Varni

Indications

Varenicline is used to help adults stop smoking. It works best as part of a quit plan that includes advice and support from a doctor, pharmacist or stop-smoking service.

How It Works

Nicotine causes pleasure and craving by acting on nicotinic receptors in the brain, which release dopamine. Varenicline partly stimulates these receptors, which eases cravings and withdrawal symptoms, and at the same time blocks nicotine from attaching to them, so smoking feels less satisfying if you do smoke.

Dosage and Administration

Set a quit date and start Varenicline 1 to 2 weeks before it (or as advised by your doctor). The usual adult schedule is: days 1 to 3, 0.5 mg once a day; days 4 to 7, 0.5 mg twice a day; from day 8, 1 mg twice a day for a total of 12 weeks. Your doctor may continue it for another 12 weeks if you have quit, or lower the dose if you cannot tolerate it or have kidney problems. Take the tablets after food with a full glass of water to reduce nausea.

Interactions

• Nicotine replacement products (patches, gum): may increase nausea, headache, vomiting and dizziness when used together.
• Alcohol: some people become more affected by alcohol, with unusual behaviour; reduce drinking until you know how you react.
• Medicines such as Theophylline, Warfarin and Insulin: doses may need adjusting after stopping smoking, as smoking affects how they work.

Contraindications

Do not take Varenicline if you are allergic to it or any ingredient in the tablet.

Side Effects

Very common side effects include nausea, unusual or vivid dreams, difficulty sleeping and headache. Others include constipation, wind, vomiting, tiredness, increased appetite and dry mouth. Changes in mood, such as depression, agitation or anxiety, can occur; these can also be caused by stopping smoking itself.

Stop taking Varenicline and get urgent medical help if you have thoughts of harming yourself, severe changes in mood or behaviour, hallucinations, fits, chest pain or symptoms of a heart attack or stroke, swelling of the face, lips or throat, difficulty breathing, or a severe skin reaction with blistering.

Pregnancy and Lactation

Varenicline is not recommended during pregnancy; pregnant smokers should seek advice on other ways to quit. It is not known whether it passes into breast milk, so it is best avoided while breastfeeding unless your doctor advises otherwise.

Precautions and Warnings

Tell your doctor if you have a history of depression or other mental health problems, fits, heart or blood vessel disease, or kidney disease. Varenicline can cause dizziness and sleepiness: do not drive or operate machinery until you know how it affects you. Irritability, low mood and sleep problems can occur when treatment ends, so your doctor may reduce the dose gradually.

Overdose

An overdose may cause severe nausea, vomiting, dizziness and other side effects. Seek medical help and take the pack with you.

Therapeutic Class

Smoking cessation aid (nicotinic receptor partial agonist).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.