From the Guidelines
Varenicline (Chantix) should be prescribed in a sequence of 0.5 mg once daily for 3 days, then 0.5 mg twice daily for 4 days, followed by 1 mg twice daily for the remainder of the treatment period, typically 3-6 months or more, as guided by response and tolerability 1. The prescription sequence for Varenicline (Chantix) is designed to gradually increase the dose to minimize side effects while maximizing efficacy.
- The initial dose is 0.5 mg once daily for 3 days,
- followed by 0.5 mg twice daily for 4 days,
- and then 1 mg twice daily for the remainder of the treatment period. Key considerations for prescribing Varenicline include:
- Taking the medication with food to reduce nausea, a common side effect 1
- Renal dosing requirements, as Varenicline is primarily cleared by the kidneys 1
- Limited drug interactions due to near-exclusive renal clearance 1
- The importance of completing the full treatment course, even if smoking cessation is achieved early, to reduce the risk of relapse. It is essential to monitor patients for potential side effects and adjust the treatment plan as needed to ensure the best possible outcome in terms of morbidity, mortality, and quality of life.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Begin varenicline tablets dosing one week before the date set by the patient to stop smoking. Alternatively, the patient can begin varenicline tablets dosing and then quit smoking between days 8 and 35 of treatment. Starting Week: 0.5 mg once daily on days 1 to 3 and 0.5 mg twice daily on days 4 to 7. Continuing Weeks: 1 mg twice daily for a total of 12 weeks. An additional 12 weeks of treatment is recommended for successful quitters to increase likelihood of long-term abstinence.
The prescription sequence for Varenicline (Chantix) is as follows:
- Starting week: 0.5 mg once daily on days 1-3, then 0.5 mg twice daily on days 4-7
- Continuing weeks: 1 mg twice daily for a total of 12 weeks
- Optional additional treatment: an additional 12 weeks of treatment for successful quitters to increase likelihood of long-term abstinence 2
From the Research
Prescription Sequence for Varenicline (Chantix)
The prescription sequence for Varenicline (Chantix) is not explicitly stated in the provided studies. However, the studies provide information on the efficacy of Varenicline compared to other smoking cessation treatments.
Efficacy of Varenicline
- Varenicline has been shown to be effective for smoking cessation, with studies indicating that it is at least as good as, and possibly more effective than, bupropion 3, 4.
- A systematic review and multiple treatment meta-analysis found that Varenicline was the only treatment that demonstrated effects over other options 5.
- A network meta-analysis of 20 randomized controlled trials found that Varenicline combined with Bupropion showed the best effect of all treatments, and that Varenicline alone was superior to Nicotine Replacement Therapy (NRT) and Bupropion alone 6.
- A randomized clinical trial found that Varenicline plus counseling may be the best pharmacological option for the treatment of smoking in smokers with major depressive disorder, given its greater efficacy effect size and similar risk of neuropsychiatric adverse events 7.