Are Smoking Cessation Drugs Safe?

January 15, 2016  |  Smoking Cessation

Currently there are three ‘approved’ medications on the market for smoking cessation and several ‘off-label’ drugs that are still used. The top drug that is used is nicotine in many varied forms. ‘Nicotine replacement therapy’ can be found as a patch, as an inhaler, as gum and as lozenges. The only nicotine replacement therapy device that one needs a prescription for is the inhaler. All of the other forms are available in different doses as over the counter medication. All of these forms of therapy are fairly safe, as long as you use them as directed and as long as you make sure your doctor knows about your efforts.

stop smokingOut of all of these types of treatments, the patch is the only one where one does not have control over rapid nicotine dose adjustments, unless one uses gum or lozenges in addition to the patch during times of intense craving. The only drawback with a patch is that, like band aids, they may cause irritation of the skin. Other side effects such as nausea and stomach upset are minor compared to the problems incurred while smoking.

Chantix, or varenicline tartrate, was touted as an amazing smoking cessation medication that did not have the side effects of nicotine. It was developed with smoking cessation in mind and works by blocking the brain’s nicotinic receptors. If the user smokes, it blocks nicotine from binding in the brain. When it binds to the receptors, it gives a little nicotine effect, but also keeps the user from experiencing withdrawals. There have been serious side effects reported from Chantix however, including suicidal tendencies, depression, behavioral changes and cardiovascular effects.

A large analysis of people who were taking Chantix showed that the cardiovascular effects were real, although not statistically significant. This study showed that, regardless of previous cardiovascular health or non-health, people who took Chantix were more likely to experience non-lethal strokes and heart attacks and lethal heart attacks. In December 2012 the FDA issued a warning to consumers and directed the makers of Chantix to strengthen the warning label. In addition, the FDA warned health professionals to do risk-benefit analysis if they are considering prescribing Chantix to their patients.

Bupropion (Zyban or Wellbutrin), a drug typically used as an antidepressant, was found to decrease nicotine cravings when dosed as an extended release medication. But this drug comes with some heavy precautionary advice. If you have bipolar disorder, seizures, eating disorders or are a heavy alcohol drinker, this is not the drug for you. Bupropion acts to increase these symptoms if they are already present.

Two other drugs used as ‘off-label’ prescription smoking cessation products include Nortriptyline and Clonidine. Both of these have been on the market for a long time. Nortriptyline was used as an anti-depressant and can react badly with other medication you might be taking. Clonidine was a drug used for high blood pressure problems. When used for smoking cessation, one can have problems controlling blood pressure and/or allergic reactions.

The best advice is to stop smoking, no matter how you accomplish it. The best way to do it is with the support of your physician and some sort of support group. If you do take medications, at the first sign of a side effect always consult your doctor.