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Smoking cessation: making repeated attempts with nicotine is safer than using varenicline (Champix° or Chantix°)

FEATURED REVIEW Varenicline, a partial agonist of nicotinic acetylcholine receptors, has been authorised since 2006 in the European Union for smoking cessation. In 2018, what is known about the harm-benefit balance of varenicline, and what role does it play in smoking cessation, compared to nicotine replacement therapy?
Full review (3 pages) available for download by subscribers.

Abstract

  • According to a meta-analysis of randomised trials, varenicline appears to be slightly more effective than nicotine patches for smoking cessation. However, three randomised trials in 2138 smokers showed that at 6 months and 1 year, varenicline is not more effective than a combination of nicotine patches plus on-demand, fast-acting nicotine.
     
  • The neuropsychiatric adverse effects observed in patients with a history of mental illness, as well as serious cardiac disorders associated with varenicline, should encourage repeated attempts to be made with nicotine rather than using varenicline.
     

©Prescrire 1 September 2018

"Smoking cessation. Varenicline: safer to make repeated attempts with nicotine" Prescrire Int 2018; 27 (196): 215-217. (Pdf, subscribers only)

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