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Todacitan: this is the smoking cessation medication that already finances public health

Since this month of February, the public health system has been financing a new medication to stop smoking. Todacitan adds to the short list of drugs authorized to quit the tobacco habit, taking into account that Champix has stopped being marketed in Spain due to the presence of impurities, and the drug Zyntabac is currently suffering from supply problems. Other options include nicotine-based medications in the form of patches and/or gum such as those from the Nicorette and Nicotinell brands, which can be purchased without a prescription and are not financed by public health.

What is known about Todacitan

The active ingredient of this drug is cytisine, a substance of plant origin, with an effect similar (although weaker) to that of nicotine, which is authorized for the treatment of tobacco dependence and the reduction of anxiety generated by it. habit. “The use of Todacitan allows a gradual reduction of nicotine dependence by relieving withdrawal symptoms,” the leaflet notes.

Effectiveness

The Organization of Consumers and Users (OCU) highlights the greater effectiveness of cytisine compared to nicotine patches and gum, and less effectiveness with regard to varenicline (active ingredient of the Champix medication, withdrawn from the market). “We know that compared to placebo, cytisine increases the probability of quitting smoking more than three times,” he details.

In clinical trials, adds the OCU, it has been proven that, six months after completing the treatment, 22% of people who had used cytisine remained without smoking compared to 15% of those who had used cytisine-based products. of nicotine. And yet, compared to varenicline, it was seen that, at six months of follow-up, 11.7% of those who had used cytisine remained smoke-free compared to 13.3% of those who had used varenicline.

Contraindications and adverse effects

Todacitan is contraindicated in people with heart problems (unstable angina, recent heart attack, arrhythmias); who have suffered a recent cerebrovascular event, and in pregnant women and during the breastfeeding period.

Likewise, it is recommended not to use this medication in people over 65 years of age, under 18 years of age and in those who suffer from liver or kidney problems due to the absence (or little) clinical experience of use in this type of person.

Regarding its adverse effects, the most frequent (more than 1 in 10 users) are increased appetite, weight gain, dizziness, irritability, mood changes, anxiety, increased blood pressure (hypertension), dry mouth , diarrhea, rash, exhaustion, sleep disorders (insomnia, drowsiness, lethargy, abnormal dreams, nightmares), headaches, increased heart rate, nausea, taste disturbance, heartburn, constipation, vomiting, abdominal pain and muscle pain.

Less frequently (between 1 and 10 out of every 100 users), there may be difficulty concentrating, slow heart rate, abdominal distension, burning of the tongue or general discomfort.

And rarely reported (affecting 1 to 10 users in 1,000), feeling of heaviness in the head, decreased libido, tearing, dyspnoea, increased sputum, excessive salivation, sweating, decreased skin elasticity, tiredness , increased serum transaminase levels.

Most of these adverse effects occur at the beginning of treatment and disappear throughout it. The medication’s package insert indicates that some of these symptoms may be due, not to the treatment itself, but as a consequence of quitting smoking itself, such as withdrawal symptoms.