> ## Documentation Index
> Fetch the complete documentation index at: https://docs.hi-doctor.ai/llms.txt
> Use this file to discover all available pages before exploring further.

# Varenicline quit-smoking guide

> The standard first-week titration for varenicline, a 12-week quit-smoking course, and how to manage nausea, sleep and mood changes along the way.

Varenicline partly stimulates nicotine receptors, reducing withdrawal and the reward from smoking. It improves the chance of stopping when combined with motivation and behavioural support, but no course guarantees abstinence.

## How to use

Two things run in parallel from day one: how the tablet is taken, and the quit
plan it is meant to support.

<CardGroup cols={2}>
  <Card title="Swallow after food with water" icon="tablets">
    Take each tablet whole after food with a full glass of water to reduce nausea. Use the starter pack in order, and don't combine it with another quit-smoking medicine unless the prescriber has planned it.
  </Card>

  <Card title="Pair tablets with a quit plan" icon="ban-smoking">
    Set the agreed target quit date, usually 1–2 weeks after starting, and use behavioural support for triggers and cravings. A flexible quit date within the first 5 weeks may be agreed in some cases.
  </Card>
</CardGroup>

## Dose schedule

| Days         | Dose                                                                 |
| ------------ | -------------------------------------------------------------------- |
| Days 1–3     | 0.5 mg once daily                                                    |
| Days 4–7     | 0.5 mg twice daily (morning and evening, spaced as directed)         |
| Day 8 onward | Usually 1 mg twice daily, for the planned course — commonly 12 weeks |

<Note>
  This gradual start improves tolerance. Kidney function or side effects may require a lower dose, and a further course is considered individually.
</Note>

## What has been reported

| Category                     | Effects                                                                                                                                                                                              |
| ---------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Nausea and digestive effects | Nausea is common, especially after dose increases — taking tablets after food with water can help. Constipation, diarrhoea, indigestion, dry mouth, or appetite changes can occur.                   |
| Sleep, mood, and behaviour   | Vivid dreams, insomnia, sleepiness, and headache are common. Mood or behaviour can change during treatment or nicotine withdrawal; involve supportive people and report concerning changes promptly. |

## Contact your doctor if

* Thoughts of self-harm, severe agitation, psychosis, a seizure, chest pain, or stroke symptoms — seek urgent help
* A severe skin reaction, facial or throat swelling, or breathing difficulty
* Nausea, insomnia, mood effects, or kidney-related concerns make it hard to continue, or smoking has not stopped as planned

## Storage

Keep in the original package, away from moisture and direct heat, and out of children's reach. Follow the temperature limit on your pack and do not use it after the expiry date.

## What to expect

The prescribed course is commonly 12 weeks. Review slips without judgement and adjust the plan with the clinician rather than stopping unreviewed.

## Related reading

See also the [cytisine quit-smoking guide](/library/guides/cytisine), [how the consultation works](/essentials/how-it-works), and [how we handle safety and eligibility](/essentials/safety).

<Warning>
  This page is reference information, not medical advice and not a prescription. Whether a medicine is appropriate for you is decided by a registered doctor after reviewing your consultation.
</Warning>