[Ryan Moore]

in reply to: Pharmacy #13858

Hi all, please see below a situation regarding Varenicline prescribing!

Question- We have had a situation today at work where we wanted to commence varenicline on a patient but pharmacy and cardio doctor have said we cannot give it to the patient as it is cautioned in cardiovascular disease – the patient does not have PMH of cardiovascular disease and was admitted with an acute event – an NSTEMI with a trop of 16,000.

I would like to run this by you to ensure we have not made a mistake in offering the Champix to the patient as surely it is better for this patient to stop smoking? Also it is not a contra-indication and as I am aware we can offer Champix in ACS.
The patients only PMH is depression – not on any meds for over 6 months and stated he was happy in himself and stable for over 6 months.

Answer- Offering champix was 100% the right thing!!!!
Unfortunately there is sometimes education needed for the doctor/pharmacist.
I would point them in the direction of two major trials Rigotti 2010 Efficacy & Safety of varenicline for smoking cessation in patients with cardiovascular diseases.
Eisenberg 2016 Varenicline for smoking cessation in hospitalised patients with acute coronary syndrome.

Both confirm there is NO increased risk of cardiovascular events with varenicline.

So you were completely correct and we need to focus on educating those that perpetuate myths like that.

[Author]

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