The Story of Chantix: Recall and Discontinuation
For many years, Chantix was a leading prescription medication for individuals determined to quit smoking. However, in June 2021, the pharmaceutical company Pfizer voluntarily halted the production and distribution of Chantix (varenicline) [1.4.3]. This decision was followed by a nationwide recall of all lots of the medication in September 2021 [1.4.1, 1.4.2].
The reason for this action was the discovery of unacceptable levels of a nitrosamine impurity, called N-nitroso-varenicline, in the tablets [1.4.2, 1.4.4]. Nitrosamines are common chemicals found in water and foods like cured meats, but long-term exposure to high levels may increase the risk of cancer [1.4.3]. Pfizer issued the recall as a precautionary measure, and brand-name Chantix has been fully discontinued since [1.4.3, 1.4.5]. The FDA determined that the drug was not withdrawn from the market for reasons of safety or effectiveness, which opened the door for generic versions to be approved as long as they meet the acceptable intake limits for nitrosamine impurities [1.2.2].
Varenicline: The Generic Alternative Is Available
Despite the discontinuation of the brand-name drug, the answer to the question, "Can you still buy Chantix to quit smoking?" is essentially yes, but under a different name. The active ingredient in Chantix, varenicline, is available in its generic form [1.3.1]. In response to the shortage created by the Chantix recall, the FDA took steps to ensure patients had access to the medication, including approving the first generic version in 2021 [1.4.6].
Today, numerous pharmaceutical companies manufacture and distribute FDA-approved generic varenicline tablets [1.2.1]. This means that patients can still access this effective smoking cessation aid with a prescription from their healthcare provider [1.3.1]. The health benefits of quitting smoking are considered to far outweigh the potential low risk associated with the nitrosamine impurity found in the original brand-name drug [1.4.3].
How Does Varenicline Work?
Varenicline is a non-nicotine prescription medication classified as a partial nicotinic acetylcholine receptor agonist [1.9.4, 1.9.5]. Its effectiveness comes from a dual mechanism of action:
- Reduces Cravings and Withdrawal: It works by partially stimulating nicotine receptors in the brain [1.3.1]. This action helps to lessen the severity of nicotine withdrawal symptoms and cravings that people experience when they stop smoking [1.9.5].
- Blocks Nicotine's Rewarding Effects: Varenicline also acts as an antagonist, meaning it blocks nicotine from binding to these receptors [1.9.2]. If a person smokes while taking varenicline, the drug reduces the pleasurable or rewarding effects of the nicotine, making smoking less satisfying [1.9.1, 1.9.5].
Treatment with varenicline typically begins one to four weeks before a person's target quit date and continues for a total of 12 weeks, though it can be extended to improve the chances of long-term success [1.3.3, 1.9.1].
Comparison of Smoking Cessation Medications
Varenicline is considered one of the most effective single-medication options for quitting smoking [1.7.1, 1.7.5]. However, other options are available, each with its own mechanism and success rate.
| Medication/Therapy | How It Works | Common Side Effects | Prescription Required? | Quit Rate (Approx.) |
|---|---|---|---|---|
| Varenicline | Partially stimulates and blocks nicotine receptors in the brain to reduce cravings and the rewarding effect of smoking [1.9.5]. | Nausea, abnormal dreams, trouble sleeping, constipation, gas [1.8.1, 1.8.5]. | Yes [1.3.3] | 33% [1.7.1] |
| Bupropion SR (Zyban) | An antidepressant that acts on brain chemicals related to nicotine craving [1.6.3]. | Insomnia, dry mouth [1.5.4, 1.7.5]. | Yes [1.6.3] | 24% [1.6.3] |
| Nicotine Replacement Therapy (NRT) | Delivers controlled doses of nicotine to reduce withdrawal symptoms [1.6.1, 1.6.4]. Comes in patch, gum, lozenge, inhaler, and nasal spray forms [1.6.2]. | Skin irritation (patch), mouth soreness (gum/lozenge), nasal irritation (spray) [1.6.6]. | Patch, gum, lozenge are OTC; inhaler and spray are prescription [1.6.1]. | 19-27% [1.6.3] |
Studies have shown that varenicline is more effective than bupropion and NRT for helping people quit smoking [1.5.1, 1.5.3]. Combining medications, such as a long-acting nicotine patch with a short-acting form like gum, or using medication alongside counseling, can significantly increase the chances of successfully quitting [1.6.1, 1.7.3].
Potential Side Effects of Varenicline
The most common side effects associated with varenicline are nausea, insomnia, abnormal or vivid dreams, and constipation [1.8.5]. Nausea can often be managed by taking the medication with food and a full glass of water [1.8.4].
There were previous concerns about neuropsychiatric side effects, such as changes in mood, depression, and suicidal thoughts, which led the FDA to issue a boxed warning in 2009. However, after large clinical trials found that varenicline did not increase the risk of these side effects compared to placebo or other cessation aids, the FDA removed the boxed warning in 2016 [1.8.4]. Nonetheless, patients should report any changes in mood or behavior to their doctor immediately [1.8.5].
Conclusion: A Viable Option for Quitting
In conclusion, while you can no longer buy brand-name Chantix, you can still get its generic equivalent, varenicline, with a doctor's prescription [1.3.1]. The recall and discontinuation of Chantix were due to an impurity, but generic versions meet strict FDA safety standards [1.2.2, 1.4.3]. Varenicline remains a highly effective, first-line treatment for smoking cessation, helping individuals overcome nicotine addiction by easing withdrawal symptoms and making smoking less enjoyable [1.5.1, 1.9.5]. If you are considering quitting smoking, talk to your healthcare provider to see if varenicline is the right choice for you.
For more information and resources on quitting, you can visit the UCSF Smoking Cessation Leadership Center.
