Cytisine, also known as baptitoxine and sophorine, is an alkaloid that occurs naturally in plants. The use of cytisine for smoking cessation remains relatively unknown outside Bulgaria. As a pharmaceutical preparation called Tabex or Desmoxan, cytisine has been used in Eastern Europe available for the treatment of tobacco smoking. Research shows that patients have more chance of giving up after 8 weeks. In this case a two box cycle of Tabex is recommended. Tabex dosage is administered according to the following schedule below: Tabex® is a natural product against smoking that contains the extract cytisine. Tabex can help you quit smoking in less than a month without any side effects. A trial by Monova et al is described in a review of evidence produced by the manufacturers of Tabex, 23 but it remains unpublished. At 4-week follow-up, cytisine was significantly more effective than placebo (Monova et al, unpublished report TAB-SPH-04014: Sopharma plc, 2004). The exact mechanism of the effect of cytisine has not been examined to date. It is likely to have effects similar to varenicline—that is, to reduce the enjoyment of smoking during the pre-quit period 35 and to reduce withdrawal discomfort after quitting. 36 Future studies should test these hypotheses. If cytisine does have both of these effects, it would strengthen the case for extending the period of use prior to quitting when reduced reward from smoking may facilitate later abstinence, and for extending its post-quit use to reduce withdrawal discomfort. None of these considerations, however, needs to prevent the use of the medication as it currently exists.

During World War II when the supply of tobacco to the Balkans was interrupted, people took to smoking the leaves of Golden Rain, a shrub endemic there 1 but also seen in English gardens. The plant, Cytisus laburnum, contains an alkaloid cytisine which is a nicotine analogue, acting as a partial nicotinic acetylcholine receptor agonist. It has a high affinity for the α-4 β-2 receptor subtype, which is thought to be the main receptor that mediates the central effects of nicotine. 2 The quantity of cigarettes smoked by an individual during the first three days must be decreased gradually. The complete smoking cessation should occur no later than the fifth day after the beginning of the start of course. Please Note: Delivery times below are based on working days and do not include weekends and bank holidays. Not to mention, because it is a natural substance, there are fewer potential side effects to worry about than with synthetic medications. The most common side effects of Tabex include nausea, vomiting, stomach pain, headaches, dizziness, and sweating, while rare side effects include allergic reactions and mood changes. However, these risks are often comparable to the side effects of smoking itself.This product is not intended to diagnose, treat, cure or prevent any disease. You should consult your doctor for guidance before taking new medication.

The patient’s leaflet recommends using 1st to 3rd day 1 tablet every 2 hours (6 tablets per day) with a contemporary reduction in the number of cigarettes. Taken together with the results from earlier studies these findings support the argument for a drug evaluation programme undertaken to modern standards. This would include large scale clinical trials of this drug to a standard that would be acceptable by regulatory authorities around the world. More information is also required on the pharmacokinetic properties of the drug, its safety profile and ideally studies varying the dose and the duration of dose. The obvious advantage of this medication is its cost. It offers the prospect of providing access to effective treatment to help with smoking cessation to millions of smokers who would not otherwise be able to afford it. For healthcare providers it offers the prospect of hugely reduced costs. Beware of counterfeit Tabex products. We only sell the original Tabex which is manufactured by Sopharma Pharmaceuticals. If the results are unsatisfactory, the treatment may be discontinued and a new one month therapy can be resumed after 2-3 months. The first randomised placebo controlled trials of Tabex were published in Eastern Europe in the 1970s, long before any smoking cessation medication was available in the West. Due to both language and Iron Curtain barriers, this went unnoticed in the West until Pfizer launched a partial nicotinic receptor agonist varenicline, inspired by and similar to Tabex, as an effective treatment for smoking cessation in 2006. 2 , 3

References

Each Tabex tablet contains 1.5 mg of cytisine. Quitters should take 6 tablets a day for the first three days after they quit smoking, and then reduce this to 2 tablets a day until day 25, the last day of treatment. Tabex has been known to have an astonishing ability to help stop smoking in a safe and natural way. As a result, demand in the UK, USA, and Australia has risen drastically. It is known as the most beneficial and cost-effective stop smoking aid today! Tabex is a life-changing over-the-counter medication for smoking cessation that has helped countless individuals successfully quit smoking. While common side effects such as nausea, vomiting, stomach pain, headaches, dizziness, and sweating may be concerning, they are manageable and shouldn’t deter you from trying Tabex. In fact, the rare side effects of allergic reactions and mood changes are extremely rare and shouldn’t stop you from experiencing the benefits of this medication. Tabex dosage and administration · Tabex is taken orally according to the following schedule outlined below: · First 3 days: 1 tablet 6 times daily (every 2 hours). The 12‐month success rate was similar to the figure observed in the evaluation of the UK smoking cessation services. This was despite the fact that the smokers were more dependent on average, as indicated by the FTND, and most only attended one session of psychological support.

The study aims to determine the efficacy of a standard course of Tabex (cytisine) in aiding attempts to stop smoking. Tabex is administered orally in a dose of 1 tablet every 2hours (6 tablets daily) for three days while smokers reduce of the number of smoked cigarettes. The treatment then proceeds according to the following scheme: from the 4th to 12th day—1 tablet every 2.5hours (5 tablets daily); from the 13th to 16th day—1 tablet every 3hours (4 tablets daily); from 17th to 20th—1 tablet every 4hours (3 tablets daily), from the 21st to 25th day—1 tablet every 6hours, 1–2 tablets daily. Smokers were instructed that they should have stopped smoking completely by the fifth day. The average duration of taking medication was 22days. The duration of the course of medication was shorter than for medication such as bupropion or nicotine replacement therapies, but this was a clinical audit of the treatment regimen currently licensed and it would not have been appropriate to operate outside the licence. Since then, two randomised placebo controlled trials of the drug which conform to the strict Russell standard of reporting the results of smoking cessation trials 6 were completed. 7 , 8 The second of these trials was published in the New England Journal of Medicine and generated interest in the media and among smokers. 8 The reason for this is that, compared with other smoking cessation treatments, Tabex is inexpensive. 5 If it is an effective medication, this would have implications for health expenditure and would be a particularly welcome development for smokers in developing countries who cannot afford the current licensed medications.

Quitting smoking can be a frustrating, difficult, and lengthy process, but it doesn’t have to be that way. Tabex might just be the solution you need!

Let’s take a closer look at this medicine. A molecule used in smoking cessation for 40 years. Cytisine is an alkaloid present in all parts of a Bulgarian acacia. Be aware of counterfeit products. Sopharma of Bulgaria are the manufacturers of Tabex Cytisine. Materials used on counterfeits are not certificated and can be harmful. The treatment programme consisted of one session before quitting and the offer of other sessions to those that wanted it. The main session involved a nurse collecting demographic information and measuring blood pressure, heart rate, height, weight, and expired‐air carbon monoxide concentration (CO). The patients then completed a questionnaire on nicotine dependence (Fagerstrom Test for Nicotine Dependence (FTND) 22). Then the patient was seen by a physician who took a smoking and medical history and obtained informed consent from eligible patients. The physician provided information about Tabex, including the usage regimen and side effects. Patients then received individually tailored advice on stopping smoking and written support materials. Patients were offered follow‐up visits as required by the patient. The session lasted approximately 30minutes in total. Follow‐up visits, where they occurred, lasted about 20minutes and did not follow a formal structure. Three hundred and forty‐two smokers were successfully followed up by telephone at 12weeks. Of these 315 indicated that they had taken at least one tablet of Tabex. One hundred and twenty participants (27.5%) of the total sample reported having not smoked at all since the quit date. When these participants were followed up at 12months, 60 (13.8% of the original sample) reported having been abstinent for the preceding 12months and were confirmed as abstinent by CO at the follow‐up.Tabex® is 100% natural which contains the known plant extract Cytisine. Tabex has been available in certain european countries for over 50 years and has helped over 9 million people Worldwide to give up smoking. Tabex® is an effective product for treatment of nicotine dependence in case of serious desire for smoking cessation.