New pill for the treatment of smoking cessation CHAMPIX

Tobacco smoking is the leading cause of premature death in developed countries. Approximately half of all long-term smokers die prematurely due to smoking-related health problems, and continuing smokers have a reduced lifespan by an average of ten years. In contrast, individuals who quit smoking by age 50 reduce their risk of dying in the following 15 years by about one-half compared with those who continue to smoke.

Pfizer's Champix (Varenicline) is a new agent for smoking cessation with a different mechanism of action than currently available medications.

What is CHAMPIX?
Varenicline is indicated for smoking cessation in persons eighteen years of age and older.

How does CHAMPIX work?
It is a partial agonist that binds selectively and with greater affinity than nicotine to alpha 4 beta 2 nicotinic acetylcholine receptors. It produces an effect that relieves symptoms of withdrawal and craving, at the same time, it prevents nicotine from binding to the receptor, thus blocking the rewarding and reinforcing effects of smoking.

How effective CHAMPIX is?

Studies demonstrate that varenicline was superior to both placebo and bupropion in short-term efficacy. Consistent benefit over placebo was also shown in the long term (at week 52), whereas results were inconsistent with respect to long-term efficacy against bupropion.

What are the adverse effects of CHAMPIX?

Varenicline was generally associated with mild to moderate adverse events in clinical trials. Nausea was the most frequently reported adverse reaction . It appears to be dose-dependent and usually decreases with continued use. One study found a lower incidence of nausea when the drug was titrated to target doses over a few days.

Other common adverse reactions reported with varenicline were vomiting, constipation, flatulence, taste perversion, abnormal dreams, and sleep disturbance.

Unlike bupropion SR and most nicotine products, varenicline does not decrease weight gain associated with smoking cessation.

Are there any drug interactions with CHAMPIX?

No known clinically meaningful drug interactions have been identified based on drug interaction studies between varenicline and digoxin, warfarin, bupropion, cimetidine, or metformin. Concomitant therapy with transdermal nicotine does not appear to affect nicotine pharmacokinectics, however, the incidence of gastrointestinal (nausea, vomiting, dyspepsia) and neurologic (headache, dizziness,fatigue) symptoms was higher with the combination than with nicotine alone.

What is the recommended dosing for CHAMPIX?

It is recommended that varenicline be started one week prior to a patient's target quit-smoking date, with the dose titrated to 1 mg twice daily as follows:

Day 1-3: 0.5 mg once daily
Day 4-7: 0.5 mg twice daily
Day 8 through the end of week 12: 1.0 mg twice daily

Varenicline should be taken after a meal, with a full glass of water.

The medication, varenicline, with tradename ChantixTM (varenicline) in the United States, received U.S. Food and Drug Administration approval as an aid to smoking cessation in May 2006.

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