Drug Action
Varenicline is a selective nicotine-receptor partial agonist.
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Drug reference
Varenicline is a selective nicotine-receptor partial agonist.
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To aid smoking cessation ▶BY MOUTH ▶Adult: Initially 500 micrograms once daily for 3 days, increased to 500 micrograms twice daily for 4 days, then 1 mg twice daily for 11 weeks; reduced if not tolerated to 500 micrograms twice daily, usually to be started 1–2 weeks before target stop date but can be started up to a maximum of 5 weeks before target stop date, 12-week course can be repeated in abstinent individuals to reduce risk of relapse
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Conditions that may lower seizure threshold. history of cardiovascular disease. history of psychiatric illness (may exacerbate underlying illness including depression). predisposition to seizures
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NICE decisions ▶Varenicline for smoking cessation (July 2007) NICE TA123 Varenicline (Champix ®) is recommended, within its licensed indications, as an option for smokers who have expressed a desire to quit smoking; it should normally be prescribed only as part of a programme of behavioural support. www.nice.org.uk/guidance/ta123
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▶Common or very common Appetite abnormal. asthenia. chest discomfort. constipation. diarrhoea. dizziness. drowsiness. dry mouth. gastrointestinal discomfort. gastrointestinal disorders. headache. joint disorders. muscle complaints. nausea. oral disorders. pain. skin reactions. sleep disorders. vomiting. weight increased ▶Uncommon Allergic rhinitis. anxiety. arrhythmias. behaviour abnormal. burping. conjunctivitis. depression. eye pain. fever. fungal infection. haemorrhage. hallucination. hot flush. hyperglycaemia. influenza like illness. malaise. menorrhagia. mood swings. numbness. palpitations. seizure. sexual dysfunction. suicidal ideation. sweat changes. thinking abnormal. tinnitus. tremor. urinary disorders ▶Rare or very rare Angioedema. bradyphrenia. coordination abnormal. costochondritis. cyst. diabetes mellitus. dysarthria. eye disorders. feeling cold. glycosuria. muscle tone increased. polydipsia. psychosis. scleral discolouration. severe cutaneous adverse reactions (SCARs). snoring. vaginal discharge. vision disorders ▶Frequency not known Loss of consciousness
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Avoid—toxicity in animal studies.
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Avoid—present in milk in animal studies.
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Dose adjustments If eGFR less than 30 mL/minute/1.73 m2, initial dose 500 micrograms once daily, increased after 3 days to 1 mg once daily.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 3 ▶Champix (Pfizer Ltd) Varenicline (as Varenicline tartrate) 500 microgram Champix 0.5mg tablets | 56 tablet P £54.60 DT = £54.60 Varenicline (as Varenicline tartrate) 1 mg Champix 1mg tablets | 28 tablet P £27.30 DT = £27.30 | 56 tablet P £54.60 Varenicline (as Varenicline tartrate) 500 microgram/1 mg Champix 0.5mg/1mg 2 week treatment initiation pack | 25 tablet P £27.30 DT = £27.30 Varenicline (as Varenicline tartrate) 500 microgram/1 mg Champix 0.5mg/1mg 4 week treatment initiation pack | 53 tablet P £54.60 8.3 Opioid dependence Other drugs used for Opioid dependence Buprenorphine, p. 468. Naltrexone hydrochloride, p. 519 ANALGESICS › OPIOIDS eiiii F 467
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Risk of relapse, irritability, depression, and insomnia on discontinuation; consider dose tapering on completion of 12-week course.
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Driving and skilled tasks Manufacturer advises patients and carers should be cautioned on the effects on driving and performance of skilled tasks—increased risk of dizziness, somnolence, and transient loss of consciousness.
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Initially 500 micrograms once daily for 3 days,
First-line fragment. Read the complete Indications and Dose section above.
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