Wednesday, July 06, 2011


Varenicline is a drug that is marketed to help patients kick the smoking addiction. Obviously, this is another "TAK NAK" strategy to try and reduce the smoking cardiovascular risk. This drug is quite potent and if taken correctly with counselling, it is said that 1:10 taking the drug will kick the habit. That is the good side.
In the 4th July online edition of the Canadian Medical Association Journal, Drs Sonal Singh ( John Hopkins University School of Medicine, Baltimore ) and Curl Furberg ( Wake Forest Baptist Medical Center, North Carolina ), published their meta-analysis of 14 clinical trials done with varenicline. It involved 8,216 patients, taking varenicline from 7-52 weeks, comparing the rate of cardiovascular events in those taking the drug and those on placebo. 13 of the trials had patients who had no known cardiac disease in the past.
They found that those taking varenicline had a 72% more incidence of cardiovascular events. Now this is worrying. We all remember that varenicline is also associated with know neurological disorders, including suicides, momentary lost of awareness, nervousness, agitations etc. So much so that the US army has ban the use of varenicline in officers manning missiles sites, pilots, truck drivers etc. They are obviously worried.
The numbers seemed to show that you need to treat 28 patients to get one with CV side effects. Now this is worrying. If we treat 10 subjects, to get one to quit, and you treat 28 to get one CV side effects, Is it worth-it? one must ask. If pilots should not take it, what about bus drivers, car drivers?
This is not the only paper of the CV side effects of varenicline. There were previous signals.
Those who oppose varenicline, now have more ammo to ask the government to ban the use of this drug, seeing the CVS and CNS dangers. Those who support the use of this drug, to help people quit, will say that stopping smoking does more good then the potential harm.
Now each of us must weight the equation for ourselves?
As for me, I have never been impressed with the data on the usefulness of varenicline. I was rather concerned about the CNS side effects. With this new meta-analysis, I am even more concern. Perhaps there is some justification is restricting its use. You cannot help 1:10 and endanger 1:28. The benefit does not outweigh the risk ( in my opinion ).
Afterall, there is something call the will to stop, if one really ones too. The good old method of cold turkey, is another way, though somewhat arcade.
Varenicline, is marketed in Malaysia as Champix.

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