Varenicline Tartrate

Adults: Start Varenicline one week before the date the patient has set for stopping smoking. The other way is to start Varenicline first and let the patient quit smoking between days 8 and 35 of treatment. In the starting week, the dose is 0.5 mg once daily on days 1 to 3, then 0.5 mg twice daily on days 4 to 7. In the continuing weeks, the dose is 1 mg twice daily, for a total of 12 weeks. For people who manage to quit, another 12 weeks of treatment is recommended to increase the likelihood of long-term abstinence. Some patients are sure they can't or won't quit all at once. For them, consider a gradual approach with Varenicline. The patient starts the medicine and cuts smoking by 50% from baseline within the first four weeks, then by another 50% over the next four weeks. After that they keep reducing, with the goal of complete abstinence by 12 weeks. Treatment then continues for another 12 weeks, making 24 weeks in all. Severe renal impairment (estimated creatinine clearance less than 30 mL/min): begin with 0.5 mg once daily and titrate to 0.5 mg twice daily. For patients with end-stage renal disease on hemodialysis, a maximum of 0.5 mg daily may be given if tolerated. Consider a lower dose for patients who can't tolerate the adverse effects. If a patient fails to stop smoking or relapses, another attempt at treatment is recommended once the factors behind the failed attempt have been addressed. Provide patients with suitable educational materials and counseling to support the quit attempt. Pediatric use: Varenicline is not recommended for patients 16 years of age or younger, because its efficacy in this group was not demonstrated.