Will This Be The End of Chantix?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Chantix (varenicline) is a nicotine agonist used to help quit smoking. Chantix is effective because it provides some nicotine effects to help with withdrawal symptoms while also blocking the effects of nicotine if the smoker relapses. Most other smoking cessation treatments either try to replace nicotine or mimic the effects of nicotine by inhibiting dopamine reuptake. Chantix was found to be more effective than nothing (placebo) and more effective than Zyban (bupropion sr, Buproban – with the same active ingredient as Wellbutrin) for quitting tobacco.

Chantix has been dogged by reports of depression and suicidal thoughts, and it now has a new problem. On December 12, 2012, the Food and Drug Administration (FDA) announced results of studies that revealed a higher incidence of major adverse cardiovascular events (heart attack and stroke) in patients receiving Chantix compared with placebo. It’s important to note these results did not reach statistical significance but the risk of heart attack and stroke was consistently higher in the Chantix group.

The problem for health care professionals and patients is that smoking is a major risk factor for cardiovascular disease, and Chantix is effective in helping patients to quit smoking. There is no question the health benefits of quitting smoking are immediate and substantial. So, it is worth the potential downsides to take a leap of faith on Chantix? Weigh in.

Dr O.

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