cytisine; cytisinicline (Tabex)
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Introduction
Indications
- smoking cessation
- more effective than nicotine replacement therapy[4]
- self-reported continuous abstinence at 1 month 40% vs 31%
- abstinence rates also favor cytisine at 2 & 6 months[4][6]
- used in Europe, not FDA-approved in U.S.
- more effective than nicotine replacement therapy[4]
Dosage
- cytisinicline (Tabex) 3 mg TID for 6-12 weeks
- duration of therapy: 25 days
Adverse effects
- gastrointestinal
- sleep disturbances[4]
- 5% discontinue drug because of adverse effects[4]
Mechanism of action
- plant-based alkaloid
- partial nicotinic acetylcholine receptor agonist
- binds selectively to alpha-4,beta-2 nicotinic acetylcholine receptors
Notes
- lower cost than Chantix;
- $15/course
- used for smoking cessation in Eastern Europe for decades but is largely unavailable elsewhere[4]
More general terms
References
- ↑ West R et al Placebo-Controlled Trial of Cytisine for Smoking Cessation N Engl J Med 2011; 365:1193-1200 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/21991893 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1102035
- ↑ PubChem: 10235
- ↑ Etter JF. Cytisine for smoking cessation: a literature review and a meta-analysis. Arch Intern Med. 2006 Aug 14-28;166(15):1553-9. Review. PMID: https://pubmed.ncbi.nlm.nih.gov/16908787
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Walker N et al Cytisine versus Nicotine for Smoking Cessation. N Engl J Med 2014; 371:2353-2362. December 18, 2014 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/25517706 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1407764
Rigotti NA Cytisine - A Tobacco Treatment Hiding in Plain Sight. N Engl J Med 2014; 371:2429-2430. December 18, 2014 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/25517710 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1412313 - ↑ Rigotti NA, Benowitz NL, Prochaska J et al Cytisinicline for Smoking Cessation. A Randomized Clinical Trial. JAMA. 2023;330(2):152-160. PMID: https://pubmed.ncbi.nlm.nih.gov/37432430 https://jamanetwork.com/journals/jama/fullarticle/2807079
- ↑ 6.0 6.1 Rigotti NA, Benowitz NL, Prochaska JJ et al Cytisinicline for Smoking Cessation: The ORCA Phase 3 Replication Randomized Clinical Trial. JAMA Intern Med. 2025 Apr 21:e250628. PMID: https://pubmed.ncbi.nlm.nih.gov/40257755 PMCID: PMC12012700 Free PMC article.
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=10235
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=241660
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=442949
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=6713952
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=131881802
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=20056518