Cytisine is the newest prescription-only stop smoking medication to become available in the UK. It’s been available in other countries for many years under different brand names. Each pack contains 100 oral tablets that contain the active ingredient cytisine. It works by reducing the urge to smoke, affecting specific receptors in your brain. This makes it easier not to smoke, especially at the start when these urges are strongest.

You’ll take the tablets over a 25-day course, following a decreasing dosage schedule. Cytisine works similarly to Champix, another stop smoking medication that’s no longer available.

Cytisine mimics the effects of nicotine, attaching to the same receptors in your brain that nicotine does. After taking the tablet, your brain thinks you’ve had a cigarette, which reduces the urge to smoke. You’ll also have fewer withdrawal symptoms and cravings. Cytisine is non-addictive, unlike nicotine, making it a great alternative to nicotine replacement therapy (NRT).

As Cytisine blocks the receptors that nicotine attaches to, nicotine from a cigarette cannot attach itself. It’s not recommended to smoke while using this medicine, but if you do, you won’t feel much satisfaction from it and could get side effects.

Cytisine works alongside other stop smoking techniques, such as:

• Staying active and eating a healthy diet – it’s easier to put on weight when you quit, as your body is looking to replace the hand-to-mouth action that comes with smoking. Having plenty of healthy snacks and meals at the ready can reduce the chances of weight gain after you quit, as can regular exercise.
• Getting extra support from friends, family or a stop smoking therapist.
• Limiting the time spent around people that smoke until your cravings have subsided – if someone else in your home smokes, ask them to not smoke around you, as this is likely to trigger strong cravings.
• Finding activities and hobbies to keep you busy, especially when you start to crave a cigarette.
• Using fidget toys and chewing gum to give your hands and mouth something to do, especially when you get cravings to smoke.

How long does Cytisine last?

Cytisine has a half-life of 4.8 hours. The half-life of a medication is how long it takes half the active ingredient to leave your system.

How long does Cytisine take to work?

It can take up to a few hours for Cytisine to reach its full effect. It works best when following the dosage schedule, rather than only taking it when you get cravings.

How effective is Cytisine?

According to a systematic review of 8 clinical studies involving 4,020 adult smokers, Cytisine helped 59% more people stop smoking compared to those who took a placebo.

Another clinical trial involving 1,310 smokers compared Cytisine use to nicotine replacement therapy (NRT) for quitting. After 1 month, 40% of people taking Cytisine had abstained from smoking compared to 31% taking NRT. After 6 months, these numbers were 22% vs 15% respectively.

Cytisine is an oral tablet that’s taken daily following a decreasing dosage schedule. Each 1.5mg Cytisine tablet should be swallowed whole, with water. Each pack contains 100 tablets, which is the number of tablets needed for the complete treatment course of 25 days. Ideally, start Cytisine on the day you quit smoking. Your quitting date must be no later than the 5th day of treatment.

If you need further help and support after your Cytisine pack is finished, speak to a stop smoking clinician or one of our doctors.

Taking more Cytisine than prescribed could cause side effects or symptoms similar to a nicotine overdose. If you take more tablets than prescribed and get any serious symptoms, such as breathing problems, seizures, or blurred vision, call 999.

When to take Cytisine

Take your first dose in the morning when you wake up, so any cravings or withdrawal symptoms are minimised straight away. Then follow the dosage schedule for the remaining tablets each day. Try to follow the dosage schedule as accurately as you can, as this will make it most effective. It can be helpful to set a timer or alarm on your phone for each dose.

How often to take Cytisine

Cytisine is taken every 2 hours for the first 3 days, which is gradually decreased until you’re only taking 1 or 2 tablets a day by day 21 of treatment. Refer back to the dosage schedule if you aren’t sure.

If you forget to take a dose, take your next one at the scheduled time and leave out the missed dose. Don’t take a double dose, as this is more likely to cause side effects than help with withdrawal symptoms.

How long do you need to take Cytisine for?

Cytisine has a treatment course of 25 days. You should finish your whole pack of tablets to get the best effect. If you’re still getting cravings or need further support once your treatment is finished, speak to your doctor.

Cytisine is only available to buy with a prescription, which you can get online from private prescribers such as Superdrug Online Doctor or through the NHS.

Can I buy Cytisine over-the-counter?

No, Cytisine is currently only available in the UK with a prescription.

Can I get Cytisine on the NHS?

Yes, Cytisine is available on the NHS and can be prescribed by your GP or stop smoking clinician. You can also be referred to a free stop smoking service in your local area. Speak to your GP for more information.

Cytisine can cause some side effects which are most likely during the first few days of treatment. Most side effects get better over time and some side effects may also be caused by quitting nicotine itself, such as weight gain and irritability. If your side effects are affecting your daily life or get worse during treatment, speak to your doctor straight away.

Very common Cytisine side effects include:

• headaches
• nausea (feeling sick)
• vomiting (being sick)
• diarrhoea
• constipation
• weight gain
• change in appetite (mainly an increase) – this is also a common side effect of quitting nicotine, as nicotine is an appetite suppressant
• dizziness
• mood changes, including irritability
• anxiety
• high blood pressure
• dry mouth
• heartburn
• abdominal pain (especially the upper abdomen)
• muscle pain
• rash
• fatigue
• sleep disorders (insomnia, drowsiness, lethargy, abnormal dreams, nightmares)
• increased pulse
• change in taste

Common Cytisine side effects include:

• slow heart rate
• difficulty concentrating
• burning tongue
• abdominal distention (swelling)
• malaise (a feeling of discomfort, illness, or unease)

Uncommon Cytisine side effects include:

• feeling of heaviness in the head
• tiredness
• sweating
• decreased libido
• lacrimation (abnormal or excessive secretion of tears)
• shortness of breath
• excessive salivation
• increased sputum (phlegm)
• decreased elasticity of the skin
• an increase in serum transaminase levels shown in blood tests

There has been no evidence of serious adverse effects whilst taking Cytisine but like all medications, there’s a risk of a severe allergic reaction. Symptoms include:

• difficulty breathing
• swelling in the face, mouth, and throat
• dizziness
• fainting
• rash

This is a medical emergency and you should call 999 straight away or go to A&E.

How long do Cytisine side effects last?

Side effects of Cytisine should only last a few days to a few weeks. Any side effects you get while taking it will go away once you stop treatment.

What to do if you get Cytisine side effects

If you get Cytisine side effects, see if they go away on their own. You can treat side effects such as nausea with anti-sickness medications and headaches with over-the-counter painkillers. If side effects are making it hard to carry out daily activities, speak to your doctor straight away.

Cytisine should not be taken if you:

• have a hypersensitivity to Cytisine or any other ingredients in the tablets
• have unstable angina
• have clinically significant arrhythmias (irregular or abnormal heart rhythm)
• have kidney or liver impairment
• have had a recent heart attack or stroke
• are pregnant or breastfeeding
• are under 18 or over 65

The impact of Cytisine on the effectiveness of the pill is not known: Women taking hormonal contraceptives like the mini or combined contraceptive pill should use a secondary contraceptive while taking Cytisine, such as condoms.

Cytisine should be taken with caution if you have:

• ischemic heart disease
• schizophrenia
• heart failure
• high blood pressure
• diabetes
• pheochromocytoma (tumour in the adrenal glands)
• hyperthyroidism (overactive thyroid)
• atherosclerosis (thickening or hardening of the arteries) or other peripheral vascular diseases
• gastroesophageal reflux disease
• gastric or duodenal ulcer

Your doctor will let you know whether it’s safe to take Cytisine if you have any of these conditions. They may want to keep a close eye on your symptoms during the treatment course.

Cytisine can be taken with most medications but isn’t suitable if you take anti-tuberculosis treatment. It’s also advised not to take Cytisine alongside nicotine replacement therapy unless otherwise specified by your doctor. Let your doctor know if you take any other medications or herbal treatments before starting Cytisine.

There are currently 2 prescription-only quit smoking treatments available in the UK: Cytisine and Zyban.

Zyban contains bupropion hydrochloride, which can also be used as an antidepressant. It affects the parts of your brain responsible for addiction and cravings, making it easier to manage withdrawal symptoms and cravings while quitting. If you do smoke during treatment, Zyban makes smoking less enjoyable, so you aren’t as likely to do it again. It’s taken over 7 to 9 weeks and the recommended dose is 1 or 2 tablets a day.

Varenicline vs Cytisine

Varenicline is the active ingredient in the stop smoking medication Champix, which is no longer available. It's been withdrawn from use as a precaution because it was found to contain an impurity. It’s not known whether varenicline (Champix) will be available again.

Is Cytisine the same as Champix?

Cytisine is very similar to Champix, as they both work on the receptors in the brain that nicotine does, so you have fewer cravings and withdrawal symptoms. They aren’t exactly the same, though, as they contain different active ingredients, which means they have different contraindications and side effects.

Is Cytisine the same as Tabex?

Yes, Cytisine is known as Tabex in some other countries. It’s the same medication used for stopping smoking but sold under a different brand name. Tabex isn’t available in the UK.

Does Cytisine cause weight gain?

One of the very common side effects of Cytisine is weight gain, although it’s not known how many patients experience this because of the medication, or because they stopped smoking. Nicotine is an appetite suppressant, so it’s common to feel hungrier and eat more after quitting. Following a healthy diet and taking regular exercise can reduce the chances of this.

Can I take Cytisine with other stop smoking aids?

Cytisine should be taken alone, without other stop smoking aids. It shouldn’t be used alongside other prescription stop smoking medications and isn’t recommended with nicotine replacement therapy.

What happens if I smoke when taking Cytisine?

If you smoke while taking Cytisine, you aren’t likely to feel any satisfaction. It could also cause side effects such as nausea, feeling generally unwell, or headaches. These effects can become serious if you keep smoking while taking the medication. If you find that you keep smoking while on Cytisine, speak to your doctor as they may recommend stopping treatment as a safety precaution.