U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ACHIRAL
Molecular Formula C13H13N3.C2H2O4.H2O
Molecular Weight 319.3126
Optical Activity NONE
Defined Stereocenters 2 / 2
E/Z Centers 0
Charge 0
Stereo Comments Meso

SHOW SMILES / InChI
Structure of Varenicline oxalate hydrate

SMILES

O.OC(=O)C(O)=O.C1[C@H]2CNC[C@@H]1C3=CC4=NC=CN=C4C=C23

InChI

InChIKey=NRULWYCGNVYADZ-DRJPZDRJSA-N
InChI=1S/C13H13N3.C2H2O4.H2O/c1-2-16-13-5-11-9-3-8(6-14-7-9)10(11)4-12(13)15-1;3-1(4)2(5)6;/h1-2,4-5,8-9,14H,3,6-7H2;(H,3,4)(H,5,6);1H2/t8-,9+;;

HIDE SMILES / InChI

Description
Curator's Comment: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/021928s039s041lbl.pdf

Varenicline is a partial nicotinic acetylcholine receptor agonist, designed to partially activate this system while displacing nicotine at its sites of action in the brain. Varenicline is an alpha-4 beta-2 neuronal nicotinic acetylcholine receptor partial agonist. The drug shows high selectiviyty for this receptor subclass, relative to other nicotinic receptors (>500-fold alpha-3 beta-4, >3500-fold alpha-7, >20,000-fold alpha-1 beta gamma delta) or non-nicotinic receptors and transporters (>2000-fold). The drug competitively inhibits the ability of nicotine to bind to and activate the alpha-4 beta-2 receptor. The drug exerts mild agonistic activity at this site, though at a level much lower than nicotine; it is presumed that this activation eases withdrawal symptoms. Varenicline is sold under the trade name Chantix and Champix, it is indicated for use as an aid to smoking cessation treatment.

Originator

Curator's Comment: # Pfizer

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Curative
CHANTIX

Approved Use

CHANTIX is a nicotinic receptor partial agonist indicated for use as an aid to smoking cessation treatment.

Launch Date

2006
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
6.38 ng/mL
1 mg single, oral
dose: 1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
VARENICLINE plasma
Homo sapiens
population: UNHEALTHY
age: ADOLESCENT
sex: FEMALE / MALE
food status: UNKNOWN
5.7 ng/mL
1 mg single, oral
dose: 1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
VARENICLINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
9.22 ng/mL
1 mg 2 times / day multiple, oral
dose: 1 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
VARENICLINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
106 ng × h/mL
1 mg single, oral
dose: 1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
VARENICLINE plasma
Homo sapiens
population: UNHEALTHY
age: ADOLESCENT
sex: FEMALE / MALE
food status: UNKNOWN
97.7 ng × h/mL
1 mg single, oral
dose: 1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
VARENICLINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
186 ng × h/mL
1 mg 2 times / day steady-state, oral
dose: 1 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
VARENICLINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
194 ng × h/mL
1 mg 2 times / day multiple, oral
dose: 1 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
VARENICLINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
10.9 h
1 mg single, oral
dose: 1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
VARENICLINE plasma
Homo sapiens
population: UNHEALTHY
age: ADOLESCENT
sex: FEMALE / MALE
food status: UNKNOWN
11.1 h
1 mg single, oral
dose: 1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
VARENICLINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
24 h
1 mg 2 times / day steady-state, oral
dose: 1 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
VARENICLINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
33 h
1 mg 2 times / day multiple, oral
dose: 1 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
VARENICLINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.15
unhealthy, 46
n = 36
Health Status: unhealthy
Condition: Smoking addiction
Age Group: 46
Sex: M+F
Population Size: 36
Sources: Page: p.15
Disc. AE: Nausea, Anger...
AEs leading to
discontinuation/dose reduction:
Nausea (4%)
Anger (1%)
Insomnia (1%)
Sources: Page: p.15
15 mg single, oral
Overdose
Dose: 15 mg
Route: oral
Route: single
Dose: 15 mg
Sources:
healthy
Health Status: healthy
Sources:
Disc. AE: Vomiting, Tachycardia...
AEs leading to
discontinuation/dose reduction:
Vomiting
Tachycardia
Sources:
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Disc. AE: Psychiatric disorder NOS, Suicidal ideation...
AEs leading to
discontinuation/dose reduction:
Psychiatric disorder NOS (serious)
Suicidal ideation (serious)
Suicidal behavior (serious)
Agitation
Hostility
Depressed mood
Angioedema
Hypersensitivity reaction
Reaction skin (grade 3-4, rare)
Accidental injury
Sources: Page: p.1
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1,3
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1,3
Disc. AE: Nausea...
AEs leading to
discontinuation/dose reduction:
Nausea (3%)
Sources: Page: p.1,3
AEs

AEs

AESignificanceDosePopulation
Anger 1%
Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.15
unhealthy, 46
n = 36
Health Status: unhealthy
Condition: Smoking addiction
Age Group: 46
Sex: M+F
Population Size: 36
Sources: Page: p.15
Insomnia 1%
Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.15
unhealthy, 46
n = 36
Health Status: unhealthy
Condition: Smoking addiction
Age Group: 46
Sex: M+F
Population Size: 36
Sources: Page: p.15
Nausea 4%
Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.15
unhealthy, 46
n = 36
Health Status: unhealthy
Condition: Smoking addiction
Age Group: 46
Sex: M+F
Population Size: 36
Sources: Page: p.15
Tachycardia Disc. AE
15 mg single, oral
Overdose
Dose: 15 mg
Route: oral
Route: single
Dose: 15 mg
Sources:
healthy
Health Status: healthy
Sources:
Vomiting Disc. AE
15 mg single, oral
Overdose
Dose: 15 mg
Route: oral
Route: single
Dose: 15 mg
Sources:
healthy
Health Status: healthy
Sources:
Accidental injury Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Agitation Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Angioedema Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Depressed mood Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Hostility Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Hypersensitivity reaction Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Reaction skin grade 3-4, rare
Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Psychiatric disorder NOS serious
Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Suicidal behavior serious
Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Suicidal ideation serious
Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1
Nausea 3%
Disc. AE
1 mg 2 times / day multiple, oral
Recommended
Dose: 1 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1 mg, 2 times / day
Sources: Page: p.1,3
unhealthy
Health Status: unhealthy
Condition: Smoking addiction
Sources: Page: p.1,3
Overview

Overview

Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no [IC50 >30 uM]
no [IC50 >30 uM]
no [IC50 >30 uM]
no [IC50 >30 uM]
no [IC50 >30 uM]
no [IC50 >30 uM]
no [IC50 >30 uM]
no [IC50 >30 uM]
no [IC50 >30 uM]
no
no
no
no (co-administration study)
Comment: digoxin remained unchanged in the presence of varenicline
Page: 36.0
weak
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
no
no
no (co-administration study)
Comment: digoxin remained unchanged in the presence of varenicline
Page: 36.0
yes
yes
yes (co-administration study)
Comment: cimetidine increased the systemic exposure of varenicline by 29%
Page: 46, 72
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
Gateways to clinical trials.
2005 Jun
[Medication for ending tobacco dependency. Current state].
2005 Jun 30
Varenicline: an alpha4beta2 nicotinic receptor partial agonist for smoking cessation.
2005 May 19
Treating smoking dependence in depressed alcoholics.
2006
Molecule of the Month. Varenicline tartrate.
2006 Apr
A rationale and model for addressing tobacco dependence in substance abuse treatment.
2006 Aug 14
Varenicline (Chantix) for tobacco dependence.
2006 Aug 14-28
Smoking cessation with varenicline, a selective alpha4beta2 nicotinic receptor partial agonist: results from a 7-week, randomized, placebo- and bupropion-controlled trial with 1-year follow-up.
2006 Aug 14-28
Multiple-dose pharmacokinetics of the selective nicotinic receptor partial agonist, varenicline, in healthy smokers.
2006 Dec
Metabolism and disposition of varenicline, a selective alpha4beta2 acetylcholine receptor partial agonist, in vivo and in vitro.
2006 Jan
Varenicline.
2006 Jul
Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial.
2006 Jul 5
The neurobiological basis for partial agonist treatment of nicotine dependence.
2006 May
Trials that matter: varenicline: a designer drug to help smokers quit.
2006 Nov 21
New prescription drug available to help smokers stop.
2006 Oct
Smoking: tackling the silent epidemic.
2007
Rimonabant for treating tobacco dependence.
2007
[Tobacco use prevention and cessation in the dental practice].
2007
An employer-based cost-benefit analysis of a novel pharmacotherapy agent for smoking cessation.
2007 Apr
Optimizing on smoke free legislation making the most of the opportunity.
2007 Aug
Varenicline: progress in smoking cessation treatment.
2007 Aug
Exacerbation of schizophrenia by varenicline.
2007 Aug
Varenicline-induced manic episode in a patient with bipolar disorder.
2007 Aug
Emerging pharmacotherapies for smoking cessation.
2007 Aug 15
Varenicline for smoking cessation.
2007 Feb
Drug approvals.
2007 Feb
Smoking cessation in patients with respiratory diseases: a high priority, integral component of therapy.
2007 Feb
Impact of pharmacometric reviews on new drug approval and labeling decisions--a survey of 31 new drug applications submitted between 2005 and 2006.
2007 Feb
Ligands selective for alpha4beta2 but not alpha3beta4 or alpha7 nicotinic receptors generalise to the nicotine discriminative stimulus in the rat.
2007 Feb
Antidepressants for smoking cessation.
2007 Jan 24
Rationale, pharmacology and clinical efficacy of partial agonists of alpha4beta2 nACh receptors for smoking cessation.
2007 Jul
Efficacy and tolerability of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, in a 12-week, randomized, placebo-controlled, dose-response study with 40-week follow-up for smoking cessation in Japanese smokers.
2007 Jun
A randomized, placebo-controlled trial of varenicline, a selective alpha4beta2 nicotinic acetylcholine receptor partial agonist, as a new therapy for smoking cessation in Asian smokers.
2007 Jun
How well does the new drug varenicline work for people who want to stop smoking?
2007 Jun
Why choose varenicline (chantix) for smoking cessation treatment?
2007 Jun
Kicking butts: smoking cessation update.
2007 May-Jun
Alcohol history and smoking cessation in nicotine replacement therapy, bupropion sustained release and varenicline trials: a review.
2007 May-Jun
Varenicline: a selective alpha4beta2 nicotinic acetylcholine receptor partial agonist approved for smoking cessation.
2007 May-Jun
Smoking cessation interventions in clinical practice.
2007 Oct
Neuronal nicotinic receptors: a perspective on two decades of drug discovery research.
2007 Oct 15
Cytisine for smoking cessation: a research agenda.
2008 Jan 1
Patents

Sample Use Guides

Begin CHANTIX (Varenicline) dosing one week before the date set by the patient to stop smoking. Alternatively, the patient can begin CHANTIX dosing and then quit smoking between days 8 and 35 of treatment. (2.1) • Starting week: 0.5 mg once daily on days 1-3 and 0.5 mg twice daily on days 4-7. (2.1) • Continuing Weeks: 1 mg twice daily for a total of 12 weeks. (2.1) • An additional 12 weeks of treatment is recommended for successful quitters to increase likelihood of long-term abstinence. (2.1) • Consider a gradual approach to quitting smoking with CHANTIX for patients who are sure that they are not able or willing to quit abruptly. Patients should begin CHANTIX dosing and reduce smoking by 50% from baseline within the first four weeks, by an additional 50% in the next four weeks, and continue reducing with the goal of reaching complete abstinence by 12 weeks. Continue treatment for an additional 12 weeks, for a total of 24 weeks. (2.1) CHANTIX should be taken orally after eating and with a full glass of water.
Route of Administration: Oral
Varenicline potently desensitized the α4β2 nAChR with IC50 value of 420 nM
Name Type Language
Varenicline oxalate hydrate
Common Name English
6,10-Methano-6H-pyrazino[2,3-h][3]benzazepine, 7,8,9,10-tetrahydro-, ethanedioate, hydrate
Systematic Name English
Varenicline oxalate hydrate [WHO-DD]
Common Name English
Code System Code Type Description
PUBCHEM
164512975
Created by admin on Sat Dec 16 19:21:08 GMT 2023 , Edited by admin on Sat Dec 16 19:21:08 GMT 2023
PRIMARY
FDA UNII
F2PGH5WAQ4
Created by admin on Sat Dec 16 19:21:08 GMT 2023 , Edited by admin on Sat Dec 16 19:21:08 GMT 2023
PRIMARY
SMS_ID
300000041015
Created by admin on Sat Dec 16 19:21:08 GMT 2023 , Edited by admin on Sat Dec 16 19:21:08 GMT 2023
PRIMARY
CAS
2041583-40-6
Created by admin on Sat Dec 16 19:21:08 GMT 2023 , Edited by admin on Sat Dec 16 19:21:08 GMT 2023
NON-SPECIFIC STOICHIOMETRY