VARENICLINE TARTRATE

Details

Stereochemistry	ABSOLUTE
Molecular Formula	C13H13N3.C4H6O6
Molecular Weight	361.3493
Optical Activity	UNSPECIFIED
Defined Stereocenters	4 / 4
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure Search

SMILES

O[C@H]([C@@H](O)C(O)=O)C(O)=O.C1[C@H]2CNC[C@@H]1C3=CC4=C(C=C23)N=CC=N4

InChI

InChIKey=TWYFGYXQSYOKLK-CYUSMAIQSA-N

InChI=1S/C13H13N3.C4H6O6/c1-2-16-13-5-11-9-3-8(6-14-7-9)10(11)4-12(13)15-1;5-1(3(7)8)2(6)4(9)10/h1-2,4-5,8-9,14H,3,6-7H2;1-2,5-6H,(H,7,8)(H,9,10)/t8-,9+;1-,2-/m.1/s1

HIDE SMILES / InChI

Molecular Formula	C4H6O6
Molecular Weight	150.0868
Charge	0
Count

Stereochemistry	ABSOLUTE
Additional Stereochemistry	No
Defined Stereocenters	2 / 2
E/Z Centers	0
Optical Activity	UNSPECIFIED

Molecular Formula	C13H13N3
Molecular Weight	211.2624
Charge	0
Count

Stereochemistry	ACHIRAL
Additional Stereochemistry	No
Defined Stereocenters	2 / 2
E/Z Centers	0
Optical Activity	NONE

Description
Sources: https://www.drugbank.ca/drugs/DB01273
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.

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Condition	Potency
Neuronal acetylcholine receptor; alpha4/beta2 75 Target ID: CHEMBL1907589 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/021928s039s041lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/22591063 \| https://www.ncbi.nlm.nih.gov/pubmed/16766716	Partial Agonist 288		0.4 nM [Ki]
Neuronal acetylcholine receptor protein alpha-7 subunit 77 Target ID: CHEMBL2492 Sources: https://www.ncbi.nlm.nih.gov/pubmed/24406270	Agonist 2662		130.0 nM [Ki]

Conditions

Condition	Modality	Targets	Highest Phase	Product
Nicotine dependence 32 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/021928s039s041lbl.pdf	Curative		Approved 8360	CHANTIX Approved Use CHANTIX is a nicotinic receptor partial agonist indicated for use as an aid to smoking cessation treatment. Launch Date 1.14713284E12

C_max

Value	Dose	Analyte	Population
6.38 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/21053991/	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 EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/16920893/	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 REVIEW https://pubmed.ncbi.nlm.nih.gov/21053991/	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

Value	Dose	Analyte	Population
106 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/21053991/	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 EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/16920893/	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 EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19916991/	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 REVIEW https://pubmed.ncbi.nlm.nih.gov/21053991/	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

T_1/2

Value	Dose	Analyte	Population
10.9 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/21053991/	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 EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/16920893/	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 EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19916991/	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 REVIEW https://pubmed.ncbi.nlm.nih.gov/21053991/	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

Dose	Population	Adverse 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: https://pubmed.ncbi.nlm.nih.gov/22007690 Page: p.15	unhealthy, 46 n = 36 Health Status: unhealthy Condition: Smoking addiction Age Group: 46 Sex: M+F Population Size: 36 Sources: https://pubmed.ncbi.nlm.nih.gov/22007690 Page: p.15	Disc. AE: Nausea, Anger... AEs leading to discontinuation/dose reduction: Nausea (4%) Anger (1%) Insomnia (1%) Sources: https://pubmed.ncbi.nlm.nih.gov/22007690 Page: p.15
15 mg single, oral Overdose Dose: 15 mg Route: oral Route: single Dose: 15 mg Sources: https://pubmed.ncbi.nlm.nih.gov/19274508	healthy Health Status: healthy Sources: https://pubmed.ncbi.nlm.nih.gov/19274508	Disc. AE: Vomiting, Tachycardia... AEs leading to discontinuation/dose reduction: Vomiting Tachycardia Sources: https://pubmed.ncbi.nlm.nih.gov/19274508
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: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021928s014s017lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Smoking addiction Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021928s014s017lbl.pdf 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: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021928s014s017lbl.pdf 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: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021928s014s017lbl.pdf Page: p.1,3	unhealthy Health Status: unhealthy Condition: Smoking addiction Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021928s014s017lbl.pdf Page: p.1,3	Disc. AE: Nausea... AEs leading to discontinuation/dose reduction: Nausea (3%) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021928s014s017lbl.pdf Page: p.1,3

AEs

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
inducer 768	inhibitor 1752	inhibitor 1837	inhibitor 1599

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
CYP1A2 1509 CYP2A6 704 CYP2B6 799 CYP2C8 901 CYP2C19 1463 CYP2E1 876 CYP3A4/5 273 P-gp 1437 OCT2 638	OCT2 348 P-gp 1527 CYP 266 UGT enzymes 27	CYP1A2 689

Drug as perpetrator

Target	Modality	Activity	Clinical evidence
CYP1A2 1673	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 35.0	no [IC50 >30 uM]
CYP2A6 736	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 35.0	no [IC50 >30 uM]
CYP2B6 985	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 35.0	no [IC50 >30 uM]
CYP2C19 1537	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 35.0	no [IC50 >30 uM]
CYP2C8 955	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 35.0	no [IC50 >30 uM]
CYP2C9 1803	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 35.0	no [IC50 >30 uM]
CYP2D6 1875	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 35.0	no [IC50 >30 uM]
CYP2E1 964	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 35.0	no [IC50 >30 uM]
CYP3A4/5 330	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 35.0	no [IC50 >30 uM]
CYP1A2 1673	inducer 1542 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 36.0	no
CYP3A4 1909	inducer 1542 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 36.0	no
P-gp 1626	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 36.0	no	no (co-administration study) Comment: digoxin remained unchanged in the presence of varenicline Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 36.0
OCT2 639	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_PharmR.pdf Page: 72.0	weak

Drug as victim

Target	Modality	Activity	Clinical evidence
CYP 266	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 35.0	no
P-gp 1527	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 36.0	no	no (co-administration study) Comment: digoxin remained unchanged in the presence of varenicline Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 36.0
UGT enzymes 27	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_BioPharmR.pdf Page: 37, 272, 276	yes
OCT2 348	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_PharmR.pdf Page: 46, 72	yes	yes (co-administration study) Comment: cimetidine increased the systemic exposure of varenicline by 29% Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_PharmR.pdf Page: 46, 72

Tox targets

Target	Modality	Activity	Metabolite	Clinical evidence
hERG 1632	inhibitor 1613 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/021928_s000_Chantix_PharmR.pdf Page: 39.0

Sourcing

Vendor/Aggregator	ID	URL
ChEBI	CHEBI:84500	https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:84500
MolPort	MolPort-006-167-759	https://www.molport.com/shop/molecule-link/MolPort-006-167-759
ZINC	ZINC000001481833	http://zinc15.docking.org/substances/ZINC000001481833
eMolecules	36500513	https://www.emolecules.com/cgi-bin/more?vid=36500513

PubMed

Title	Date	PubMed
[New tobacco dependence drug: Varenicline, partial agonist of alpha4beta2 acetylcholine-nicotine receptors].	2006	17168413
Varenicline: a review of its use as an aid to smoking cessation therapy.	2006	17044731
A rationale and model for addressing tobacco dependence in substance abuse treatment.	2006 Aug 14	16907984
Efficacy and safety of the novel selective nicotinic acetylcholine receptor partial agonist, varenicline, for smoking cessation.	2006 Aug 14-28	16908789
Multiple-dose pharmacokinetics of the selective nicotinic receptor partial agonist, varenicline, in healthy smokers.	2006 Dec	17101743
Effectiveness of smoking cessation therapies: a systematic review and meta-analysis.	2006 Dec 11	17156479
Efficacy of varenicline for smoking cessation.	2006 Dec 6	17148718
Varenicline.	2006 Jul	16883648
The FDA approves new drug for smoking cessation.	2006 Jul-Aug	17243286
New drugs: varenicline tartrate, insulin glulisine, and insulin detemir.	2006 Jul-Aug	16913399
[Smoking cessation intervention: 2006 update].	2006 Jun 28	16884060
Pharmacokinetics, safety, and tolerability after single and multiple oral doses of varenicline in elderly smokers.	2006 Nov	17050788
Trials that matter: varenicline: a designer drug to help smokers quit.	2006 Nov 21	17116925
Smoking cessation efficacy and safety of varenicline, an alpha4beta2 nicotinic receptor partial agonist.	2006 Nov-Dec	17293731
New prescription drug available to help smokers stop.	2006 Oct	17176520
Varenicline effective for smoking cessation.	2006 Oct	17089472
Smoking: tackling the silent epidemic.	2007	17824207
Rimonabant for treating tobacco dependence.	2007	17703638
[Tobacco use prevention and cessation in the dental practice].	2007	17425242
Non-nicotinic therapies for smoking cessation.	2007	17209799
Mechanism of varenicline (clinical ramifications): electron transfer and oxidative stress.	2007	17127014
Comment: Oral varenicline for smoking cessation.	2007 Apr	17374627
Optimizing on smoke free legislation making the most of the opportunity.	2007 Aug	17851296
Exacerbation of schizophrenia by varenicline.	2007 Aug	17671295
[Drug of the month. Varenicline (Champix)].	2007 Feb	17461303
Varenicline for smoking cessation.	2007 Feb	17286546
Drug approvals.	2007 Feb	17264794
Smoking cessation in patients with respiratory diseases: a high priority, integral component of therapy.	2007 Feb	17264326
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	17259946
Ligands selective for alpha4beta2 but not alpha3beta4 or alpha7 nicotinic receptors generalise to the nicotine discriminative stimulus in the rat.	2007 Feb	17115136
[Giving up smoking is crucial for COPD patients].	2007 Feb 22	17615702
[The best of epidemiology and cardiovascular prevention in 2006].	2007 Jan	17405566
Advances in the management of chronic obstructive pulmonary disease.	2007 Jan	17163804
Nicotine receptor partial agonists for smoking cessation.	2007 Jan 24	17253581
Antidepressants for smoking cessation.	2007 Jan 24	17253443
[Champix has become a registered drug].	2007 Jan 28	17344137
The pharmacist's role in tobacco cessation: overview and introduction to the series.	2007 Jul 1	17592012
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	17692720
How well does the new drug varenicline work for people who want to stop smoking?	2007 Jun	17657893
Smoking cessation update.	2007 Jun	17649863
Why choose varenicline (chantix) for smoking cessation treatment?	2007 Jun	17613164
New non-nicotine drug to help smoking cessation efforts.	2007 Jun 12-18	17598689
The most addictive drug, the most deadly substance: smoking cessation tactics for the busy clinician.	2007 Mar	17481990
[The path from cigarettes--with support it works better].	2007 Mar	17405479
Confirmatory factor analyses and reliability of the modified cigarette evaluation questionnaire.	2007 May	16875787
Kicking butts: smoking cessation update.	2007 May-Jun	17619503
Alcohol history and smoking cessation in nicotine replacement therapy, bupropion sustained release and varenicline trials: a review.	2007 May-Jun	17526629
Smoking cessation interventions in clinical practice.	2007 Oct	17681834
Maximizing smoking cessation in clinical practice: pharmacologic and behavioral interventions.	2007 Spring	17396064
Cytisine for smoking cessation: a research agenda.	2008 Jan 1	17825502

Patents

Sample Use Guides

In Vivo Use Guide

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

In Vitro Use Guide

Varenicline potently desensitized the α4β2 nAChR with IC50 value of 420 nM

Substance Class	Chemical Created by `admin` on `Wed Jul 05 23:25:52 UTC 2023` Edited by `admin` on `Wed Jul 05 23:25:52 UTC 2023`
Record UNII	82269ASB48
Record Status	`Validated (UNII)`
Record Version

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Name

Type

Language

VARENICLINE TARTRATE

Official Name

English

7,8,9,10-TETRAHYDRO-6, 10-METHANO-6H-PYRAZINA(2,3-H)(3)BENZAZEPINE, (2R,3R)-2,3-DIHYDROXYBUTANEDIOATE (1:1)

Common Name

English

VARENICLINE TARTRATE [MART.]

Common Name

English

TYRVAYA

Brand Name

English

6,10-METHANO-6H-PYRAZINO(2,3-H)(3)BENZAZEPINE, 7,8,9,10-TETRAHYDRO-,(2R,3R)-2,3-DIHYDROXYBUTANEDIOATE (1:1)

Common Name

English

CP-526,555-18

Code

English

VARENICLINE TARTRATE [JAN]

Common Name

English

VARENICLINE TARTRATE [ORANGE BOOK]

Common Name

English

Varenicline tartrate [WHO-DD]

Common Name

English

CP-526555-18

Code

English

VARENICLINE TARTRATE [VANDF]

Common Name

English

CHAMPIX

Brand Name

English

CHANTIX

Brand Name

English

VARENICLINE TARTRATE [USAN]

Common Name

English

VARENICLINE TARTRATE [MI]

Common Name

English

Classification Tree Code System Code

NCI_THESAURUS

C73579