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Cytisinicline

Cytisinicline is a smoking cessation medication.

Cytisinicline is a naturally occurring plant-based alkaloid.

It binds selectively to the alpha4beta2 nicotinic acetylcholine receptor subtype that mediates nicotine dependence, acting as a partial agonist to reduce nicotine withdrawal symptoms, while also blocking the reinforcement generated by nicotine when smoking cigarettes.

Its mechanism of action are: 1) acts as a selective partial agonist, stimulating, subtypes of nicotinic acetylcholine receptors in the brain, much as nicotine does, and reduces, nicotine withdrawal, and craving, and 2) acts as a temporary partial antagonist at these same receptors, blocking the effects of nicotine, and reducing the reinforcing effects of a lapse cigarette. 

Its effects are similar to the use of a varenicline.

810 participants in a study of a placebo controlled phase 3 randomized clinical trial had a 6 to 8 fold higher odds of continuous smoking abstinence at the end of treatment than2 participants receiving placebo plus behavioral support.

Effective dose scheduling 3 mg three times per day for 6 to 12 weeks. 

Adverse events include insomnia, and abnormal dreams. 

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