Varenicline 1mg tablets are a UK Prescription Only Medicine for smoking cessation in adults.
Taken twice daily after a one-week titration, the standard course lasts 12 weeks, with the option to extend by a further 12 weeks for the maintenance of abstinence.
Varenicline targets the brain’s nicotine receptors directly, easing cravings and withdrawal while reducing the rewarding feeling of smoking.
Available from Courier Pharmacy after a quick online consultation reviewed by a UK-qualified prescriber, with optional free pharmacist support to help you build a quit plan that fits your life.
Varenicline 1mg tablets are an oral prescription medicine used to help adults stop smoking. They contain 1mg of varenicline (as varenicline tartrate) per film-coated tablet, and are taken twice daily following a one-week titration period. The standard course lasts 12 weeks, with the option to extend for a further 12 weeks if you’ve successfully quit and want to consolidate that result for the long term.
The generic version of Champix
Originally licensed in the UK over 15 years ago, varenicline was previously sold under the brand name Champix. After a global recall in 2021 over a manufacturing impurity, varenicline was unavailable in the UK for several years. It returned to the UK market in late 2024 as a generic medicine and is now once again routinely prescribed through NHS Stop Smoking Services and private prescribers, including Courier Pharmacy.
Varenicline’s dual action
Where varenicline 1mg tablets really earn their place is in the day-to-day experience of stopping. Most quit attempts fail in the first two weeks, when withdrawal peaks and cravings hit hardest.
Varenicline reduces those cravings while also dulling the rewarding feeling of smoking if you do slip. That dual action is why head-to-head trials place it ahead of bupropion and most single-product nicotine replacement therapy regimens (Lindson et al., 2023).
A calmer, more practical guide to one of the most effective stop-smoking medicines in the UK, written for adults who are tired of half-finished quit attempts and want a real plan they can stick to.
If you’re staring at your last packet of cigarettes wondering whether this attempt will go the same way as the last three, you’re not alone. Quitting smoking is one of the hardest changes anyone can make, and it has very little to do with willpower. It has everything to do with biology, behaviour, and whether you have the right tools and support around you.
Varenicline 1mg tablets are one of those tools. Used properly, alongside guidance and follow-up, they roughly triple your chance of stopping for good compared to going it alone (Lindson et al., 2023).
At Courier Pharmacy, we don’t just dispense the medicine. We help you build the plan around it, including a free fortnightly community talk if you’d rather speak to a real person before deciding anything. Healthcare that fits you, not the other way round.
Five key takeaways
Varenicline 1mg tablets are a Prescription Only Medicine (POM) licensed in the UK for smoking cessation in adults, taken as a 12-week course with a one-week starter titration.
Varenicline acts as a partial agonist at the brain’s alpha 4 beta 2 nicotinic receptors, easing cravings and withdrawal while reducing the rewarding feeling of smoking if you slip during the course.
In randomised controlled trials, varenicline produced continuous abstinence rates of around 44% at 12 weeks, significantly higher than bupropion (around 30%) and placebo (around 18%).
The most common side effects are nausea, vivid dreams, sleep disturbance, and headache. Most settle within the first few weeks, and dose adjustments are possible if needed.
At Courier Pharmacy, every prescription smoking cessation medicine is available after a quick online consultation reviewed by a UK-qualified prescriber, with optional free pharmacist support before or after you order.
Treatment dosage varenicline 1mg tablets
The recommended dose of varenicline is 1mg twice daily after a one-week titration period. The titration is structured to help your body adjust to the medicine and to minimise nausea, which is the most common early side effect.
Standard titration and dosing schedule:
Days 1 to 3: 0.5mg once daily
Days 4 to 7: 0.5mg twice daily
Day 8 to end of treatment: 1mg twice daily
The full treatment course lasts 12 weeks. You should set your target quit date for between days 8 and 14 of treatment, although the SmPC also allows a flexible quit date up to week 5 if you’d rather ease into it. If you’ve successfully quit at the end of 12 weeks, your prescriber may suggest an additional 12-week maintenance course at 1mg twice daily to consolidate the result.
If side effects feel too much at the full dose, the dose can be reduced to 0.5mg twice daily, either temporarily or for the rest of the course. Patients with severe renal impairment usually take 1mg once daily, after a 0.5mg starter phase.
Overview of varenicline 1mg tablets
Five things worth knowing before you start:
Varenicline 1mg tablets are taken twice daily for 12 weeks as a structured course
They roughly triple your chance of stopping smoking compared with no treatment
The medicine works best when paired with behavioural support and a clear quit date
Side effects are usually mild and settle within the first one to two weeks
Mood, sleep, and behavioural changes should always be flagged to a prescriber promptly
Most patients start to notice cravings easing by the end of the first week. By the end of the titration period, the full 1mg twice-daily dose helps blunt the drive to smoke even when you’re tired, stressed, or out with people who smoke. That is the moment when many people realise they’re going to make it through this attempt.
The course is structured rather than open-ended, which a lot of patients find easier than the open question of how long to keep using NRT. There’s a clear start, a clear end, and a defined plan in between. If your previous quit attempts have unravelled because the plan was vague, varenicline often gives you the structure you need.
A maintenance phase exists for a reason. The first three months after stopping are when relapse risk is highest, and an extra 12-week course at 1mg twice daily significantly reduces that risk for people who are already abstinent at the end of the initial course.
It works in patients with a history of psychiatric conditions too. The large randomised EAGLES trial, summarised in the SmPC, showed no significant increase in serious neuropsychiatric events in patients with or without a psychiatric history compared to placebo. That said, mood and behavioural changes can still occur and should be flagged early.
It also works in patients with stable cardiovascular disease, although close monitoring of any new chest pain, breathlessness, or symptoms of stroke is essential during treatment. The same applies to anyone with a history of seizures or other conditions that lower the seizure threshold.
Why choose Courier Pharmacy for varenicline 1mg tablets
Quitting smoking deserves more than an automated checkout. We built our smoking cessation service around the four things we believe make the difference between another half-finished attempt and one that actually sticks: personalisation, guidance, trust, and community.
Personalisation comes first. Our online consultation looks at your smoking pattern, your medical history, your previous quit attempts, and what got in the way last time. From there, the questionnaire is designed to help you decide whether varenicline is the right fit, or whether cytisine, NRT, combination NRT, or Zyban would suit you better. We’re a referral partner for personalised medicine, not a vending machine for prescriptions. Guidance follows. We don’t just dispense the tablets. Our pharmacist team can talk you through the titration, the quit date, what to expect in week one, and what to flag if anything feels off.
Trust is the baseline, not the differentiator. All prescribing is reviewed by UK-qualified prescribers, all medicines are dispensed by a UK-registered pharmacy, and all our clinical content is grounded in NHS, NICE, BNF, and EMC guidance. Community is the bit most pharmacies skip.
Our brand ambassador, Dr Ada Jex-Cori, exists to remind us that healthcare should listen, adapt, and show up for people, even when they’re not buying anything. That’s why our free fortnightly community talks at Insomnia in Derby are open to anyone, including people who are still deciding whether varenicline, NRT, or another route is right for them.
Buy varenicline 1mg tablets (prescription only) from Courier Pharmacy
Varenicline 1mg tablets are a Prescription Only Medicine in the UK and can only be supplied after a prescriber has reviewed your suitability. At Courier Pharmacy, every prescription smoking cessation medicine is available after a quick online consultation reviewed by a UK-qualified prescriber, with optional free pharmacist support before or after you order.
How it works:
Complete a quick online consultation
A UK prescriber reviews your answers
If approved, a prescription is issued
We dispense and deliver discreetly to your door
If varenicline isn’t suitable for you, we’ll explain why and suggest the next best option. That might be cytisine if you’d prefer a shorter course, NRT or combination NRT if you’d rather avoid prescription medicine, Zyban if varenicline and cytisine aren’t suitable, or your local NHS Stop Smoking Service if a face-to-face programme would be a better fit.
Active ingredient in varenicline 1mg tablets
The active ingredient is varenicline tartrate, equivalent to 1mg of varenicline per film-coated tablet. Varenicline is a small molecule designed specifically to bind to the alpha 4 beta 2 nicotinic acetylcholine receptor in the brain, which is the same receptor that nicotine binds to when you smoke.
Each tablet also contains microcrystalline cellulose, calcium hydrogen phosphate dihydrate, croscarmellose sodium, stearic acid, and a thin film coating made from hypromellose, titanium dioxide, macrogol 400, and indigo carmine aluminium lake.
The tablets are essentially sodium-free, containing less than 1mmol (23mg) of sodium per dose. They're swallowed whole with water and can be taken with or without food, which is a useful flexibility for people on shift patterns or irregular routines.
What is varenicline 1mg tablets for?
Varenicline 1mg tablets are licensed for one purpose in the UK: smoking cessation in adults. It is the most clinically tested non-nicotine option in the UK pharmacy formulary and is recommended in NICE guidance NG209 as a first-line option for adults who want to stop smoking, alongside nicotine replacement therapy, cytisine, and bupropion.
Varenicline tends to suit moderate to heavy smokers who have tried NRT before without success, those who want a structured course rather than open-ended NRT use, and those who prefer a tablet to patches, gum, or sprays. It can also be a useful option for patients with stable cardiovascular disease, mild to moderate COPD, or stable depression, all of whom have been studied in dedicated trials with positive results.
It isn't licensed for under-18s, isn't recommended in pregnancy or breastfeeding, and needs careful prescriber assessment in patients with end-stage renal disease, a history of seizures, or significant psychiatric conditions. None of these are blanket exclusions; they're flags for a more careful conversation before starting.
How do varenicline 1mg tablets work?
To understand varenicline, it helps to think about what nicotine does first. When you smoke a cigarette, nicotine reaches the brain within about ten seconds and binds to alpha 4 beta 2 nicotinic receptors, triggering a rapid release of dopamine. That dopamine spike is what makes smoking feel rewarding, and over time, the brain's reward system rewires itself to expect that hit at regular intervals.
Varenicline binds to the same alpha 4 beta 2 receptor, but it does so as a partial agonist. That's a useful word in pharmacology. It means varenicline activates the receptor partially, producing enough of an effect to ease cravings and withdrawal symptoms, while also blocking nicotine from binding to the receptor fully.
That dual action is what makes varenicline distinctive. Cravings and withdrawal are reduced because the receptor is partially activated. The rewarding feeling of smoking is reduced because nicotine can no longer fully activate the receptor while varenicline is sitting on it. If you slip and smoke a cigarette during the course, it doesn't feel as satisfying, which makes it much easier not to slip again.
The medicine is highly selective for the alpha 4 beta 2 receptor over other nicotinic and non-nicotinic receptors. That's why side effects tend to be limited to nausea, vivid dreams, and sleep disturbance, rather than the broader autonomic effects you'd expect from a less selective drug.
This is also why varenicline works in a fundamentally different way from nicotine replacement therapy. NRT replaces nicotine with a slower, safer source. Varenicline works directly on the receptor itself. For patients who haven't done well on NRT, that mechanism difference is often exactly what's needed.
How to use varenicline 1mg tablets
Take one varenicline 1mg tablet twice daily, swallowed whole with water, with or without food. The standard schedule is one tablet in the morning and one in the evening, ideally around the same times each day to keep blood levels steady. Most patients find that taking the second dose with their main evening meal, rather than just before bed, helps with both nausea and sleep disturbance.
The first week is a titration phase. You start at 0.5mg once daily for three days, then 0.5mg twice daily for four days, then move to the full 1mg twice daily from day 8. The titration exists to let your body adjust gradually and to reduce the chance of nausea, which is by far the most common early side effect.
Set your target quit date for between days 8 and 14 of treatment. You'll still be smoking during the first week or two while the medicine reaches steady state. That's normal and expected. The aim is to be fully on board by the morning of your quit date, with cravings already softened by varenicline before you stub out your last cigarette.
If you miss a dose, take it as soon as you remember, unless it's nearly time for your next dose. In that case, skip the missed dose and continue as normal. Don't double up. Consistency matters far more than catching up on a single missed tablet.
Warnings and precautions for varenicline 1mg tablets
Varenicline is generally well tolerated, but it is a Prescription Only Medicine for a reason. There are a handful of warnings worth understanding before starting.
The most clinically significant is around mood, behaviour, and mental health. There have been post-marketing reports of changes in behaviour or thinking, anxiety, low mood, agitation, suicidal ideation, and rarely psychosis in patients attempting to quit smoking with varenicline. The large EAGLES randomised trial later showed no significantly increased risk of serious neuropsychiatric events compared to placebo, but the SmPC still asks both patients and prescribers to stay alert. Any new low mood, anxiety, agitation, unusual thoughts, or thoughts of self-harm should be reported to a prescriber promptly.
Cardiovascular monitoring matters too. Varenicline has been studied in patients with stable cardiovascular disease, and it works well in that group, but any new or worsening chest pain, breathlessness, palpitations, or symptoms suggestive of stroke during treatment should trigger an urgent medical review. The medicine should not be used in patients who are haemodynamically unstable or hospitalised for acute cardiac events.
Seizures are listed as both an uncommon side effect and a precaution. Varenicline should be used cautiously in patients with a history of seizures or any condition that lowers the seizure threshold. There have also been rare post-marketing reports of severe skin reactions including Stevens-Johnson syndrome and erythema multiforme, and rare reports of life-threatening angioedema. Treatment should be stopped immediately at the first sign of rash, skin reaction, or facial swelling, with urgent medical advice sought.
A note on the act of stopping smoking itself. Smoking induces certain liver enzymes (notably CYP1A2) that break down some medicines, including theophylline, warfarin, clozapine, olanzapine, ropinirole, and insulin. When you stop smoking, levels of these medicines can rise. If you take any of them, your prescriber will want to monitor you a little more closely during the quit attempt and may adjust your dose.
Side effects of varenicline 1mg tablets
Most side effects of varenicline are mild and settle within the first one to two weeks. Below is a summary based on the SmPC, organised by frequency.
Very common (more than 1 in 10 people):
Nausea, the most common early side effect, usually mild to moderate and rarely severe enough to stop treatment
Headache
Insomnia and abnormal or vivid dreams
Common (between 1 in 100 and 1 in 10):
Bronchitis, sinusitis, nasopharyngitis
Increased or decreased appetite, weight gain
Drowsiness, dizziness, altered taste
Dry mouth, reflux, vomiting, constipation, diarrhoea, abdominal pain or bloating
Severe skin reactions including Stevens-Johnson syndrome and erythema multiforme
Angioedema
If you suspect you've experienced a side effect, you can report it to the MHRA Yellow Card Scheme at https://yellowcard.mhra.gov.uk. Reporting helps regulators monitor the safety of varenicline in real-world use across the UK.
Drug interactions with varenicline 1mg tablets
Varenicline has very few clinically significant drug interactions, which is one of the reasons it's been so widely adopted in UK practice. Less than 10% of varenicline is metabolised, and it does not inhibit or induce the cytochrome P450 enzymes that handle most other medicines.
That said, there are a few situations worth flagging during consultation:
Cimetidine, a histamine H2 blocker used for reflux and ulcers, increases varenicline blood levels by around 29% by reducing renal clearance. No dose adjustment is needed in patients with normal renal function or mild to moderate kidney impairment, but the combination should be avoided in patients with severe renal impairment.
Adenosine, sometimes used in cardiology, can have its haemodynamic and chest-pain-provoking effects amplified by nicotine. This is more relevant for nicotine replacement therapy than for varenicline itself, but worth flagging if you have a history of using NRT and have ever had adenosine for an investigation.
Smoking cessation itself (rather than varenicline) can change blood levels of certain medicines, including theophylline, warfarin, clozapine, olanzapine, ropinirole, and insulin. This is the single most important interaction concept for any quit attempt. If you take any of these, your prescriber will want to monitor you more closely during the first few weeks of being smoke-free, and may adjust the dose.
Alcohol is worth a brief note. There have been post-marketing reports of increased intoxicating effects of alcohol in patients on varenicline, although a causal relationship has not been confirmed. Many UK prescribers suggest avoiding heavy alcohol use during the first week or two of treatment until you know how you respond.
Combining varenicline with NRT or bupropion isn't usually recommended outside specialist settings, although small clinical studies have looked at varenicline with transdermal nicotine patches and showed slightly more nausea, dizziness, and tiredness than NRT alone.
Frequently asked questions about varenicline 1mg tablets
What are varenicline 1mg tablets used for?
Varenicline 1mg tablets are used to help adults stop smoking. They're licensed in the UK for smoking cessation only and are recommended as a first-line option in NICE guidance NG209.
How long do I take varenicline 1mg tablets for?
The standard course is 12 weeks. If you've successfully quit at the end of 12 weeks, your prescriber may offer an additional 12-week maintenance course to consolidate the result and reduce the risk of relapse.
When should I set my quit date?
Most patients set their quit date for between days 8 and 14 of treatment, after the one-week titration. The SmPC also allows a flexible quit date up to week 5 of treatment if you'd rather ease into it gradually.
How do varenicline 1mg tablets work?
Varenicline is a partial agonist at the alpha 4 beta 2 nicotinic receptor in the brain. It partially activates the receptor, easing cravings and withdrawal, while also blocking nicotine from binding fully, which reduces the rewarding feeling of smoking if you slip.
How effective is varenicline?
In randomised controlled trials, varenicline produced 12-week continuous abstinence rates of around 44%, compared to around 30% for bupropion and around 18% for placebo. It roughly triples your chance of stopping smoking compared with no treatment.
What are the most common side effects of varenicline?
The most common side effects are nausea, headache, insomnia, and vivid dreams. Most are mild to moderate and settle within the first one to two weeks. Taking the evening dose with food rather than just before bed often helps.
Can I take varenicline if I have depression or anxiety?
Varenicline has been studied in patients with stable depression and produced similar quit rates to those seen in the general population without worsening depression scores. The medicine is still used cautiously in patients with a history of psychiatric illness, and any new mood or behavioural changes should be flagged promptly.
Can I take varenicline if I have heart disease?
Varenicline has been studied in patients with stable cardiovascular disease and produced significantly higher quit rates than placebo without a clear increase in serious cardiac events. New chest pain, breathlessness, or stroke symptoms during treatment should still trigger urgent medical review.
Is varenicline safe in pregnancy?
Varenicline is not recommended in pregnancy or in women trying to conceive. Stopping smoking before or during pregnancy is strongly recommended, but UK guidance favours short-acting NRT under midwife or specialist supervision rather than varenicline .
Can I drink alcohol while taking varenicline?
There have been post-marketing reports of increased intoxicating effects of alcohol in patients on varenicline, although a causal relationship hasn't been confirmed. Many UK prescribers suggest avoiding heavy drinking, particularly during the first week or two, until you know how you respond.
Can I drive while taking varenicline?
Varenicline can cause dizziness, drowsiness, and very rarely transient loss of consciousness. Don't drive, operate complex machinery, or do anything potentially hazardous until you know how the medicine affects you.
What happens if I miss a dose?
Take it as soon as you remember, unless it's almost time for your next dose. In that case, skip the missed dose and continue as normal. Don't double up. Consistency over many weeks matters far more than catching up on a single missed tablet.
What happens if I slip and smoke a cigarette during the course?
A slip is not a failure. Many patients have one or two slips during a successful quit attempt. Varenicline blunts the rewarding feeling of smoking, which makes it easier to get back on track. Tell your prescriber if slips become more frequent, so the plan can be adjusted.
Can I use NRT alongside varenicline?
This isn't usually recommended outside specialist settings. A small study showed slightly more nausea, dizziness, and tiredness when transdermal nicotine was added to varenicline. Speak to a pharmacist before combining the two.
Will I gain weight?
Some weight gain is common after stopping smoking, with or without varenicline, because nicotine suppresses appetite. The benefit of stopping smoking far outweighs the risk of a modest weight gain, and your pharmacist can talk you through practical strategies to manage it.
Can I take varenicline if I have kidney problems?
Mild to moderate kidney impairment doesn't usually need a dose adjustment. For severe renal impairment, the recommended dose is 1mg once daily, after a 0.5mg starter phase. Varenicline isn't recommended in end-stage renal disease.
Can older adults take varenicline?
Yes. No dose adjustment is needed for elderly patients, although kidney function will be checked given that it's more likely to be reduced with age. Quit rates in older adults are similar to those seen in younger patients.
Can I stop varenicline suddenly when the course ends?
Most patients stop without issues, although up to 3% of patients report increased irritability, urge to smoke, low mood, or insomnia at the end of treatment. If you've had a difficult quit attempt, your prescriber may suggest tapering the dose down rather than stopping abruptly.
How does varenicline compare with cytisine?
Varenicline and cytisine work on the same brain receptor and have comparable effectiveness in head-to-head trials. Cytisine is a shorter, 25-day course; varenicline is a 12-week course with the option to extend. Both are evidence-based first-line options in the UK (Lindson et al., 2023).
How do I get varenicline 1mg tablets from Courier Pharmacy?
Complete the online consultation at courierpharmacy.co.uk. A UK-qualified prescriber will review your answers, issue a prescription if appropriate, and our pharmacy team will dispense and deliver discreetly. Free pharmacist support is available before or after you order.
Disclaimer: This article is for general information only and isn’t a substitute for personal medical advice, diagnosis, or treatment. Always check with a GP, pharmacist, or specialist before starting a new supplement if you have a medical condition or take regular medicines.
More than a prescription: our community
Stopping smoking is rarely just a tablet decision. It's a lifestyle decision that touches sleep, stress, weight, mood, and the people around you. That's why we run free fortnightly drop-in talks and clinics at Insomnia in Derby, every fortnight from 10 am to 12 pm, open to anyone living with long-term conditions or working through a big change like quitting smoking. There's no cost, no pressure, and you're welcome to bring a friend or partner who's supporting you through the quit attempt. Learn more about our community talks on the courierpharmacy.co.uk community page.
How this content was created
Written by the Courier Pharmacy editorial team and reviewed by a GPhC-registered pharmacist. Grounded in the latest NHS, NICE, BNF, and EMC guidance, peer-reviewed studies, and the real questions patients bring to our drop-in clinics in Derby.
