Varenicline Side Effects

Medically reviewed by Drugs.com. Last updated on Dec 17, 2023.

Applies to varenicline: oral tablet.

Other dosage forms:

• nasal spray

Common side effects of varenicline

Some side effects of varenicline may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

• abnormal dreams
• absence of menstruation
• change in taste
• diarrhea
• difficulty having a bowel movement
• difficulty in moving
• excess air or gas in the stomach or bowels
• joint pain or swelling
• lack or loss of strength
• loss of taste
• muscle stiffness
• painful menstruation
• passing gas
• toothache
• trouble sleeping

Less common side effects

• belching
• body aches or pain
• burning, dry, or itching eyes
• continuing ringing or buzzing or other unexplained noise in the ears
• decreased interest in sexual intercourse
• discharge, excessive tearing
• ear congestion
• feeling of constant movement of self or surroundings
• feeling of warmth
• hearing loss
• inability to have or keep an erection
• increased appetite
• increased urge to urinate during the night
• loss in sexual ability, desire, drive, or performance
• loss of voice
• nightmares
• redness in the joints
• redness of the face, neck, arms and occasionally, upper chest
• redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
• sensation of spinning
• sleepiness or unusual drowsiness
• sneezing
• sore throat
• stomach discomfort
• stuffy or runny nose
• transient, mild, pleasant aromatic odor
• trouble concentrating
• waking to urinate at night

Rare side effects

• change in color vision
• difficulty seeing at night
• increased sensitivity of the eyes to sunlight
• night blindness
• seeing floating dark spots or material before the eyes

Serious side effects of varenicline

Along with its needed effects, varenicline may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking varenicline:

Less common side effects

• anxiety
• black, tarry stools
• bloating or swelling of the face, arms, hands, lower legs, or feet
• bloody stools
• blurred vision
• burning feeling in the chest or stomach
• chest pain or discomfort
• chills
• cold hands and feet
• cold sweats
• confusion
• cool, pale skin cough
• deep or fast breathing with dizziness
• difficult or labored breathing
• dizziness
• dry mouth
• fainting
• fast, pounding, or irregular heartbeat or pulse
• flushed, dry skin
• fruit-like breath odor
• headache
• headache, severe and throbbing
• increased hunger
• increased thirst
• increased urination
• indigestion
• loss of consciousness
• nausea
• nervousness
• nightmares
• noisy breathing
• nosebleed
• numbness of the feet, hands and around the mouth
• pain or discomfort in the arms, jaw, back, or neck
• pale skin
• pounding in the ears
• rapid weight gain
• seizures
• shakiness
• slow heartbeat
• slurred speech
• stomach pain or upset
• sweating
• swollen, painful, or tender lymph glands in the neck, armpit, or groin
• tenderness in the stomach area
• tightness in the chest
• tingling of the hands or feet
• tremor
• troubled breathing with exertion
• unexplained weight loss
• unusual bleeding or bruising
• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
• unusual weight gain or loss
• vomiting
• vomiting of blood or material that looks like coffee grounds

Rare side effects

• agitation
• bleeding gums
• bloating
• blood in the urine or stools
• constipation
• dark urine
• decrease in height
• decreased awareness or responsiveness
• difficulty in swallowing
• eye pain
• feeling of fullness
• fever
• frequent urination
• general feeling of illness
• heartburn
• hostility
• increased sensitivity of the skin to sunlight
• increased volume of pale, dilute urine
• irritability
• itching, skin rash
• loss of appetite
• mood changes
• muscle pain, cramps, or twitching
• numbness or tingling in the hands, feet, or lips
• pain or burning in the throat
• pains in the stomach, side, or abdomen, possibly radiating to the back
• pinpoint red spots on the skin
• red, scaling, or crusted skin
• redness or other discoloration of the skin
• severe sleepiness
• severe stomach pain
• severe sunburn
• sores, ulcers, or white spots on the lips, tongue, or inside the mouth
• tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area
• uncontrolled eye movements
• yellow eyes or skin

Incidence not known

• anger
• anxiety
• behavior changes
• discouragement
• feeling sad or empty
• feelings of panic
• irregular heartbeat
• loss of interest or pleasure
• mood swings
• restlessness
• seeing, hearing, or feeling things that are not there
• sleepwalking
• thoughts of killing oneself

For healthcare professionals

Applies to varenicline: nasal spray, oral tablet.

General adverse events

The most commonly reported side effects included nausea, headache, insomnia, and abnormal dreams.^[Ref]

Psychiatric

• Very common (10% or more): Insomnia (up to 19%), abnormal dreams (up to 13%), depressed mood disorders and disturbances (up to 11%), irritability (up to 11%)
• Common (1% to 10%): Agitation, anxiety, depressed mood, depression, hostility, middle insomnia, nervousness, nightmare, restlessness, sleep disorder, tension
• Uncommon (0.1% to 1%): Aggression, dissociation, hallucinations, libido decreased, libido increased, mood swings, panic reaction, suicidal ideation, thinking abnormal
• Rare (less than 0.1%): Abnormal behavior, bradyphrenia, disorientation, dysphoria, euphoric mood, psychosis, somnambulism
• Frequency not reported: Early morning awakening, initial insomnia, neuropsychiatric adverse events, suicidality
• Postmarketing reports: Aggressive behavior, changes in behavior, changes in thinking, delusions, completed suicide, exacerbation of underlying psychiatric illness, homicidal ideation, nicotine withdrawal symptoms, panic, suicide, suicide attempt^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (up to 40%), vomiting (up to 11%)
• Common (1% to 10%): Abdominal discomfort, abdominal distension, abdominal pain, abdominal pain upper, constipation, diarrhea, dry mouth, dyspepsia, flatulence, gastroenteritis, gastroesophageal reflux disease, toothache
• Uncommon (0.1% to 1%): Aphthous stomatitis, change of bowel habit, dysphagia, eructation, gastritis, gastrointestinal hemorrhage, gingival pain, hematochezia, mouth ulceration
• Rare (less than 0.1%): Abnormal feces, acute pancreatitis, enterocolitis, esophagitis, gallbladder disorder, gastric ulcer, hematemesis, intestinal obstruction, tongue coated^[Ref]

Nervous system

• Very common (10% or more): Headache (up to 19%)
• Common (1% to 10%): Disturbance in attention, dizziness, dysgeusia, lethargy, somnolence
• Uncommon (0.1% to 1%): Amnesia, convulsion, hypoesthesia, hypogeusia, migraine, parosmia, seizure, syncope, tremor, vertigo
• Rare (less than 0.1%): Balance disorder, cerebrovascular accident, coordination abnormal, circadian rhythm sleep disorder, dysarthria, hypertonia, mental impairment, multiple sclerosis, nystagmus, psychomotor hyperactivity, psychomotor skills impaired, restless legs syndrome, scotoma, sensory disturbance, transient ischemic attack, VIIth nerve paralysis, visual field defect
• Frequency not reported: Transient loss of consciousness
• Postmarketing reports: Blackouts, hemorrhagic cerebrovascular event, ischemic cerebrovascular event, loss of consciousness^[Ref]

Respiratory

• Very common (10% or more): Nasopharyngitis (up to 11%)
• Common (1% to 10%): Bronchitis, cough, dyspnea, oropharyngeal pain, respiratory disorders, rhinorrhea, upper respiratory tract disorder, upper respiratory tract infection
• Uncommon (0.1% to 1%): Allergic rhinitis, asthma, dysphonia, epistaxis, respiratory tract congestion, sinus congestion, throat irritation, upper- airway cough syndrome, upper respiratory tract inflammation
• Rare (less than 0.1%): Laryngeal pain, pleurisy, pulmonary embolism, snoring^[Ref]

Local

• Very common (10% or more): Application site pruritus (up to 11%)^[Ref]

Cardiovascular

• Common (1% to 10%): Angina pectoris, chest pain, hospitalization for angina pectoris, hypertension, need for coronary revascularization, new diagnosis of peripheral vascular disease (PVD)/admission for a PVD procedure, nonfatal myocardial infarction, peripheral edema
• Uncommon (0.1% to 1%): Blood pressure increased, chest discomfort, ECG abnormal, edema, heart rate increased, hospitalization for angina pectoris, hot flush, myocardial infarction, palpitations, tachycardia
• Rare (less than 0.1%): Acute coronary syndrome, arrhythmia, atrial fibrillation, bradycardia, cardiac flutter, cor pulmonale, coronary artery disease, electrocardiogram ST segment depression, electrocardiogram T wave amplitude decreased, thrombosis, ventricular extrasystoles
• Frequency not reported: Cardiovascular events^[Ref]

Metabolic

• Common (1% to 10%): Anorexia, decreased appetite, increased appetite, weight increased
• Uncommon (0.1% to 1%): Diabetes mellitus, hyperglycemia, hypoglycemia
• Rare (less than 0.1%): Blood calcium decreased, C-reactive protein increased, hyperlipidemia, hypokalemia, polydipsia^[Ref]

Musculoskeletal

• Common (1% to 10%): Arthralgia, back pain, myalgia, pain in extremity
• Uncommon (0.1% to 1%): arthritis, muscle cramp, muscle spasms, musculoskeletal chest pain, musculoskeletal pain
• Rare (less than 0.1%): costochondritis, joint stiffness, muscle enzyme increased, myositis, osteoporosis^[Ref]

Other

• Common (1% to 10%): Asthenia, fatigue, malaise
• Uncommon (0.1% to 1%): Chills, pyrexia, tinnitus
• Rare (less than 0.1%): Cyst, deafness, feeling cold, Meniere's disease
• Frequency not reported: Accidental injury, interaction with alcohol^[Ref]

Dermatologic

• Common (1% to 10%): Pruritus, rash
• Uncommon (0.1% to 1%): Acne, dry skin, eczema, erythema, hyperhidrosis, night sweats, urticaria
• Rare (less than 0.1%): Erythema multiforme, photosensitivity, psoriasis, severe cutaneous reactions, Stevens-Johnson Syndrome
• Frequency not reported: Serious skin reactions^[Ref]

Genitourinary

• Common (1% to 10%): Menstrual disorder
• Uncommon (0.1% to 1%): Erectile dysfunction, menorrhagia, nocturia, pollakiuria, polyuria, urine abnormality
• Rare (less than 0.1%): Glycosuria, semen analysis abnormal, sexual dysfunction, urethral syndrome, urinary retention, vaginal discharge^[Ref]

Immunologic

• Common (1% to 10%): Influenza
• Uncommon (0.1% to 1%): Fungal infection, influenza like illness, viral infection^[Ref]

Hepatic

• Common (1% to 10%): Liver function test abnormal^[Ref]

Ocular

• Uncommon (0.1% to 1%): Conjunctivitis, eye pain, eye irritation, vision blurred, visual disturbance
• Rare (less than 0.1%): Blindness transient, cataract subcapsular, dry eye, lacrimation increased, mydriasis, myopia, night blindness, ocular vascular disorder, photophobia, scleral discoloration, vitreous floaters^[Ref]

Hematologic

• Uncommon (0.1% to 1%): Anemia, lymphadenopathy
• Rare (less than 0.1%): Leukocytosis, platelet count decreased, splenomegaly, thrombocytopenia^[Ref]

Endocrine

• Uncommon (0.1% to 1%): Thyroid gland disorders^[Ref]

Renal

• Rare (less than 0.1%): Acute renal failure, nephrolithiasis, urine analysis abnormal^[Ref]

Hypersensitivity

• Rare (less than 0.1%): Angioedema
• Frequency not reported: Hypersensitivity reactions^[Ref]

Frequently asked questions

• What is the mechanism of action of Tyrvaya?
• How long does a bottle of Tyrvaya last?
• Does Tyrvaya reduce inflammation?

Further information

Varenicline side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer