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Doménico Chiappe
Madrid
Sunday, 12 November 2023
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Spain's Ministry of Health has authorised funding for a second drug to help people quit smoking, with the active ingredient 'cytisinicline'. Marketed under the name Recigarum by the pharmaceutical company Adamed, the price for a pack of 100 tablets has been reduced this month from 111 euros to 71 euros. The general recommended dosage is one tablet every two hours at first, then one or two a day. One box is "sufficient for a full course of treatment" lasting 25 days, the drug's data sheet states.
Recigarum joins another authorised smoking cessation drug, Todacitan, which is also discounted for smokers. With the same active ingredient and similar packaging, it also promises to control nicotine addiction in 25 days. The price of both products is similar.
In the case of Recigarum, "smoking should be stopped on the fifth day of treatment at the latest" and "smoking should not be continued because it could worsen adverse reactions," which affected up to 15% of those who participated in the clinical trial, according to Adamed's study. Only those who "have the firm intention to quit smoking" should use it the company said.
If the treatment fails, it can be resumed two or three months later. But the health service only funds one treatment a year. The drug is not recommended for people with kidney or liver failure, a history of myocardial infarction, stroke or arrhythmia; nor for people over 65, under 18 or pregnant. It can be taken, but with caution, by those with heart problems, ulcers, reflux, diabetes or schizophrenia.
During treatment, the pharmaceutical company asks physicians to be "alert to the possible occurrence of severe neuropsychiatric symptoms in patients who are trying to quit smoking with or without treatment. A depressed mood, including, rarely, suicidal ideation or suicide attempts, can be a symptom of nicotine withdrawal," it said.
The Spanish Medicines Agency, said this drug provides "help to quit smoking and to alleviate the anxiety that occurs when quitting smoking", with symptoms such as depressed mood, irritability, anxiety, difficulty concentrating, insomnia or increased appetite. "The goal of the treatment is permanent smoking cessation".
The active ingredient of both drugs, cytisynicline, is a plant alkaloid, obtained from the seeds of trees of the genus Laburnum. It is similar in chemical structure and action in the body to nicotine. Because of the way it acts once ingested, it competes with nicotine for the same receptors and gradually displaces nicotine by having a stronger binding and moderately increases the level of dopamine in the brain, which relieves the central symptoms of nicotine withdrawal.
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