From the Guidelines
Champix, also known as varenicline, is the most effective prescription medication for smoking cessation, with a success rate of up to 28% compared to 12% for placebo, as shown in the most recent study from 2021 1.
Key Points to Consider
- The standard treatment regimen for Champix involves starting with a low dose of 0.5 mg once daily for the first three days, then 0.5 mg twice daily for days 4-7, and then increasing to 1 mg twice daily for the remainder of the treatment period, which typically lasts 12 weeks.
- Users should set a quit date within the first week of treatment and continue taking Champix for the full course even if they have successfully quit smoking.
- Common side effects include nausea, sleep disturbances, headaches, and constipation.
- Champix is effective because it addresses both the physical and psychological aspects of nicotine addiction by easing withdrawal while making smoking less rewarding.
Important Considerations
- It's essential to discuss any history of psychiatric conditions, kidney problems, or cardiovascular disease with your doctor before starting this medication, as it may not be suitable for everyone.
- The use of Champix has been shown to be more effective than other pharmacotherapy interventions, including nicotine replacement therapy (NRT) and bupropion, as stated in the 2021 study 1.
- A combination of NRT products, such as combining short-acting and long-acting forms of NRT, has been found to be more effective than using a single form of NRT, as mentioned in the 2021 study 1.
Recommendations
- Champix should be prescribed as part of an abstinent-contingent treatment, in which the smoker makes a commitment to stop smoking on a particular date.
- Patients should be monitored for potential side effects, including nausea, sleep disturbances, headaches, and constipation, and the medication should be adjusted or discontinued if necessary.
- The benefits of Champix in helping people quit smoking outweigh the potential risks, as stated by the European Medicines Agency, and it should be considered as a first-line treatment option for smoking cessation.
From the FDA Drug Label
Varenicline is a nicotinic receptor partial agonist indicated for use as an aid to smoking cessation treatment. The main use of Champix, also known as varenicline, is as an aid to smoking cessation treatment 2.
- Key points:
- It is a nicotinic receptor partial agonist.
- It is used to help people stop smoking.
- The drug works by binding to nicotinic receptors in the brain, which helps to reduce cravings for smoking 2.
From the Research
Overview of Champix (Varenicline)
- Champix, also known as varenicline, is an orally administered alpha4beta2 nicotinic acetylcholine receptor partial agonist used as an aid to smoking cessation therapy 3.
- It has been approved by the US FDA (Chantix) and the European Commission (Champix) for use in smokers who want to quit 3.
Efficacy of Varenicline
- Varenicline is an effective and generally well-tolerated treatment for smoking cessation, with higher continuous abstinence rates compared to placebo or bupropion sustained-release (SR) 3, 4.
- It attenuates the urge to smoke, negative affect withdrawal symptoms, and the reinforcing effects of smoking 3.
- Extending varenicline therapy by an additional 12 weeks helps maintain abstinence in individuals who have quit smoking 3, 5.
Comparison with Other Smoking Cessation Therapies
- Varenicline is at least as effective as, and probably more effective than, bupropion for smoking cessation 4.
- A network meta-analysis showed that varenicline monotherapy or its combination with other interventions is superior in achieving smoking cessation compared to bupropion, nicotine replacement therapy, counselling, and placebo 6.
- The combination of varenicline and bupropion may achieve a better abstinence effect than varenicline monotherapy 6.
Safety and Tolerability
- Varenicline is generally well-tolerated, with nausea being the most commonly occurring adverse event, which diminishes over time 3, 5.
- There is a need for more data regarding the potential for neuropsychiatric events in varenicline recipients 5.
Cost-Effectiveness
- Varenicline is predicted to be cost-effective from a healthcare payer perspective in numerous countries, with acceptable incremental costs per QALY gained relative to other smoking cessation options 5.
- Administering varenicline for an additional 12 weeks in participants who have successfully quit smoking is estimated to have acceptable incremental costs per QALY gained 5.