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Varenicline Tartrate side effects: what 79,553 FDA adverse event reports show

Varenicline Tartrate · 1,180 reaction terms · 244,091 drug–reaction co-reports · data 2026-09-14
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Drug class

Not stated in label

Who reports

79,553 reports · 41% serious · 1,637 with death outcome · 64% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Varenicline tablets are indicated for use as an aid to smoking cessation treatment. Varenicline tablets are a nicotinic receptor partial agonist indicated for use as an aid to smoking cessation treatment. ( 1 and 2.1 )

FDA label, Indications and Usage

What it is

Varenicline tablets contain varenicline (as the tartrate salt), which is a partial nicotinic agonist selective for α4β2 nicotinic acetylcholine receptor subtypes. Varenicline, as the tartrate .

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 10Labeled (related wording) 3Reporting / coding artifact 2Not in label — unassessed 25
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,140 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Tobacco user793299.5
270.5–331.7ROR 302.5 · calibrated p 1e-11 ✓
139.0 EB05 131.1 · IC025 +6.9
3/3 methods agree
Not in label — unassessedserious n=198 · 81% consumernot reported in cached trials
Smoker63128.5
95.0–173.8ROR 128.6 · calibrated p 3e-8 ✓
84.1 EB05 68.1 · IC025 +5.3
3/3 methods agree
Labeled adverse reaction
exact term
serious n=62 · 74% consumernot reported in cached trials
Exposure to contaminated air19123.1
71.3–212.5ROR 123.1 · calibrated p 2e-7 ✓
77.5 EB05 52.4 · IC025 +4.0
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Abnormal dreams7,825103.4
100.8–106.0ROR 114.6 · calibrated p 4e-8 ✓
74.2 EB05 72.8 · IC025 +6.2
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 81.3 · serious PRR 70.8 · 81% consumerNCT01456936: 201/2,016 (10.0%) on Varenicline; 92/2,014 (4.6%) control
Hostility41951.3
46.2–57.0ROR 51.6 · calibrated p 1e-5 ✓
42.9 EB05 39.6 · IC025 +5.2
3/3 methods agree
Labeled adverse reaction
exact term
serious n=293 · 81% consumernot reported in cached trials
Homicidal ideation55841.8
38.2–45.7ROR 42.1 · calibrated p 4e-5 ✓
36.1 EB05 33.6 · IC025 +5.0
3/3 methods agree
Labeled adverse reaction
exact term
serious n=533not reported in cached trials
Violence-related symptom17533.2
28.4–38.9ROR 33.3 · calibrated p 2e-4 ✓
29.5 EB05 26.0 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=163not reported in cached trials
Nightmare3,34728.0
27.1–29.0ROR 29.2 · calibrated p 3e-4 ✓
25.4 EB05 24.7 · IC025 +4.6
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 28.5 · serious PRR 23.7 · 73% consumernot reported in cached trials
Suicidal behaviour33923.2
20.7–25.9ROR 23.3 · calibrated p 1e-3 ✓
21.3 EB05 19.5 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=332NCT01456936: 1/2,014 (0.0%) control (serious AE)
Feeling of relaxation4920.1
15.0–26.9ROR 20.1 · calibrated p 0.002 ✓
18.6 EB05 14.6 · IC025 +3.5
3/3 methods agree
Not in label — unassessed100% consumernot reported in cached trials
Anger2,25118.7
17.9–19.5ROR 19.2 · calibrated p 0.002 ✓
17.5 EB05 16.9 · IC025 +4.1
3/3 methods agree
Not in label — unassessedage-adj. PRR 18.5 · serious PRR 26.5 · 72% consumernot reported in cached trials
Marital problem3518.0
12.8–25.3ROR 18.0 · calibrated p 0.004 ✓
16.7 EB05 12.4 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=31 · ♀ 39% (drug 64%)not reported in cached trials
Verbal abuse3117.6
12.2–25.3ROR 17.6 · calibrated p 0.005 ✓
16.3 EB05 11.9 · IC025 +3.1
3/3 methods agree
Reporting / coding artifactserious n=23 · ♀ 0% (drug 64%)not reported in cached trials
Flight of ideas3317.6
12.3–25.0ROR 17.6 · calibrated p 0.005 ✓
16.3 EB05 12.0 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=31not reported in cached trials
Physical assault12516.7
13.9–20.0ROR 16.7 · calibrated p 0.005 ✓
15.7 EB05 13.5 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=121 · ♀ 35% (drug 64%)not reported in cached trials
Boredom2016.3
10.4–25.7ROR 16.4 · calibrated p 0.007 ✓
14.9 EB05 9.8 · IC025 +2.8
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Frustration20715.9
13.8–18.3ROR 15.9 · calibrated p 0.006 ✓
15.0 EB05 13.3 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=119 · 83% consumernot reported in cached trials
Aggression2,76815.3
14.8–15.9ROR 15.9 · calibrated p 0.006 ✓
14.5 EB05 14.1 · IC025 +3.8
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 12.9 · serious PRR 21.6NCT01456936: 1/2,014 (0.0%) control (serious AE)
Morbid thoughts6415.1
11.7–19.4ROR 15.1 · calibrated p 0.008 ✓
14.2 EB05 11.4 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=49not reported in cached trials
Personality change50314.9
13.7–16.3ROR 15.0 · calibrated p 0.007 ✓
14.2 EB05 13.2 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious PRR 18.2 · 71% consumernot reported in cached trials
Flashback3114.9
10.4–21.4ROR 14.9 · calibrated p 0.009 ✓
13.8 EB05 10.0 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious n=19not reported in cached trials
Delusional perception2214.6
9.5–22.4ROR 14.6 · calibrated p 0.011 ✓
13.3 EB05 8.8 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=21not reported in cached trials
Oropharyngeal blistering8414.1
11.3–17.6ROR 14.1 · calibrated p 0.010 ✓
13.3 EB05 11.1 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=68 · 88% consumernot reported in cached trials
Tobacco abuse2713.8
9.4–20.3ROR 13.8 · calibrated p 0.013 ✓
12.7 EB05 8.8 · IC025 +2.8
3/3 methods agree
Reporting / coding artifactserious n=21not reported in cached trials
Paranoia84813.5
12.6–14.5ROR 13.7 · calibrated p 0.010 ✓
12.9 EB05 12.2 · IC025 +3.6
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 10.1 · serious PRR 21.6not reported in cached trials
Bipolar disorder52613.3
12.1–14.5ROR 13.3 · calibrated p 0.011 ✓
12.6 EB05 11.8 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious PRR 20.4NCT01456936: 1/2,016 (0.0%) on Varenicline (serious AE)
Suicidal ideation (thoughts of suicide)4,20312.6
12.3–13.0ROR 13.3 · calibrated p 0.011 ✓
12.1 EB05 11.8 · IC025 +3.5
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 11.6 · serious PRR 16.9NCT01456936: 2/2,016 (0.1%) on Varenicline; 3/2,014 (0.1%) control (serious AE)
Impatience8512.5
10.0–15.5ROR 12.5 · calibrated p 0.016 ✓
11.8 EB05 9.8 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=43 · 82% consumernot reported in cached trials
Recalled product administered38211.9
10.8–13.2ROR 12.0 · calibrated p 0.017 ✓
11.4 EB05 10.5 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=97 · 95% consumernot reported in cached trials
Elevated mood1911.8
7.4–18.7ROR 11.8 · calibrated p 0.024 ✓
10.3 EB05 6.6 · IC025 +2.4
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Mood swings1,35111.6
11.0–12.3ROR 11.8 · calibrated p 0.018 ✓
11.2 EB05 10.7 · IC025 +3.4
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 17.4not reported in cached trials
Abnormal behaviour1,67111.5
10.9–12.1ROR 11.7 · calibrated p 0.018 ✓
11.0 EB05 10.6 · IC025 +3.4
3/3 methods agree
Not in label — unassessedage-adj. PRR 13.2 · serious PRR 17.0NCT01456936: 1/2,014 (0.0%) control (serious AE)
Thinking abnormal76511.2
10.4–12.0ROR 11.3 · calibrated p 0.021 ✓
10.7 EB05 10.1 · IC025 +3.3
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 12.1 · serious PRR 14.9 · 73% consumernot reported in cached trials
Pre-existing condition improved25010.8
9.6–12.3ROR 10.9 · calibrated p 0.025 ✓
10.4 EB05 9.3 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=33 · 82% consumernot reported in cached trials
Personality disorder10410.8
8.9–13.1ROR 10.8 · calibrated p 0.026 ✓
10.2 EB05 8.6 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=78 · 71% consumerNCT01456936: 1/2,014 (0.0%) control (serious AE)
Hypoaesthesia facial6010.8
8.3–13.9ROR 10.8 · calibrated p 0.027 ✓
10.1 EB05 8.0 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=40 · 70% consumernot reported in cached trials
Sleep talking6710.7
8.4–13.7ROR 10.7 · calibrated p 0.027 ✓
10.1 EB05 8.1 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious n=26 · 76% consumernot reported in cached trials

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Depression9,8389.59.3–9.7signal
Suicidality7,0657.87.6–8.0signal
Seizure9311.31.2–1.3raised
Dependence / withdrawal9300.80.8–0.9lower than other drugs
Myocardial infarction6370.80.8–0.9lower than other drugs
Hyperglycaemia / diabetes1,0160.80.7–0.8lower than other drugs
Stroke5710.60.6–0.7lower than other drugs
Fall / fracture8520.60.6–0.6lower than other drugs
Extrapyramidal2130.50.5–0.6lower than other drugs
Pancreatitis1600.50.4–0.6lower than other drugs
Hyponatraemia1450.50.4–0.6lower than other drugs
Hypoglycaemia1660.50.4–0.5lower than other drugs
Venous thromboembolism3210.40.3–0.4lower than other drugs
Malignancy5550.40.4–0.4lower than other drugs
Gi bleeding2650.40.3–0.4lower than other drugs
Serious infection9950.30.3–0.4lower than other drugs

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Varenicline as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (8 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Nausea14,4644.9
4.8–5.0ROR 5.8 · calibrated p 0.165
4.8 EB05 4.8 · IC025 +2.2
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 3.0 · serious PRR 2.8 · 79% consumerNCT01456936: 511/2,016 (25.3%) on Varenicline; 137/2,014 (6.8%) control
Depression8,67810.4
10.2–10.6ROR 11.5 · calibrated p 0.019 ✓
10.0 EB05 9.8 · IC025 +3.3
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 7.8 · serious PRR 15.0NCT01456936: 1/2,016 (0.0%) on Varenicline (serious AE)
Abnormal dreams7,825103.4
100.8–106.0ROR 114.6 · calibrated p 4e-8 ✓
74.2 EB05 72.8 · IC025 +6.2
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 81.3 · serious PRR 70.8 · 81% consumerNCT01456936: 201/2,016 (10.0%) on Varenicline; 92/2,014 (4.6%) control
Anxiety5,9485.6
5.5–5.7ROR 6.0 · calibrated p 0.152
5.5 EB05 5.4 · IC025 +2.4
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 3.9 · serious PRR 8.4NCT01456936: 2/2,022 (0.1%) on Varenicline (serious AE)
Drug ineffective (drug did not work)5,6491.1
1.1–1.2ROR 1.1 · calibrated p 0.400
1.1 EB05 1.1 · IC025 +0.1Reporting / coding artifactage-adj. PRR 1.5 · serious PRR 0.9 · 84% consumernot reported in cached trials
Insomnia (trouble sleeping)5,5725.6
5.5–5.7ROR 5.9 · calibrated p 0.153
5.5 EB05 5.4 · IC025 +2.4
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 3.9 · serious PRR 5.9 · 77% consumerNCT01456936: 189/2,016 (9.4%) on Varenicline; 139/2,014 (6.9%) control
Vomiting4,5982.6
2.5–2.7ROR 2.7 · calibrated p 0.732
2.6 EB05 2.5 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.1 · serious PRR 1.6 · 76% consumernot reported in cached trials
Suicidal ideation (thoughts of suicide)4,20312.6
12.3–13.0ROR 13.3 · calibrated p 0.011 ✓
12.1 EB05 11.8 · IC025 +3.5
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 11.6 · serious PRR 16.9NCT01456936: 2/2,016 (0.1%) on Varenicline; 3/2,014 (0.1%) control (serious AE)
Headache4,1501.8
1.7–1.8ROR 1.8 · calibrated p 0.826
1.7 EB05 1.7 · IC025 +0.8Labeled adverse reaction
exact term
age-adj. PRR 1.2 · serious PRR 1.8 · 76% consumerNCT01456936: 245/2,016 (12.2%) on Varenicline; 199/2,014 (9.9%) control
Feeling abnormal3,9904.4
4.3–4.6ROR 4.6 · calibrated p 0.281
4.4 EB05 4.3 · IC025 +2.1
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 4.2 · serious PRR 5.5 · 77% consumernot reported in cached trials
Malaise (feeling unwell)3,9892.4
2.3–2.5ROR 2.5 · calibrated p 0.822
2.4 EB05 2.3 · IC025 +1.2
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.0 · serious PRR 1.7 · 84% consumernot reported in cached trials
Nightmare3,34728.0
27.1–29.0ROR 29.2 · calibrated p 3e-4 ✓
25.4 EB05 24.7 · IC025 +4.6
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 28.5 · serious PRR 23.7 · 73% consumernot reported in cached trials
Fatigue (tiredness)3,1741.1
1.0–1.1ROR 1.1 · calibrated p 0.360
1.1 EB05 1.0 · IC025 +0.0Labeled adverse reaction
exact term
age-adj. PRR 0.9 · serious PRR 1.1 · 75% consumerNCT01456936: 124/2,016 (6.2%) on Varenicline; 83/2,014 (4.1%) control
Dizziness3,0321.6
1.6–1.7ROR 1.6 · calibrated p 0.727
1.6 EB05 1.6 · IC025 +0.6Labeled adverse reaction
exact term
age-adj. PRR 1.3 · serious PRR 1.8 · 73% consumerNCT01456936: 1/2,022 (0.0%) on Varenicline (serious AE)
Aggression2,76815.3
14.8–15.9ROR 15.9 · calibrated p 0.006 ✓
14.5 EB05 14.1 · IC025 +3.8
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 12.9 · serious PRR 21.6NCT01456936: 1/2,014 (0.0%) control (serious AE)

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Varenicline (Chantix) ↔ Suicidal ideation / depression.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Varenicline?

In FDA FAERS, the most frequently co-reported reaction terms for Varenicline are nausea, depression, abnormal dreams, anxiety, insomnia, vomiting. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Varenicline have an FDA boxed warning?

No. The FDA label retrieved for Varenicline has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Varenicline causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.