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Smoking cessation - Management
Which dose of varenicline should I prescribe and for how long?
- The recommended treatment dose is 1 mg varenicline twice daily following a 1-week titration as follows:
- Days 1–3: 500 micrograms once a day.
- Days 4–7: 500 micrograms twice a day.
- Day 8 onwards: 1 mg twice a day.
- For people who cannot tolerate the adverse effects of higher doses (1 mg twice daily) of varenicline, the dose may be reduced to 0.5 mg twice a day.
- Advise the person to stop smoking 7–14 days after starting varenicline.
- The recommended course of treatment is 12 weeks.
- For people who have successfully stopped smoking at the end of 12 weeks, an additional course of 12 weeks' treatment with varenicline at 1 mg twice daily may be considered to help maintain abstinence.
- Varenicline may be stopped without tapering the dose. However, immediately after stopping treatment with varenicline, up to 3% of people experience an increase in irritability, urge to smoke, depression, or insomnia. Inform the person accordingly and discuss or consider the need for dose tapering.
In depth
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