Champix

What is Champix?

Champix is the trade name of a drug called varenicline launched in the UK in December 2006 as a stop-smoking aid for adults. It is a non-nicotine based medicine designed to help people stop smoking.

What does it do?

Champix can help reduce the cravings and withdrawal symptoms associated with stopping smoking.  Also if someone taking Champix smokes a cigarette they may find it less satisfying and less pleasurable than before, which can reduce the risk of a complete relapse. Immediately after treatment, the risk of relapse is increased and some patients experience irritability, depression or insomnia.

Does it work?

A systemic review of published research shows that Champix does increase a smoker's chance of stopping smoking between two- and three-fold when compared with placebo, also performing slightly better than nicotine replacement patches and bupropion (Zyban).

Where can I get it?

Champix is available on prescription in Scotland. It was approved by the Scottish Medicines Consortium (SMC) in January 2007:  Varenicline (Champix) for smoking cessation and by the National Institute of Clinical Excellence (NICE) in February 2008: NICE guidance.

Can anyone use it?

Champix is not recommended for:

• Children under the age of 18
• Pregnant or breast-feeding women
• Anyone who may be allergic to varenicline or any of the other ingredients

You must not use varenicline without speaking to your doctor if you:

• have a history of depression or have a history of any psychiatric illness

It's important that you tell your doctor what other medicines you are taking (including those bought without a prescription) before Champix is prescribed for you, and to tell your doctor or pharmacist that you are taking Champix before you take any new medicines.

NB (November 2010 update): Clinical trials during drug development excluded patients with active psychiatric illnesses leaving the risks associated with varenicline use in this patient population unknown. A review of the evidence in Expert Opinion on Drug Safety (1) has concluded that although the risk of potential neuropsychiatric events is evident through voluntary reporting systems and reported cases in the literature, multiple studies and case reports support the use of varenicline in the mental health population.
(1) Purvis, T. L., Nelson, L. A., and Mambourg, S. E. Varenicline use in patients with mental illness: an update of the evidence. Expert.Opinon on Drug Safety . 18-2-2010.
Available from : www.biomedsearch.com/nih/Varenicline-use-in-patients-with/20166836.html [Accessed 22 Nov. 2010]

Side effects including depression

Information in this section taken from the Medicines and Healthcare products Regulatory Agency - the government agency responsible for ensuring that medicines work, and are safe.

• Trying to stop smoking, or stopping smoking, may cause symptoms of depression
• Reactions such as symptoms of depression with a medication may not be caused by that particular drug - they may relate to other factors such as nicotine withdrawal from stopping smoking, other conditions, or other medications taken by the patient at the same time
• However depression, suicidal thoughts, suicide attempts and completed suicides have been reported in patients taking varenicline who have no known pre-existing psychiatric conditions, and in patients who continue to smoke
• Since varenicline was put on the market in 2006, psychiatric disorders have been the most commonly reported side-effects for this drug in the UK

Patients who are taking varenicline who develop suicidal thoughts, agitation, depressed mood, or display any changes in behaviour that are of concern for the patient, family, or caregiver should stop use of varenicline and contact their doctor immediately.

As varenicline is a relativey new drug on the market, information about its use in the general population is limited. Healthcare professionals and patients are encouraged to report any side effects believed to be associated with varenicline use via MHRA's Yellow Card Scheme.

Further information

• Medicines and Healthcare products Regulatory Agency section on 'stop smoking' treatments
• The Scottish Medicines Consortium

For further information please contact the ASH Scotland Information Service by email at enquiries@ashscotland.org.uk or by phone on 0131 225 4725 (open Monday-Friday during office hours)

For help and advice on stopping smoking please call the NHS Health Scotland Smokeline on 0800 84 84 84 (open daily from noon to midnight) or visit canstopsmoking.com