In keeping with the paradigm shift in addiction medicine there is now a reasonable medical treatment for
nicotine addiction. The treatment of nicotine addiction in the past has has been through classic behavioral
models such as cognitive behavior therapy, self-help, hypnosis, etc. In recent years there has been the
use of Nicotine Replacement Therapy (NRT) to assist with the other therapies. Many pharmaceutical companies
have produced various forms of nicotine delivery systems for replacement therapy. They have included
inhalers, gum, and patches. Now there is something new: a partial agonist of nicotine.
Varencline (Chantix) is a partial agonist of nicotine, as buprenorphine is a partial agonist of opiates.
Therefore, it blocks the agoinst, nicotine, at the same time it alleviates withdrawal symptoms and
its withdrawal syndrome produces significantly less discomfort.
Information for Patients:
Patients should be instructed to set a date to quit smoking and to initiate CHANTIX
treatment one week before the quit date.
Patients should be advised that CHANTIX should be taken after eating, and with a full
glass of water.
Patients should be instructed how to titrate CHANTIX, beginning at a dose of 0.5
mg/day. Prescribers should explain that one 0.5 mg tablet should be taken daily for the
first three days, and that for the next four days, one 0.5 mg tablet should be taken in the
morning and one 0.5 mg tablet should be taken in the evening.
Patients should be advised that, after the first seven days, the dose should be increased to
one 1 mg tablet in the morning and one 1 mg tablet in the evening.
Patients should be encouraged to continue to attempt to quit if they have early lapses after
quit day.
Patients should be informed that nausea and insomnia are side effects of CHANTIX and
are usually transient; however, patients should be advised that if they are persistently
troubled by these symptoms, they should notify the prescribing physician so that a dose
reduction can be considered.
Patients should also be provided with educational materials and necessary counseling to
support an attempt at quitting smoking.
Patients should be informed that some medications may require dose adjustment after
quitting smoking.
Patients intending to become pregnant or planning to breast-feed an infant should be
advised of the risks of smoking and risks and benefits of smoking cessation with
CHANTIX.
