How to Use Varenicline
There are seven medicines approved by the Food and Drug Administration (FDA) to help you quit. They work in different ways. All have been shown to be safe and effective for adults who smoke cigarettes.
These quit-smoking medicines include nicotine replacement medicines (the nicotine patch, lozenge, gum, oral inhaler, and nasal spray) and pill medicines (varenicline and bupropion SR).
Some other strategies, with or without medicines, can help you quit as well.
Varenicline is a pill that does not contain nicotine. You need a prescription for it. It works differently than other quit-smoking medicines and may be an especially good option for people who have tried using other medicines to quit before but haven’t been able to quit successfully.
Varenicline comes in two strengths: 0.5 mg (a white pill) and 1 mg (a blue pill). Your doctor or pharmacist can give you detailed instructions on how to use it. They can also help you set and adjust your dose.
- You’ll need a prescription from a prescribing healthcare provider for varenicline. Take varenicline exactly as directed by your doctor or other healthcare provider.
- Varenicline is a pill that comes in two strengths: 0.5 mg (a white pill) and 1 mg (a blue pill). Varenicline does not contain nicotine.
- Your doctor or other healthcare provider will help you decide when to start taking varenicline. There are two ways that people commonly use it:
- Option 1: You choose a quit date when you will stop smoking and then start taking varenicline one week before your quit date. This helps the medicine build up in your body before you quit. You can keep smoking during this time but be sure to stop smoking on your quit date.
- Option 2: You start taking varenicline before you choose your exact quit date. Then you pick a quit date that is 8 to 35 days after you start taking varenicline. Be sure to quit smoking on the quit date you’ve set.
- Your doctor or other healthcare provider will give you dosing instructions. Most people are started on a lower dose at first to get used to the medication:
- Days 1 to 3: Take one white pill (0.5 mg) each day.
- Days 4 to 7: Take two white pills (0.5 mg each) per day – one in the morning and one in the evening.
- Days 8 until the end of treatment: Take two blue pills (1 mg each) per day – one in the morning and one in the evening.
- Take varenicline with food or a full glass of water to minimize potential nausea from the medication
- If you miss a dose of varenicline, take it as soon as you remember. If it is close to your next dose, just wait and take your next dose at your regular dosing time.
- Most people take varenicline for 12 weeks. Your healthcare provider might prescribe it for longer, if needed.
- Varenicline can have side effects:
- Be careful when driving or operating machinery until you know how varenicline may affect you. Some people may feel sleepy or dizzy, or have trouble concentrating.
- If you are using varenicline and experience hostility, agitation, depression, suicidal thoughts, or changes in how you act that you don’t think are due to quitting smoking, you should stop taking the medicine and talk to your doctor right away. Get emergency medical help if needed.
- Tell your doctor or other healthcare provider if you have new or worsening symptoms of heart disease while taking varenicline, including chest pain and shortness of breath. Get emergency medical help if needed.
- Keep out of reach of children and pets. In case of accidental use or ingestion of varenicline, contact a Poison Control Center (1-800-222-1222) and/or visit an emergency room right away.
- Quitting smoking may make some people depressed or anxious, whether quitting with medication or not. Get help if you have feelings of depression or anxiety that last for more than two weeks or that get worse.
- Learn more about varenicline, including side effects and precautions.
- Varenicline works differently than other quit-smoking medicines and may be a good option for people who have tried using other medicines to quit before but haven’t been able to quit successfully.
- What if I can’t sleep or I start having unusual dreams while taking varenicline? Varenicline can cause sleep disturbances and abnormal or vivid dreams. If these bother you, contact your healthcare provider.
- What if I feel nauseous while taking varenicline? Nausea is a common side effect of taking varenicline. If you feel nauseous, be sure you are taking varenicline with a full glass of water. You can also talk with your healthcare provider about lowering the dose of your medication.
- For best results, use varenicline as part of a program that includes coaching support. Talk with your healthcare provider and connect with your state tobacco quitline (1-800-QUIT-NOW) for help.
Varenicline is a pill you take twice a day. You start taking it at least one week before you quit, gradually increasing the dose. It does not contain nicotine, so it works differently than the nicotine replacement medicines.
- Simple to use so may be easier to stick with it.
- Your chance of successful quitting with a single medicine is best with varenicline.
- Varenicline gets in the way of nicotine in the brain so you don’t enjoy nicotine as much if you use a cigarette.
- Can gradually reduce your smoking, since you start taking it before quitting.
- Need to take it with food or a full glass of water to help avoid nausea.
- May cost more if you have to pay for it yourself.
- Requires a prescription.
Possible Side Effects (talk to your doctor or other healthcare provider about what you can do):
- Nausea or vomiting at full dose (take with food or a glass of water. If persists, talk to your doctor about lowering the dose).
- Sleep disturbances such as difficulty sleeping and vivid dreams (talk to your doctor about lowering your evening dose).
- Constipation or flatulence (talk to your healthcare provider about diet changes or over-the-counter medicines you can take).
- Changes in your mood or behavior (rare – see precautions)
Varenicline Precautions (If any of these apply to you, talk to your doctor or other healthcare provider before starting to take varenicline.):
- Severe kidney problems (dose may need to be lowered).
- Could be pregnant or are breastfeeding.
- Less than 18 years old.
In addition, if you decide to take varenicline and experience hostility, agitation, depression, suicidal thoughts, or changes in how you act that you don’t think are due to quitting smoking, you should stop taking the medicine and talk to your doctor right away.
More precautions and general information are available about varenicline.
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