Cytisine

What is Cytisine?

Cytisine is an alkaloid that is naturally found in many plants and seeds, particularly those of Laburnum. It plays an important role in counteracting nicotine addiction because it mimics the actions of nicotine to help you give up smoking.

In the UK, a prescription from a doctor or medical professional is required to obtain Cytisine.

How does Cytisine work?

Cytisine works similarly to Champix because it copies the effects of nicotine by selectively stimulating the nicotine receptors in the brain so that when you smoke, you receive only a partial reward. 

Over time, this makes it easier to manage the withdrawal and give up tobacco smoking altogether. By attaching itself to the nicotine receptor, nicotine cannot bind to it.

Cytisine dosage

Cytisine is a tablet. Each tablet contains 1.5 mg of the active ingredient, cytisine.

One pack of Cytisine contains 100 tablets, which is equivalent to a complete course of 25 days. Below is a dosage table.

You should stop smoking no later than the fifth day of Cytisine treatment. If you carry on smoking beyond this while taking Cytisine, you may increase the chance of experiencing side effects. To take Cytisine, you should swallow the tablet whole with a glass of water.

What happens if I take too much Cytisine?

If you take too much Cytisine, it can cause some unwanted side effects. You should seek urgent medical advice if you have taken too many tablets.

What if I miss a dose of Cytisine?

If you miss your usual dose of Cytisine, you must not take a double dose to make up for the missed dose. Just skip the missed dose and take your next scheduled tablet as usual.

How effective is Cytisine?

When it comes to quitting smoking, a study published in the Cochrane Database of Systematic Reviews found Cytisine to be one of the most effective treatments, alongside e-cigarettes and varenicline. 

A study published in The New England Journal of Medicine (NEJM) found that compared to a placebo, cytisine was more effective for giving up smoking. 

A review analysing the results from 8 clinical trials involving 4020 adult smokers found that Cytisine users had a 59% higher rate of abstinence compared to placebo. The same review found that cytisine may be more effective than nicotine replacement therapy.

Where can I buy Cytisine online?

You can purchase Cytisine from Prescription Doctor using our online consultation service. Complete our brief online questionnaire, and one of our clinicians will review and approve the treatment if it is appropriate. After checkout, you can chat with Customer Service advisers or our medical team via ‘My Account’.

Who can use Cytisine?

Cytisine is intended for use by people who are serious about giving up smoking. You should avoid nicotine-based products, including cigarettes and nicotine replacement therapy, while taking Cytisine because it can lead to adverse effects.

Is Cytisine safe?

Evidence shows that Cytisine is a safe and effective smoking cessation method. It has been used in Europe as a stop-smoking aid by several million people without prescription, and no serious side effects have been reported. 

A research trial involving adults who smoked more than 10 cigarettes a day found that any side effects linked to Cytisine use, although common, were not serious.

Cytisine side effects

Common side effects of cytisine may include:

• Nausea
• Vomiting
• Abdominal pain or discomfort
• Dry mouth
• Increased heart rate
• Insomnia or sleep disturbances
• Headache
• Dizziness
• Changes in taste perception

Cytisine warnings

Before taking Cytisine, you should let our clinicians know if you have:

• ischaemic heart disease
• heart failure
• high blood pressure (hypertension)
• gastric or duodenal ulcers
• gastroesophageal reflux disease
• an overactive thyroid
• diabetes
• schizophrenia
• atherosclerosis
• a tumour in the adrenal glands (pheochromocytoma)

Having one of these conditions doesn’t necessarily mean you can’t use Cytisine to give up smoking. It simply means that our clinicians will need to assess the risks, and if they believe the medication is suitable for you, they will monitor your body’s response.

Cytisine contraindications

You should not take Cytisine if you:

• are under 18
• are 65 or over
• are allergic to Cytisine
• are allergic to any of the ingredients in Cytisine tablets
• have unstable angina
• have recently had a heart attack
• experience an irregular or abnormal heartbeat (arrhythmias)
• have recently had a stroke
• are pregnant or breastfeeding

If you are taking an oral contraceptive pill, like the combined pill, you should consider using additional contraception methods, such as condoms, while using Cytisine. 

That’s because not enough is known about the effect of Cytisine on hormonal contraceptives, so additional precautions are recommended. You should not use Cytisine with any anti-tuberculosis (TB) medicines. Please inform our clinician if you are taking any other medications before using Cytisine, so they can assess your suitability.

Cytisine during pregnancy and breastfeeding

Cytisine should not be used by pregnant or breastfeeding women because there is limited evidence relating to its effects. 

If you are pregnant, you can use nicotine replacement therapy if you are unable to quit without it. However, it is strongly recommended that you consult a healthcare provider before starting any new treatment.

Are there any alternatives to Cytisine?

Yes, at Prescription Doctor, we offer other smoking cessation options. They are:

• Champix (our clinicians will look to prescribe Zyban or Cytisine)
• Zyban

Zyban helps you to quit smoking by acting on the neurotransmitters in the brain responsible for nicotine cravings and withdrawal. The active ingredient, bupropion hydrochloride, helps to make these symptoms more manageable.

What’s the difference between Cytisine and varenicline?

Varenicline (Champix) and Cytisine contain different active ingredients. Champix has been considered the most effective smoking cessation aid, but it can cause side effects that can lead to people stopping treatment early. Cytisine, however, is a plant-based alkaloid that works similarly to varenicline. Cytisine is associated with a lower incidence of side effects compared to varenicline.

Sources

Addiction, (2023). Evaluation of the effectiveness of cytisine for the treatment of smoking cessation: A systematic review and meta-analysis

Addiction, (2021). Cytisine versus varenicline for smoking cessation in New Zealand indigenous Māori: a randomized controlled trial.

Addictive Behaviours, (2018). Use of hormonal contraceptives and smoking cessation: A preliminary report

BMJ, (2013). Efficacy of cytisine in helping smokers quit: systematic review and meta-analysis

International Journal of Environmental Research and Public Health, (2022). Efficacy and Safety of Cytisine in Combination with a Community Pharmacists’ Counselling for Smoking Cessation in Thailand: A Randomized Double-Blinded Placebo-Controlled Trial

JAMA, (2021). Effect of Cytisine vs Varenicline on Smoking Cessation.

The New England Journal of Medicine, 2011. Placebo-Controlled Trial of Cytisine for Smoking Cessation