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cytisine; cytisinicline (Tabex)
Extracted from acacia seeds.
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]
- used in Europe, not FDA-approved in U.S.
Dosage:
- duration of therapy: 25 days
Adverse effects:
- gastrointestinal
- epigastric pain
- xerostomia
- dyspepsia
- nausea, vomiting
- 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]
General
alkaloid
amine
heterocyclic compound, 2 rings
neurologic agent
Database Correlations
PUBCHEM correlations
References
- West R et al
Placebo-Controlled Trial of Cytisine for Smoking Cessation
N Engl J Med 2011; 365:1193-1200
PMID: 21991893
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: 16908787
- Walker N et al
Cytisine versus Nicotine for Smoking Cessation.
N Engl J Med 2014; 371:2353-2362. December 18, 2014
PMID: 25517706
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
PMID: 25517710
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: 37432430
https://jamanetwork.com/journals/jama/fullarticle/2807079