Varenicline is a partial agonist at nicotine receptors and it is therefore expected that it will reduce cravings and the minimise rewards gained from smoking while it is used. It is licensed for smoking cessation in adults. Existing data for varenicline compares it to bupropion, there are no comparative data with nicotine replacement therapy (NRT).
The license also states that this product should not be used in pregnancy and there are only limited data for many chronic disease including COPD and cardiovascular disease. Additionally abnormal dreams, insomnia, headache and nausea are very common side effects, occurring in at least 10% of patients.
Action: Varenicline is a promising product to aid motivated individuals to quit smoking. Limited efficacy and safety data place this product as third line. NRT remains the first line choice in smokers who are motivated to quit. Bupropion and then varenicline can be considered where NRT fails to achieve successful smoking cessation.