illness should be monitored closely
• Patients should use caution when driving or operating machinery until they know how Chantix affects them
• Reduce alcohol consumption while taking Chantix until tolerance is established 1

Follow-up and Support

• Combining Chantix with counseling significantly improves quit rates compared to either approach alone 3
• For patients who relapse, another attempt with Chantix is recommended after identifying and addressing factors that contributed to the failed attempt 1

Chantix works through a unique mechanism as a partial agonist of α4β2 nicotinic acetylcholine receptors, which helps reduce both cravings and withdrawal symptoms while blocking the pleasurable effects of smoking if relapse occurs 3. This dual action makes it more effective than bupropion or single nicotine replacement therapy for smoking cessation 3.