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    Cytisine

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    How does cytisine help to quit smoking

    Cytisine is a tablet that can help you stop smoking. Available with a prescription in the UK, the medication contains no nicotine. But it does mimic its effects. It works to relieve cravings and withdrawal symptoms associated with quitting smoking. 

    Cytisine works by attaching to the same receptors in the brain that nicotine does. It ‘tricks’ your brain into thinking you’ve had a cigarette. This reduces urges and the withdrawal symptoms of stopping smoking.

    Evidence suggests it is as effective as nicotine replacement therapy, such as patches and gum.

    It may be a helpful option:

    • For smokers who have tried to quit before
    • For those who found other cessation methods haven't worked
    • As it's shown in studies to be twice as effective as placebo at helping people quit smoking 

    What are the side effects of cytisine?

    Like with all medications, there’s a risk of side effects. However, these may not affect everyone.

    Some of the most common side effects affecting more than 1 in 10 people include:

    • Changes in appetite (usually an increase)
    • Dizziness
    • Mood changes
    • Sleep problems
    • Headaches
    • High blood pressure
    • Slow heart rate
    • Dry mouth
    • Diarrhoea
    • Sickness
    • Nausea
    • Heartburn
    • Fatigue
    • Rash
    • Muscle pain 

    For more information on side effects, please read the patient information leaflet.

    “If you’re struggling with side effects, talk to your GP or prescriber. Stopping smoking can also cause withdrawal symptoms which you may experience at the same time.” - Dr Bhavini Shah 

    Does cytisine cause weight gain?

    Weight gain is a common side effect of cytisine. However, stopping smoking often causes weight gain (without treatment) as nicotine is an appetite suppressant.   

    How to take cytisine

    Cytisine should be taken with water. You should plan a quit date (the day of your last cigarette) no later than the fifth day of treatment. After your planned quit date, you should not smoke again as it can make the harmful effects of nicotine even worse.

    100 tablets (one pack) are enough for a complete quit attempt over a 25-day period. If your quit attempt doesn’t work this time, you can resume treatment in two to three months.

    A dosing schedule can be seen below. It’s useful to set timers on your phone to remind you to take the tablets. If you forget a dose, do not double up next time. 

    Cytisine dosing schedule

    1. ​​​​​​​Day 1-3: 6 tablets daily, 1 tablet every 2 hours
    2. Day 4-12: 5 tablets daily, 1 tablet every 2.5 hours
    3. Day 13-16: 4 tablets daily, 1 tablet every 3 hours
    4. Day 17-20: 3 tablets daily, 1 tablet every 5 hours
    5. Day 21-25: 2 tablets daily, 1-2 tablets a day

    Cytisine dosing schedule

    How long does cytisine take to work?

    The standard course of treatment is 25 days. You’re likely to notice your cravings start to reduce quite soon into your treatment journey and the benefits of smoking can be felt quite quickly. However, it’s important you finish a complete course.

    Alternative smoking cessation treatments

    There are many ways to quit smoking, such as:

    Stop smoking treatment
    Type of treatment
    Available
    Nicotine replacement therapy (NRT)
    • Lozenge
    • Patches
    • Gums
    • Sprays
    • Inhalers 
    • Pharmacies
    • Online
    • Supermarkets
    • NHS stop smoking service 
    CytisineTablet
    Prescription only
    VareniclineTablet
    Prescription only
    ChampixTabletNo longer available in UK

    Counselling, hypnotherapy, acupuncture and quitting 'cold turkey' with no support are all other ways of quitting smoking.

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      More information about cytisine

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      Who can take cytisine?

      Cytisine is suitable for smokers between the ages of 18 – 65 wanting to quit. You should not take cytisine if you have liver, kidney or heart problems, or a history of stroke. Pregnant and breastfeeding women should also not take cytisine.

      Women taking the pill to prevent pregnancy should also use a barrier method of contraception when taking cytisine, such as condoms (cytisine makes the pill less effective). Alternatively, talk to your doctor about switching to a highly effective (around 99%) long-acting contraceptive, such as the coil.

      Is cytisine safe? 

      In 2011, a large trial confirmed that cytisine is a safe and effective treatment to help with stopping smoking. Since then, several other trials have confirmed its safety.

      This section would benefit from authority markers, including who has declared this treatment safe.

      What happens if you smoke when taking cytisine?

      You can smoke while taking cytisine. However, you should stop smoking no later than the fifth day of taking cytisine.

      If you smoke for longer, you risk worsening the treatment reactions. If you take more cytisine than you should, you may experience symptoms such as; feeling generally unwell, feeling and being sick, blurred vision, breathing problems, and convulsions. If you experience this, it’s important you get medical advice immediately 

      Taking other medicines

      Cytisine should not be used with anti-tuberculosis drugs. You should also let us know of any other prescription medicines you are taking during your consultation.

      Reordering treatment

      100 tablets (one pack) are enough for a complete quit attempt over a 25 day period. If your quit attempt doesn't work this time, you can re-order treatment in two to three months time in your Patient Record.

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