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GPs get go ahead to prescribe varenicline

NICE has given GPs the green light to prescribe varenicline for smoking cessation as drug regulators moved to allay fears that it might prompt suicidal thoughts in some patients.

A committee of the UK's Commission on Human Medicines discussed the possibility of a link between the drug and suicidal ideation and behaviour ­ but decided there was no evidence to justify altering product information.The commission has asked to be kept informed on adverse events, following reports of a potential signal in an EU member state.

The institute's final appraisal determination approved varenicline as a first-line option for smoking cessation, normally to be prescribed with behavioural support.

Dr Peter Elliot, prescribing lead at Redbridge PCT and a GP in South Woodford, east London, said his practice had been waiting for NICE approval before prescribing varenicline.

But he said he would be warning local GPs to exercise caution when using the drug in people with a history of psychiatric illness.

'There are an awful lot of drugs that come out in a blaze of publicity and are then withdrawn.

'Whether this will turn out to be another Zyban [bupropion] I don't know, but we'll have to be careful about handing it out like sweeties.' Julie James, a healthcare assistant and smoking cessation adviser in Wandsworth, south London, said people with severe depression who were trying to quit should always be closely monitored, whatever method they were using.

But she said the approval was 'extremely good news'.

Pfizer, manufacturer of varenicline under the brand-name Champix, said it had conducted a 'thorough review' of clinical trial data, and found no evidence of an increased risk of suicidal behaviour.

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