Since February 1, Spain’s Ministry of Health began to finance a new treatment designed to help people to quit smoking in 25 days. Todacitan, to date, is the only drug financed by the state after the previous two were withdrawn from the market.
As explained by Carlos Rabade, the smoking coordinator of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), its key compound is cytisine, ‘a non-nicotinic drug for smoking cessation’. He described the drug as ‘a partial agonist of nicotinic receptors’. Todacitan began to be marketed more than a year ago by Aflofarm, a Polish pharmaceutical company.
In other words, the main function of the drug is to ensure that nicotine does not reach the receptors, That results in the smoker not feeling pleasure, thereby reducing nicotine anxiety and subsequently, its dependence.
To be eligible for this new treatment, there are a number of requirements that must be met. This therapy is recommended for all smokers who are included in a support programme, who consume more than ten cigarettes a day, “who have a nicotine dependence” and who have not made an attempt to quit the treatment once it has been subsidised.
However, there are some exceptions, as treatment is not suitable for everyone. ‘For example’, Rabade continued, ‘patients with an uncontrolled psychiatric pathology, who have an acute cardiovascular disease, or patients with some kind of allergic reaction’.
How can I apply?
Until now, one of the most serious problems of this treatment was its high cost, €198 euros, a price that for many people could be an impediment. From February 1, after being subsidised, it now costs €116.93, more than €80 less than before.
How do you order it?
It is not enough to go to the pharmacy, its purchase requires a prior prescription from your GP. It is a medicine that lasts for 25 days.
How should it be applied?
In order to carry out this treatment, it must be done by taking tablets. Firstly, six tablets – one every two hours – should be taken daily for the first three days of treatment. From the fourth to the twelfth day, the dose is reduced to five tablets a day – one every 2.5 hours.
From the 13th to the 16th day, the dose will be further reduced to four tablets a day. In the penultimate phase, three tablets per day will be taken between days 17 and 20. From this point until the end of therapy, the dose will be reduced to one or two tablets until 25 days of treatment are completed.
Does it have side effects?
This treatment is highly adherent and its drop-out rate is lower than that of its ‘competitors’, as it has few side effects, according to Carlos Rabade.
The package leaflet specifies that only one in ten people might suffer some contraindications, such as changes in appetite, weight gain, dizziness, mood swings or headaches. Less likely symptoms include – with a probability of 1 in 100 people – difficulty concentrating, general malaise, or a slow heart rate.
‘Very positive news’
It should be remembered that tobacco consumption accounts, according to the World Health Organisation (WHO), for the death of 500,000 people a year worldwide, some 50,000 in Spain. Experts, therefore, applaud this initiative. “On the part of the health system, I think the news has produced great satisfaction, it is very positive”, said Rabade.
He also wanted to highlight the importance of funding in this cause. “It is an element that makes it easier for a smoker to have access to drugs, which in turn triples, or even quadruples, the possibilities of accessing treatment”.
A breath of fresh air
“It has been a few months since there was a treatment financed in Spain to stop smoking”, Rabade continued. He was referring to the two medicines that the state financed until a few months ago – until they were withdrawn from the market.
This was the case of Champix -varenicline – which ceased to be financed in July 2021 for containing nitrosamine above the levels permitted by the Spanish Agency for Medicines and Health Products (AEMPS).
Zyntabac – Bupropion – the other state-funded treatment until a few months ago, was withdrawn from the market in October 2022 due to distribution problems. In addition, both contained nitrosamines, a compound considered carcinogenic.
The main difference between Todacitan and these other drugs is that varenicline (a component of Champix) has similar characteristics to cytisine (a component of Todacitan) as “both are partial nicotinic receptor agonists”.
Despite this, “the digestive side effects of cytisine are lower than those of varenicline, as evidenced by comparative studies between these two drugs”.
What other treatments are available?
There are other alternatives that may help people to quit smoking. These include nicotine replacement treatments, which aim to reduce the urge to smoke and alleviate withdrawal symptoms.
This technique uses products to deliver low doses of nicotine, according to Medline Plus. There is a wide range of options, including chewing gum, inhalers, lozenges, nasal sprays, and skin patches, as reported by 20minutos.es.
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