Champix (varenicline) is used to help patients quit smoking. The medication both partially stimulates nicotine receptors in the brain and partially blocks them; it reduces the cravings and withdrawal symptoms while reducing the beneficial effects effects of nicotine.

Patients should be aware that Champix works best when the patient is determined to quit. The medication is unlikely to be effective without the extra willpower from a person who really wants to stop smoking.

12 Weeks to Freedom

There are three primary methods for quitting with Champix; all of them work on a 12-week course:

• Fixed quit - Set a date one week after starting Champix. The remaining 11 weeks of treatment will prevent cravings and withdrawal symptoms.
• Flexible quit - Set a quit date somewhere between 8 and 35 days after starting treatment with Champix.
• Gradual quit - Start Champix and cut smoking in half during each month of treatment, with the goal of quitting by week 12.

The first two methods---fixed & flexible quit---are the most effective; 44 and 54 percent, respectively. Gradual quit is the least successful, at 32 percent, but is still far more effective than placebo, with its highest quitting-success rate of 19 percent. Patients often find their success in quitting is much higher if attending counseling or support groups while trying to quit.

The medication is simple to use:

• On days 1 to 3 take 0.5 mg once per day.
• On days 4 to 7 take 0.5 mg twice per day.
• On day 8 to the end of treatment, take 1 mg twice per day.

Tablets should be taken after a meal and with a full glass of water.

If a patient has stopped smoking by the 12-week mark but still feels withdrawal symptoms and/or craves cigarettes, Champix may be prescribed for an additional 12 weeks. Studies have shown little benefit in continuing treatment in patients who have not quit smoking after the first 12 weeks.

Nicotine Withdrawal

Nicotine withdrawal alone can produce a number of side effects, which Champix helps reduce or eliminate. In spite of this reduction, however, some patients may still feel:

• Desire to smoke
• Irritability
• Frustration
• Anxiety
• Restlessness
• Depression
• Difficulty sleeping
• Difficulty concentrating
• Increased appetite

The above side effects are generally not cause for concern unless severe enough to be disruptive. Many patients can manage them, provided the desire to quit is strong enough, even without counseling. Others have better effects with counseling or support groups.

Effects of withdrawal peak about 24 hours after the last cigarette and gradually decline for another 2 to 4 weeks, after which time most patients start to feel like themselves again.

Champix Side Effects

The majority of patients take Champix with no side effects, or only a few mild symptoms. Most commonly reported are:

• Difficulty sleeping
• Unusual, vivid dreams
• Constipation
• Nausea
• Vomiting
• Gas

Champix is somewhat associated with more worrisome side effects, which warrant medical attention. In most cases these happen in patients with a history of related disorders, including:

• Mental health disorders
• Cardiovascular issues
• Seizures
• Sleepwalking

Patients with a history of the above should be alert for warning signs, and at the first symptoms stop taking Champix and seek medical attention. It is disputed as to Champix's role in worsening these conditions; the increase in frequency of such events is statistically insignificant and often mimics nicotine withdrawal, even without Champix. In numerous studies, however, there was a very small increase in patients taking Champix versus those taking placebo.

The effects of Champix on unborn or nursing babies is unclear. Women who are pregnant or breastfeeding should consult a doctor as to the wisdom of taking Champix.