Patient leaflet - Varenicline Ascend 0.5 mg + 1 mg film-coated tablets (Initiation Pack)
1. What Varenicline Ascend is and what it is used for
Varenicline Ascend contains the active substance varenicline. Varenicline Ascend is a medicine which is used in adults to help them stop smoking.
Varenicline Ascend can help to relieve the craving and withdrawal symptoms associated with stopping smoking.
Varenicline Ascend can also reduce the enjoyment of cigarettes if you do smoke when on treatment.
2. What you need to know before you take Varenicline Ascend
Do not take Varenicline Ascend
If you are allergic to varenicline or any of the other ingredients of this medicine
(listed in section 6).
Warnings and precautions
Talk to your doctor or pharmacist before taking Varenicline Ascend.
There have been reports of depression, suicidal ideation and behaviour and suicide attempts in patients taking Varenicline Ascend. If you are taking Varenicline Ascend and develop agitation, depressed mood, changes in behaviour that are of concern to you or your family or if you develop suicidal thoughts or behaviours you should stop taking Varenicline Ascend and contact your doctor immediately for treatment assessment.
The effects of stopping smoking
The effects of changes in your body resulting from stopping smoking, with or without treatment with Varenicline Ascend, may alter the way other medicines work. Therefore, in some cases an adjustment of the dose may be necessary. See below under 'Other medicines and Varenicline Ascend' for further details.
For some people, stopping smoking with or without treatment has been associated with an increased risk of experiencing changes in thinking or behaviour, feelings of depression and anxiety and can be associated with a worsening of psychiatric disorder. If you have a history of psychiatric disorder you should discuss this with your doctor.
Heart symptoms
New or worse heart or blood vessel (cardiovascular) problems have been reported primarily in people who already have cardiovascular problems. Tell your doctor if you have any changes in symptoms during treatment with Varenicline Ascend. Get emergency medical help right away if you have symptoms of a heart attack or stroke.
Seizures
Tell your doctor if you have experienced seizures or have epilepsy before your start Varenicline Ascend treatment. Some people have reported seizures while taking Varenicline Ascend.
Hypersensitivity reactions
Stop taking Varenicline Ascend and tell your doctor immediately if you experience any of the following signs and symptoms that may indicate a serious allergic reaction: swelling of the face, lips, tongue, gums, throat or body and/or difficulty breathing, wheezing.
Skin reactions
Potentially life-threatening skin rashes (Stevens-Johnson syndrome and Erythema Multiforme) have been reported with the use of Varenicline Ascend. If you develop a rash or if your skin starts to peel or blister you should stop taking Varenicline Ascend and seek emergency medical help.
Children and adolescents
Varenicline Ascend is not recommended for use in paediatric patients as efficacy was not demonstrated.
Other medicines and Varenicline Ascend
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
In some cases as a result of stopping smoking, with or without Varenicline Ascend, an adjustment of the dose of other medicines may be necessary. Examples include theophylline (a medicine to treat breathing problems), warfarin (a medicine to reduce blood clotting), and insulin (a medicine to treat diabetes). If in doubt, you should consult your doctor or pharmacist.
If you have severe kidney disease you should avoid taking cimetidine (a medicine used for gastric problems) at the same time as Varenicline Ascend as this may cause increased blood levels of Varenicline Ascend.
Use of Varenicline Ascend with other therapies for smoking cessation Consult your doctor before using Varenicline Ascend in combination with other smoking cessation therapies.
Varenicline Ascend with food and drink
There have been some reports of increased intoxicating effects of alcohol in patients taking this medicine. However, it is not known if Varenicline Ascend actually increases alcohol intoxication.
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
It is preferable to avoid the use of Varenicline Ascend while you are pregnant. Talk to your doctor if you are intending to become pregnant
Although it was not studied, Varenicline Ascend may pass into breast milk. You should ask your doctor or pharmacist for advice before taking Varenicline Ascend.
Driving and using machines
Varenicline Ascend may be linked with dizziness, sleepiness and transient loss of consciousness. You should not drive, operate complex machinery or engage in any other potentially hazardous activities until you know whether this medicine affects your ability to perform these activities.
Varenicline Ascend contains sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.
3. How to take Varenicline Ascend
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
You are more likely to stop smoking if you are motivated to stop. Your doctor and pharmacist can provide advice, support and sources of further information to help ensure your attempt to stop smoking is successful.
Before starting your course of Varenicline Ascend you should usually decide on a date in the second week of treatment (between day 8 and day 14) when you will stop smoking. If you are not willing or able to set a target quit date within 2 weeks, you may choose your own target quit date within 5 weeks after starting treatment. You should write this date on the pack as a reminder.
Varenicline Ascend comes as a white tablet (0.5 mg) and a light blue tablet (1 mg). You start with the white tablet and then usually go to the light blue tablet. See the chart below for the usual dosing instruction which you should follow from Day 1
After 12 weeks of treatment, if you have stopped smoking, your doctor may recommend an additional 12 weeks of treatment with Varenicline Ascend 1 mg film-coated tablets twice daily to help avoid returning back to smoking.
If you are not able or willing to quit smoking straight away, you should reduce smoking during the first 12 weeks of treatment and quit by the end of that treatment period. You should then continue to take Varenicline Ascend 1 mg film-coated tablets twice daily for a further 12 weeks resulting in a total of 24 weeks of treatment.
Should you experience adverse effects that you cannot tolerate your doctor may decide to reduce your dose temporarily or permanently to 0.5 mg twice daily.
If you have problems with your kidneys, you should speak to your doctor before taking Varenicline Ascend. You may need a lower dose.
Varenicline Ascend is for oral use.
The tablets should be swallowed whole with water and can be taken with or without food.
If you take more Varenicline Ascend than you should
If you accidentally take more Varenicline Ascend than your doctor prescribed, you must seek medical advice or go to the nearest hospital casualty department immediately. Take your box of tablets with you.
If you forget to take Varenicline Ascend
Do not take a double dose to make up for a forgotten tablet. It is important that you take Varenicline Ascend regularly at the same time each day. If you forget to take a dose, take it as soon as you remember. If, it is within 3-4 hours before your next dose, do not take the tablet that you have missed.
If you stop taking Varenicline Ascend
It has been shown in clinical trials that taking all doses of your medicine at the appropriate times and for the recommended duration of treatment described above will increase your chances of stopping smoking. Therefore, unless your doctor instructs you to stop treatment, it is important to keep taking Varenicline Ascend, according to the instructions described in the table above.
In smoking cessation therapy, risk of returning to smoking may be elevated in the period immediately following the end of treatment. You may temporarily experience increased irritability, urge to smoke, depression and/or sleep disturbances when you stop taking Varenicline Ascend. Your doctor may decide to gradually lower your dose of Varenicline Ascend at the end of treatment.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Giving up smoking with or without treatment can cause various symptoms. These could include changes of mood (like feeling depressed, irritable, frustrated or anxious), sleeplessness, difficulty concentrating, decreased heart rate and increased appetite or weight gain.
You should be aware of the possible emergence of serious neuropsychiatric symptoms, such as agitation, depressed mood, or changes in behaviour during a quit attempt with or without Varenicline Ascend and you should contact a doctor or pharmacist if you experience such symptoms.
Package leaflet: Information for the patient
Varenicline Ascend 0.5 mg Film-coated Tablets Varenicline Ascend 1 mg Film-coated Tablets Varenicline Ascend 0.5 mg + 1 mg Film-coated Tablets (Initiation Pack)
varenicline
4582 What Varenicline Ascend looks like and contents of the pack
- Varenicline Ascend 0.5 mg film-coated tablets White to off white, capsular biconvex, film coated tablets, debossed with ‘VC’ on one side and ‘0.5’on other side.
- Varenicline Ascend 1 mg film-coated tablets are Light blue, capsular biconvex, film coated tablets, debossed with ‘VC’ on one side and ‘1’ on other side.
Varenicline Ascend is available in the following pack presentations:
Treatment initiation pack of a carton containing 2 blisters; 1 clear blister of 11 x
Varenicline Ascend 0.5 mg film-coated tablets and 1 clear blister of 14 x Varenicline Ascend 1 mg film-coated tablets in card packaging.
Treatment initiation pack of a carton containing 2 blisters; 1 clear blister of 11 x
Varenicline Ascend 0.5 mg and 14 x 1 mg film-coated tablets and 1 clear blister of 28 or 2 clear blisters of 14 x Varenicline Ascend 1 mg film-coated tablets in card packaging.
- Treatment initiation pack in an outer carton containing 1 pack with 1 clear blister of 11 x Varenicline Ascend 0.5 mg and 14 x 1 mg film-coated tablets and 1 clear blister of 28 or 2 clear blisters of 14 x Varenicline Ascend 1 mg film-coated tablets in card packaging and 2 packs each containing 2 clear blisters of 28 or 4 clear blisters of 14 x Varenicline Ascend 1 mg film-coated tablets in card packaging.
- Follow-on (maintenance) packs of a carton containing 2 or 4 clear blisters of 14 or 2 clear blisters of 28 x Varenicline Ascend 1 mg film-coated tablets in card packaging.
Follow-on (maintenance) packs of a carton containing 2 or 4 clear blisters of 14 or
2 clear blisters of 28 Varenicline Ascend 0.5 mg film-coated tablets in card packaging.
Treatment initiation pack containing 2 blisters; 1 clear blister of 11 x Varenicline
Ascend 0.5 mg film-coated tablets and 1 clear blister of 14 x Varenicline Ascend 1 mg film-coated tablets in a carton.
Follow-on (maintenance) packs containing 2, 4, 8, or 10 clear blisters of 14 x
Varenicline Ascend 1 mg film-coated tablets in a carton.
- Sealed white HDPE bottle pack, with a child resistant screw cap, in a carton, containing 56 x Varenicline Ascend 1 mg film-coated tablets.
- Sealed white HDPE bottle pack, with a child resistant screw cap, in a carton, containing 56 x Varenicline Ascend 0.5 mg film-coated tablets
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Ascend Laboratories (UK) Limited
Elsley Court 20-22
Great Titchfield Street
London, W1W 8BE
United Kingdom
Manufacturer
Ascend Laboratories (UK) Limited
Cavendish House,
369 Burnt Oak Broadway,
Edgware, HA85AW
United Kingdom
This leaflet was last revised in 04/2024.
Serious side effects of either an uncommon or rare frequency have occurred in people attempting to quit smoking with Varenicline Ascend: seizure, stroke, heart attack, suicidal thoughts, loss of contact with reality and unable to think or judge clearly (psychosis), changes in thinking or behaviour (such as aggression and abnormal behaviour). There have also been reports of severe skin reactions including Erythema Multiforme (a type of rash) and Stevens - Johnson syndrome (a serious illness with blistering of the skin, mouth, around the eyes or genitals) and serious allergic reactions including angioedema (swelling of the face, mouth, or throat).
Very common: may affect more than 1 in 10 people
Inflammation of the nose and throat, abnormal dreams, difficulty sleeping,
headache,
- Nausea
Common: may affect up to 1 in 10 people
- Chest infection, inflammation of the sinuses
- Increased weight, decreased appetite, increased appetite
- Sleepiness, dizziness, changes in the way things taste
- Shortness of breath, cough
Heartburn, vomiting, constipation, diarrhoea, feeling bloated, abdominal pain,
toothache, indigestion, flatulence, dry mouth
- Skin rash, itching
- Joint ache, muscle ache, back pain
- Chest pain, tiredness
Uncommon: may affect up to 1 in 100 people
- Fungal infection, viral infection
Feeling of panic, difficulty thinking, restlessness, mood swings, depression,
anxiety, hallucinations, changes in sex drive
- Seizure, tremor, feeling sluggish, less sensitive to touch
- Conjunctivitis, eye pain
- Ringing in the ears
- Angina, rapid heart rate, palpitations, increased heart rate
- Increased blood pressure, hot flush
Inflammation of nose, sinuses and throat, congestion of nose, throat and chest,
hoarseness, hay fever, throat irritation, congested sinuses, excess mucous from nose causing cough, runny nose
Red blood in stools, irritated stomach, change of bowel habit, belching, mouth
ulcers, pain in the gums
- Reddening of the skin, acne, increased sweating, night sweats · Muscle spasms, chest wall pain
- Abnormally frequent urination, urination at night
- Increased menstrual flow
- Chest discomfort, flu like illness, fever, feeling weak or unwell · High blood sugar
- Heart attack
- Suicidal thoughts
- Changes in thinking or behaviour (such as aggression)
Rare: may affect up to 1 in 1,000 people
- Excessive thirst
- Feeling unwell or unhappy, slow thinking
- Stroke
Increased muscle tension, difficulty with speech, difficulty with coordination,
reduced sense of taste, altered sleep pattern
Disturbed vision, eyeball discolouration, dilated pupils, sensitivity to light,
shortsightedness, watery eyes
- Irregular heart beat or heart rhythm disturbances
- Throat pain, snoring
- Blood in vomit, abnormal stools, coated tongue
- Stiff joints, rib pain
- Glucose in urine, increased urine volume and frequency
- Vaginal discharge, changes in sexual ability
- Feeling cold, cyst
- Diabetes
- Sleep walking
- Loss of contact with reality and unable to think or judge clearly (psychosis) · Abnormal behavior
Severe skin reactions including Erythema Multiforme (a type of rash) and
Stevens- Johnson Syndrome (a serious illness with blistering of the skin, mouth, around the eyes or genitals)
Serious allergic reactions including angioedema (swelling of the face, mouth, or
throat)
Not known
- Transient loss of consciousness
Reporting of side effects
If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.
5. How to store Varenicline Ascend
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the card packaging or carton after
EXP. The expiry date refers to the last day of that month.
Blister and Bottle Packs: Store below 25°C. Store in original package in order to protect from light.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Varenicline Ascend contains
- The active substance is varenicline.
- Each 0.5 mg film-coated tablet contains 0.5 mg of varenicline (as tartrate).
- Each 1 mg film-coated tablet contains 1 mg of varenicline (as tartrate).
The other ingredients are:
Tablet Core - Varenicline Ascend 0.5 mg and 1 mg film-coated tablets
Cellulose, microcrystalline
Croscarmellose sodium (see section 2 Varenicline Ascend contains sodium” Maltodextrin
Stearic acid
Barrier coating material Varenicline Ascend 0.5 mg and 1 mg film-coated tablets
Opadry clear 04K59023 (for both 0.5 mg & 1 mg strength):
Hypromellose
Triacetin
Tablet film coating - Varenicline Ascend 0.5 mg film-coated tablets
Opadry white 03F180011
Hypromellose
Titanium dioxide (E171)
Macrogol
Tablet film coating - Varenicline Ascend 1 mg film-coated tablets
Opadry blue 03F505152
Hypromellose
Macrogol
Titanium dioxide (E171)
Talc
FD&C blue #2 indigo carmine aluminum lake (E132)
FD&C blue #1/brilliant blue FCF aluminum lake (E133)
Iron oxide yellow (E172)