OriginalDrugs

Wellbutrin and Chantix

Varenicline and bupropion are both safe and effective for tobacco smoking cessation, but each has a different mechanism of action.

Varenicline is a specific partial nicotine-receptor agonist that targets the alpha-4 beta-2 nicotinic receptor. It is thought to work by reducing craving and withdrawal symptoms, and by reducing reinforcement of the smoking habit due to its satisfying or enjoyable effects.

Bupropion is a dopamine/norepinephrine reuptake inhibitor that also may function as a nicotinic actetylcholine-receptor antagonist.

Wellbutrin vs Chantix

Chantix (varenicline) is more effective than Wellbutrin (bupropion) in helping smokers quit. Varenicline doubles or triples a person's chances of successfully quitting smoking 1, 7.

Several studies compared varenicline (Chantix) to bupropion SR (Wellbutrin/Zyban). At 3 months about 44% of those taking varenicline were able to stop smoking, compared to just 30% of those taking bupropion SR4.

Chances of continuous smoking abstinence are also higher with Chantix. In one study2, the abstinence rate at 1 year was 23% for varenicline, compared with 15% for bupropion.

The latest smoking cessation trial focused on young smokers compared varenicline and bupropion XL. Over the 8-week course of treatment5, participants receiving varenicline reduced the number of cigarettes per day from 14.1 ± 6.3 to 0.9 ± 2.1 and 4 smokers achieved abstinence. Those receiving bupropion XL reduced the number of cigarettes per day from 15.8 ± 4.4 to 3.1 ± 4.0 and 2 achieved abstinence.

Varenicline with Bupropion combination

Can you take Chantix and Wellbutrin together at the same time? The benefits and risks of varenicline in combination with bupropion have not been well studied. However, these drugs have different therapeutic targets and there is no drug interaction between them.

The study published study in "Nicotine and Tobacco Research" provides early evidence that bupropion SR and varenicline combination may be more effective in helping people stop smoking than monotherapies3.

The study participants smoked about 19.9 cigarettes per day for an average of 30 years. The smokers were given 1 mg of varenicline twice a day along with 150 mg of bupropion twice a day for 12 weeks. Abstinence rates were 71% at 3 months (the end of treatment) and 58% at six months. At six months, combination therapy continued to appear more effective than monotherapy.

The latest 2014 study combined use of varenicline and bupropion, compared with varenicline alone, may increase prolonged smoking abstinence 8.

Cost

A one-month supply of varenicline will cost about $70 for the maintenance dose (1mg 60 tablets). It is more expensive than generic bupropion SR, which one-month supply costs $36 (150mg 60 tablets). And persons who smoke one pack per day will spend an average of $150 per month on cigarettes6.

See also

References

  • 1. Cahill K, Stead LF, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev 2010;12:CD006103. PubMed
  • 2. Jorenby DE, Hays JT, Rigotti NA, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation. JAMA. 2006 Jul 5;296(1):56-63.
  • 3. Ebbert JO, Croghan IT, Sood A, Schroeder DR, Hays JT, Hurt RD. Varenicline and bupropion sustained-release combination therapy for smoking cessation. Nicotine Tob Res. 2009 Mar;11(3):234-9. PubMed
  • 4. Nides M, Glover ED, Reus VI, Christen AG, Make BJ, Billing CB Jr, Williams KE. Varenicline versus bupropion SR or placebo for smoking cessation. Am J Health Behav. 2008 Nov-Dec;32(6):664-75.
  • 5. Gray KM, Carpenter MJ, Lewis AL, Klintworth EM, Upadhyaya HP. Varenicline versus bupropion XL for smoking cessation in older adolescents. Nicotine Tob Res. 2012 Feb;14(2):234-9. PubMed
  • 6. Campaign for Tobacco-Free Kids, July 6, 2012. Available PDF
  • 7. Cinciripini PM, Robinson JD, Karam-Hage M, Minnix JA, Lam C, Versace F, Brown VL, Engelmann JM, Wetter DW. Effects of varenicline and bupropion sustained-release use plus intensive smoking cessation counseling on prolonged abstinence from smoking and on depression, negative affect, and other symptoms of nicotine withdrawal. JAMA Psychiatry. 2013 May
    8. Ebbert JO, Hatsukami DK, Croghan IT, Schroeder DR, Allen SS, Hays JT, Hurt RD. Combination varenicline and bupropion SR for tobacco-dependence treatment in cigarette smokers: a randomized trial. JAMA. 2014 Jan 8;311(2):155-63.

Author: OriginalDrugs Team
Last reviewed: March 23, 2014