From the Guidelines
Varenicline is contraindicated in patients with brain metastases due to an increased risk of seizures, as stated in the NCCN clinical practice guidelines in oncology 1. The primary concern with varenicline use is its potential to cause neuropsychiatric events, such as depression and suicidal ideation/behavior, although recent studies have shown that these risks may be lower than previously thought 1. Some key points to consider when prescribing varenicline include:
- Monitoring for the development or worsening of serious neuropsychiatric issues, including depression and suicidal ideation/behavior, and discontinuing use if these signs occur 1
- Avoiding use in patients with a history of seizures or epilepsy, as varenicline may lower the seizure threshold 1
- Weighing the benefits of smoking cessation against the potential risks of varenicline, particularly in patients with a history of psychiatric disorders 1 It is essential to carefully evaluate the risks and benefits of varenicline use in each patient, taking into account their individual medical history and current health status, as recommended by the NCCN guidelines 1.
From the FDA Drug Label
Varenicline tablets are contraindicated in patients with a known history of serious hypersensitivity reactions or skin reactions to varenicline tablets. The contraindications for Verinacline (varenicline) are:
- A known history of serious hypersensitivity reactions to varenicline tablets
- A known history of skin reactions to varenicline tablets 2, 2, 2
From the Research
Verinacline Contraindications
There are no direct mentions of Verinacline contraindications in the provided studies. However, we can look at the information related to varenicline, which might be relevant:
- Varenicline is used for smoking cessation and has been studied for its neuropsychiatric safety in various populations 3.
- The study found that varenicline was associated with a decreased risk of total neuropsychiatric adverse events (NPAEs) in the general population, both with and without psychiatric disorders, compared to nicotine replacement therapy (NRT) 3.
- However, the study also noted that the incidence of NPAEs was higher in the psychiatric cohort, suggesting that patients with pre-existing psychiatric conditions may be more susceptible to these adverse events 3.
- There is no direct information on Verinacline contraindications in patients with end-stage renal disease (ESRD) or other kidney diseases in the provided studies.
- Patients with ESRD often have multiple comorbid conditions, including mental health disorders, and require careful management of their medications and medical conditions 4, 5, 6, 7.
Some key points to consider:
- Varenicline may be associated with a decreased risk of NPAEs in certain populations, but its use should be carefully considered in patients with pre-existing psychiatric conditions 3.
- Patients with ESRD require comprehensive management of their medical conditions, including careful consideration of medication use and potential interactions 4, 5, 6, 7.
- There is limited information available on the use of varenicline in patients with ESRD, and more research is needed to fully understand its safety and efficacy in this population 3.