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Cytisine is a natural health product approved in August 2017 by Heath Canada as a smoking cessation aid. It works by blocking the effects of nicotine to reduce cravings and withdrawal symptoms. How would you counsel a patient to take cytisine during the first 3 days of treatment?

A. Take 1 capsule once daily with a corresponding reduction of the number of cigarettes smoked
B. Take 1 capsule 2 times daily every 6 hrs with a corresponding reduction of the number of cigarettes smoked
C. Take 1 capsule 3 times daily every 4 hrs with a corresponding reduction of the number of cigarettes smoked
D. Take 1 capsule 6 times daily every 2 hrs with a corresponding reduction of the number of cigarettes smoked
E. Take 1 capsule as needed with a corresponding reduction of the number of cigarettes smoked

Answer: D

Cytisine is a new smoking cessation drug approved by Health Canada in August 2017 as a natural health product (NHP) which acts as a partial agonist of the α4β2 nicotinic acetylcholine receptor responsible for the central effects of nicotine. Cytisine is available without a prescription. Contraindications include arterial hypertension, advanced atherosclerosis, and pregnancy or breastfeeding. The adverse effects reported with Cytisine are largely gastrointestinal (dyspepsia and nausea) and sleep disturbance, which are self-limiting.

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