cytisine

What to do if you missed your cytisine dose

Other known brand names

Tabex, Desmoxan

About cytisine

Cytisine is an effective nicotine replacement therapy (NRT) for smoking cessation and the reduction of nicotine cravings. It has historically been used medically in Eastern Europe with studies going back to the 1960s. It became available on prescription through the National Health Service (NHS), as of January 22nd 2024.

Cytisine is derived from a plant alkaloid (Laburnum, Cytisus, Retama) with a structure similar to nicotine. It works in a similar way to varenicline by acting as a nicotine receptor partial agonist of ⍺4-β2 nicotinic acetylcholine receptors, stimulating the release of dopamine while also preventing nicotine from binding to the receptor. (This is believed to be central to nicotines addictive effect). This dual action helps alleviate nicotine withdrawal symptoms and reduce the rewarding effects of tobacco.

NowPatient offers cytisine as a smoking cessation aid, following an online consultation with a prescribing clinician.

Key facts about cytisine

• For the treatment of smoking cessation
• Cytisine reaches peak levels in the body after two hours. It is excreted from the body unchanged, reducing the risks of drug interactions
• Cytisine has some common side effects which include constipation, vomiting and abdominal pain
• It can be dangerous if you take cytisine with certain medications. If you’re not sure if it is safe, discuss this with the prescribing clinician

Who is cytisine not suitable for?

Cytisine may not be suitable for some people. To make sure it’s safe for you, speak to the prescribing clinician before taking cytisine if you:

• Have had an allergic reaction to cytisine or any of the non-active ingredients in the past
• Have unstable angina, recently had a heart attack or stroke, an irregular heart rhythm, ischemic heart disease, heart failure, hypertension, or atherosclerosis
• Have a tumour in the adrenal glands
• Have gastric, duodenal ulcers or gastroesophageal reflux disease
• Have an overactive thyroid
• Have diabetes
• Have kidney or liver problems
• Have schizophrenia
• Are pregnant or breastfeeding
• Are under 18 or over 65 years of age

How and where to get cytisine?

Cytisine is available, only with a prescription. It is not available over the counter at a pharmacy.

NowPatient does not allow customers to buy cytisine directly. Our service is certified, safe and effective, and we only ever treat conditions. If you book a consultation with a prescribing clinician for smoking cessation, you can discuss if cytisine is a suitable treatment option for you.

At the end of the consultation, the clinician will decide if a treatment plan is suitable for you. If it is, the clinician will issue you with a prescription which can then be ordered, paid for and delivered directly to your chosen address by NowPatient.

Dosage and strength for cytisine for smoking cessation

Cytisine is available as 1.5 mg tablets when used for smoking cessation.

Information about how to take cytisine for smoking cessation

Cytisine tablets are taken orally, following a reducing dosing schedule over 25 days. Continuous abstinence rates from smoking are greater in those also receiving behavioural support.

It is important for those using cytisine intervention to complete the course of treatment by following the dosing regimen, to successfully quit smoking. Please speak to a healthcare professional at NowPatient for further medical advice.

What happens if you take too much cytisine?

If you take more than prescribed, then it can lead to some unpleasant side effects.

You should talk to your doctor or reach out to one of our prescribing clinicians, if you have taken too much cytisine and you experience any of the following side effects:

• Tiredness
• Nausea, vomiting
• Increased heart rate
• Changes in your blood pressure
• Problems breathing
• Changes in vision
• Seizures

What are the side effects of cytisine?

Side effects of cytisine are split into common and serious.

Common side effects include:

• Weight gain, changes in appetite
• Dizziness, nausea, headaches
• Irritability, changes in mood, anxiety
• Hypertension
• Dry mouth
• Diarrhoea, constipation, abdominal pain, heartburn
• Skin rash
• Insomnia, drowsiness, abnormal dreams

If you experience any serious adverse events, you should contact NHS 111.

If you experience a serious allergic reaction with the signs shown below you should contact emergency services on 999.

• Your lips, mouth, throat or tongue suddenly become swollen
• You’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
• Your throat feels tight or you’re struggling to swallow
• Your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• You suddenly become very confused, drowsy or dizzy
• Someone faints and cannot be woken up

Information about taking cytisine at the same time as other medications or herbal supplements

There is not enough evidence to suggest there are any drug interactions between herbal supplements and cytisine. In any event, you should let your prescribing clinician know if you are taking any herbal supplements.

Why might cytisine not work for smoking cessation?

It is important to take cytisine as directed by your doctor. Failure to complete the course of treatment as directed, by following the dosing schedule, may reduce quit rates and cause you to not be successful in quitting smoking.

Can cytisine taken for smoking cessation be taken long term?

Cytisine tablets are taken orally, following a reducing dosing schedule over 25 days.

Is there a herbal cytisine?

No. Herbal cytisine does not exist. If you have been marketed such a formulation, it may be fake.

Can women use cytisine?

Women can take cytisine to help them quit smoking. However, cytisine is not recommended for use in pregnant or breastfeeding women, as clinical trials for the effects of cytisine on pregnant women, or those who are breastfeeding have been conducted.

Should I avoid any particular food or drink when taking cytisine?

You can eat and drink normally when taking cytisine.

What lifestyle changes can I make to help me with smoking cessation?

You may modify your lifestyle in a number of ways, these may include:

• Telling people you’re quitting smoking
• Use stop smoking aids
• Make a plan
• Avoid your smoking triggers
• Keeping busy to prevent urges
• Exercise away the urge

Alternatives to cytisine

Alternative smoking cessation treatments include nicotine patches, nicotine lozenges, nicotine gum, bupropion, varenicline and e-cigarettes.

Sources

NHS – Stop smoking treatments

Peter Hajek, Hayden McRobbie, Katie Myers – Efficacy of cytisine in helping smokers quit

NCSCT – Cytisine