fbpx Skip to content

The Ultimate Guide to Finding the Perfect Varenicline Dose

Quitting smoking isn’t easy. But Varenicline, an oral prescription medication, may help. You are more likely to quit smoking if you take the Varenicline dose correctly and successfully. Varenicline dose has been prescribed to more than 24 million smokers.

Many smokers have found varenicline effective in their journey to quit smoking. In a podcast by HealingUS Centers, Ashley and Frank Salage discuss the challenging journey of quitting smoking and overcoming other addictions. Despite facing many difficulties in different treatment centers, Frank found a turning point through his determination and with the right medical help. By overcoming these challenges, he has now been sober for almost a year, showing how much effort and commitment it takes to quit smoking.

However, Varenicline isn’t approved for people under 18. In this guide, we’ll review the approved Varenicline dosages for adults, their side effects, and what to expect after treatment.

What is Varenicline?

Varenicline is a pill that does not contain nicotine and requires a prescription. It works differently from other quit-smoking medicines and may be a perfect option for people who have tried different medicines to quit but haven’t been successful.

Varenicline comes in two strengths: 0.5 mg (a white pill) and 1 mg (a blue pill). Your doctor or pharmacist can provide detailed instructions on how to use it and help you set and adjust your dose.

Varenicline helps you quit smoking by reducing cravings for nicotine, the addictive substance in tobacco. It is most effective when used in combination with a stop-smoking program. This medicine may also be used for other purposes.

Due to certain complexities, Pfizer stopped making Varenicline in July 2021 because of a nitrosamine impurity and withdrew it from the market in September 2021. As of May 2023, the unavailability of Varenicline had led to a 75% reduction in prescriptions in the US.

However, it remains an essential option for those trying to quit smoking once it becomes available again.

Mechanism of Varenicline Dose

When nicotine attaches to specific receptors in the brain called α4β2 nicotinic acetylcholine receptors, it triggers the release of dopamine, a chemical that makes you feel good. This release encourages learning and behaviors driven by rewards.

Over time, the brain adapts and becomes more sensitive, increasing the number of these receptors. This leads to a strong urge to keep using nicotine to feel normal.

Varenicline Dosage

Usual Adult Dose

According to the National Library Of Medicine, provides patients with counseling and educational support. Set a target quit date and start Varenicline 1 week before. Alternatively, start Varenicline and quit smoking between days 8 and 35 of treatment. Take Varenicline after eating with a glass of water.


Days 1–3: 0.5 mg once daily

Days 4–7: 0.5 mg twice daily

Day 8 onward: 1 mg twice daily

If nausea or side effects occur, the varenicline dose may be reduced. Treat for 12 weeks, and if successful, continue for another 12 weeks to improve abstinence.

For gradual quitting, reduce smoking by 50% in the first four weeks and another 50% in the next four weeks, aiming for complete abstinence by 12 weeks. Continue treatment for a total of 24 weeks.

If the patient is motivated but unsuccessful, encourage another attempt after addressing contributing factors.

For severe renal impairment, start with 0.5 mg once daily, with a maximum of 0.5 mg twice daily. If tolerated, the maximum for ESRD with hemodialysis is 0.5 mg once daily.

Varenicline Alternative Dosage:

A study of Pfizer Laboratories Div Pfizer Inc shows the alternative ways and dosage of Varenicline:

Flexible Approach

Start taking varenicline dose and plan to quit smoking between days 8 and 35 of treatment.

Reduce to Quit

  • For those who cannot or do not want to quit suddenly, follow a gradual reduction plan:
  • Reduce smoking by 50% in the first 4 weeks.
  • Reduce smoking by another 50% in the next 4 weeks.
  • Aim for complete abstinence by 12 weeks.
  • Continue taking Varenicline for an additional 12 weeks, totaling 24 weeks of treatment.

Low Dose Varenicline

  • Take 0.5 mg twice daily.
  • Causes less nausea compared to the standard 1 mg dose.

High Dose Varenicline

Doses up to 5 mg per day showed no additional benefits.

Usual Adult Dose for Smoking Cessation

Dosage Schedule

Days 1 to 3: Take 0.5 mg once a day

Days 4 to 7: Take 0.5 mg twice a day

Day 8 to end of treatment: Take 1 mg twice a day

Treatment Duration: 12 weeks

Set a quit date and start taking varenicline dose 1 to 2 weeks before this date, or start treatment and plan to quit smoking between days 8 and 35. Success is more likely if you are motivated and receive additional support and advice. Be aware that the risk of returning to smoking is higher right after finishing the treatment.

Dose Adjustments

Renal Dose Adjustments

Mild to Moderate Renal Dysfunction (CrCl 30 mL/min or greater): No dose adjustment is needed.

Severe Renal Dysfunction (CrCl less than 30 mL/min): Start with 0.5 mg once a day; if needed, increase to a maximum of 0.5 mg twice daily.

End-Stage Renal Disease (undergoing hemodialysis): Maximum dose is 0.5 mg once a day if tolerated.

What happens if you miss a dose of Varenicline?

If you miss a varenicline dose, take it as soon as you remember. However, skip the missed dose if it’s almost time for your next dose. Do not take two doses simultaneously to make up for a missed dose.

Since your Varenicline dosage changes over the 1st week, write your dosing schedule on a calendar to help you remember it. Varenicline also comes in a dosing pack to help you take it properly.

Ask your healthcare provider about prescribing the dosing pack if it could help you. Remember that you’ll need two prescriptions:

  • One for the first month (when you’re gradually increasing your dosage)
  • One for the next two months (once you’ve reached the recommended dosage).


Que: Does varenicline cause weight gain?

Ans: Varenicline may help limit weight gain after you quit smoking, but it is generally associated with a modest increase in weight.

Que: Who should not use varenicline?

Ans: Before starting varenicline, talk to your doctor if you: – Have severe kidney problems. – Are you pregnant or breastfeeding? – Are under 18 years old.

Que: What happens when you stop taking varenicline?

Ans: When you stop taking Varenicline, you might experience withdrawal symptoms like: – Increased appetite and weight gain, Trouble sleeping, Slower heart rate, Feeling anxiety or restlessness, And urges to smoke again.

Que: Does varenicline help with anxiety?

Ans: Yes, varenicline, along with bupropion and nicotine patches, is effective and well-tolerated in adults with psychotic, anxiety, and mood disorders.

Que: How long do you take varenicline?

Ans: You should set a quit date and start taking varenicline one week before this date. Alternatively, you can start taking varenicline and plan to quit smoking between days 8 and 35 of treatment. Typically, you will take varenicline for 12 weeks, but your doctor might recommend continuing for an additional 12 weeks.


Varenicline is a beneficial medication for adults looking to quit smoking. It’s important to stay aware of potential side effects while taking Varenicline, such as nausea, headache, insomnia, and changes in dreaming.

Your doctor may suggest a lower varenicline dose for kidney problems or side effects. They’ll help you find the correct dose for you to quit smoking successfully.

Request a Callback

"*" indicates required fields