Wellbutrin vs. Chantix: Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

In July 2021, Pfizer paused production of Chantix and recalled the drug due to increased nitrosamine levels. The FDA later approved varenicline tartrate, the generic version, which is what is now widely available. Although people still use the term “Chantix,” the brand-name drug isn’t currently available.

Congratulations—you have decided to stop smoking! You are making a great decision for your overall health. Right away, your blood pressure and heart rate will decrease. Within just one day, your risk of a heart attack will decrease. Other benefits include lower cholesterol, lower chance of lung cancer, and stronger bones and immune system.

Sometimes, it is hard to quit smoking on your own, and your doctor may have mentioned using a prescription medication to help you become smoke-free. Wellbutrin (bupropion hydrochloride) and Chantix (varenicline tartrate), made by Pfizer, are two popular drugs used to help patients stop smoking, and are approved by the FDA for smoking cessation. Although they are both used for the same purpose, they have many differences.

What are the main differences between Wellbutrin and Chantix?

Wellbutrin is an antidepressant medication, which is prescribed off-label for smoking cessation. It is not clear how Wellbutrin works for smoking cessation, but we know that it helps reduce cravings and also reduces withdrawal symptoms. It is available in an immediate-release tablet (generic) as well as a sustained-release (SR) and extended-release (XL) tablet. The SR and XL formulations are both available in brand and generic. The SR is prescribed twice a day and the XL is prescribed once a day.

Chantix is a nicotinic agonist—it attaches to nicotine receptors in the brain, so that nicotine cannot. It is available in brand name in tablet form. Neither drug contains nicotine.

Main differences between Wellbutrin vs. Chantix
	Wellbutrin	Chantix
Drug class	Aminoketone antidepressant	Nicotinic agonist smoking cessation aid
Brand/generic status	Brand and generic	Brand
What is the generic name?	Bupropion	Varenicline
What form(s) does the drug come in?	Tablet SR tablet (sustained release, twice daily dosing) XL tablet (extended-release, once-daily dosing)	Tablet
What is the standard dosage?	Start one week before smoking quit date: 150 mg SR daily for 3 days, then 150 mg SR twice daily	Start one week before smoking quit date: 0.5 mg daily for 3 days, then 0.5 mg twice daily for 4 days, then 1 mg twice daily thereafter
How long is the typical treatment?	Varies	12 weeks, may continue another 12 weeks
Who typically uses the medication?	Adults	Adults

Conditions treated by Wellbutrin vs. Chantix

Wellbutrin is prescribed off-label as an aid to smoking cessation treatment. Wellbutrin may be prescribed with or without nicotine replacement therapy (NRT). Nicotine replacement may be used in the form of a nicotine patch or lozenge, for example, and together with Wellbutrin, your nicotine cravings should decrease.

Wellbutrin (all forms) is indicated for major depressive disorder. Wellbutrin XL is also indicated for seasonal affective disorder. Wellbutrin has a variety of off-label uses, detailed in the chart below.

You may also have heard of Zyban, which contains the same active ingredient (bupropion) as Wellbutrin. Zyban is indicated for use in smoking cessation treatment. Wellbutrin is often used for smoking cessation, even though it is not officially indicated for this purpose. The prescribing information states, “Wellbutrin SR is not approved for smoking cessation treatment; however, it contains the same active ingredient as the smoking cessation medication Zyban.” Nevertheless, doctors often prescribe Wellbutrin for smoking cessation for purposes of insurance coverage.

Chantix is indicated for smoking cessation treatment. Chantix should not be taken along with NRT because it could cause increased nausea, vomiting, headache, dizziness, upset stomach, and tiredness.

Condition	Wellbutrin	Chantix
Aid to smoking cessation treatment	Off-label	Yes
Major depressive disorder (Wellbutrin immediate release, SR, XL)	Yes	No
Seasonal affective disorder (Wellbutrin XL)	Yes	No
ADHD	Off-label	No
Obesity	Off-label	No
Bipolar disorder	Off-label	No
PTSD	Off-label	No
Social phobia	Off-label	No
Sexual dysfunction	Off-label	No

Is Wellbutrin or Chantix more effective?

The safety and efficacy of bupropion was studied in several trials, using bupropion in the form of Zyban along with counseling. In a seven-week study, bupropion was shown to be significantly more effective than the placebo. At six months, patients did better at maintaining abstinence after having been treated with bupropion. In another study, treatment with bupropion was also significantly more effective than a placebo, reducing the urge to smoke, and reducing withdrawal symptoms (such as irritability, anger, and anxiety).

In clinical trials, Chantix was found to reduce the urge to smoke, reduce withdrawal symptoms, and help patients maintain abstinence. Two studies compared Chantix to bupropion to placebo for 12 weeks and patients were followed for 40 weeks after treatment. In one study, 44% of patients taking Chantix stopped smoking during weeks 9 through 12, compared to 30% of patients taking bupropion and 17% of patients taking a placebo. Another study showed similar results.

The studies found that both drugs were better than the placebo, and concluded that Chantix was slightly more effective than Zyban.

Both drugs can be very effective for the treatment of smoking cessation, but everyone is different in how they react to certain medications. The most effective medication for you can be determined by your doctor, who can look at your medical condition(s) and history, as well as any other medications you take that may interact with Wellbutrin or Chantix.

Coverage and cost comparison of Wellbutrin vs. Chantix

Wellbutrin is typically covered by insurance and Medicare Part D, in the generic form of bupropion. Requesting the brand-name product will be more expensive and may not be covered. Without insurance, brand-name Wellbutrin SR costs about $541 for a one-month supply, while generic costs as low as $15 with a SingleCare coupon.

Chantix is typically covered by insurance as well as Medicare Part D. Without insurance, a starting-month pack of Chantix costs between $500-$600, and a continuing-month pack costs under $450 by using a SingleCare discount card.

	Wellbutrin	Chantix
Typically covered by insurance?	Yes (generic; brand may have higher copay or require prior authorization)	Yes
Typically covered by Medicare Part D?	Yes (generic)	Yes
Standard dosage	#60, 150 mg SR tablets	1 starting month pack or 1 continuing month pack
Typical Medicare Part D copay	$0-$47	$25-$578
SingleCare cost	$15-$40	$450+

Common side effects of Wellbutrin and Chantix

The most common side effects of Wellbutrin are headache, dry mouth, nausea, insomnia, constipation, and dizziness. The most common side effects of Chantix are headache, nausea, insomnia, and abnormal dreams. You will receive a medication guide, with information about side effects, with a new or refill prescription of Wellbutrin or Chantix. Other adverse effects may occur. Consult your healthcare provider for a full list of side effects.

	Wellbutrin		Chantix
Side Effect	Applicable?	Frequency	Applicable?	Frequency
Headache	Yes	26%	Yes	15-19%*
Dry mouth	Yes	17%	Yes	4-6%
Nausea	Yes	13%	Yes	16-30%
Constipation	Yes	10%	Yes	5-8%
Loss of appetite	Yes	5%	Yes	1-2%
Insomnia/trouble sleeping	Yes	11%	Yes	18-19%
Abnormal/vivid dreams	No	N/a	Yes	9-13%
Dizziness	Yes	7%	Yes	Reported as “frequent”
Tremor	Yes	6%	Yes	Reported as “infrequent”
Anxiety	Yes	5%	Yes	% not reported
Sweating	Yes	6%	No	N/a
Rash	Yes	5%	Yes	1-3%
Tinnitus	Yes	6%	Yes	Reported as “infrequent”

*Varies according to doseSource: DailyMed (Wellbutrin), DailyMed (Chantix)

Drug interactions of Wellbutrin vs. Chantix

While Wellbutrin can be used in conjunction with NRT, Chantix should not be used with nicotine due to the risk of increased side effects. Alcohol should not be used with Wellbutrin or Chantix.

Wellbutrin has many other drug interactions. Wellbutrin should not be used in conjunction with MAO inhibitors—their use should be separated by at least 14 days. Wellbutrin can also interact with various anticonvulsants, antidepressants, antipsychotics, benzodiazepines, opioids, or beta blockers. Other drug interactions may occur. Consult your healthcare provider for a full list of drug interactions.

Drug	Drug Class	Wellbutrin	Chantix
Nicotine	Nicotine replacement therapy	No	Yes
Alcohol	Alcohol	Yes	Yes
Carbamazepine Divalproex sodium Gabapentin Lamotrigine Oxcarbazepine Phenobarbital Phenytoin Topiramate	Anticonvulsants	Yes	No
Clonazepam Diazepam Lorazepam	Benzodiazepines	Yes	No
Amitriptyline Citalopram Desipramine Desvenlafaxine Duloxetine Escitalopram	Antidepressants	Yes	No
Phenelzine Rasagiline Selegiline Tranylcypromine	MAO inhibitors	Yes	No
Codeine Fentanyl Hydrocodone Hydromorphone Methadone Morphine Tramadol	Opioids	Yes	No
Haloperidol Risperidone Thioridazine	Antipsychotics	Yes	No
Atenolol Metoprolol Propranolol	Beta blockers	Yes	No
Clopidogrel	Antiplatelet	Yes	No
Digoxin	Cardiac glycoside	Yes	No

Warnings of Wellbutrin and Chantix

Wellbutrin warnings:

• Wellbutrin comes with a black box warning (the strongest warning as required by the FDA) of suicidality. Antidepressants, such as bupropion, may increase the risk of suicidal thoughts and behavior in patients ages 24 years and younger. Patients and their caregivers should be aware of any changes in mood, hallucinations, paranoia, delusions, homicidal ideation, aggression, hostility, agitation, anxiety, and/or panic. Any patient taking Wellbutrin, regardless of age, should be closely monitored for these signs and symptoms.
• There is a risk of mania or psychosis—the risk is higher in patients with bipolar disorder.
• Wellbutrin can cause seizures. The risk is dose-related—the dose should be slowly increased and should not exceed 300 mg per day. Other medical conditions can also increase the risk of seizures. Consult your healthcare professional for more information.
• Because Wellbutrin may cause high blood pressure, blood pressure should be monitored while taking Wellbutrin.
• Certain patients may be at risk for glaucoma. Consult your ophthalmologist for more information.
• Stevens-Johnson syndrome may occur. This is a serious, potentially life-threatening, skin reaction. Contact your healthcare provider immediately if you develop a skin rash.

Wellbutrin is generally not used in pregnancy, and should only be used if the potential benefit justifies the potential risk to the fetus. Pregnant smokers should be encouraged to stop smoking through behavioral techniques before using Wellbutrin. Consult your OB-GYN for advice.

Chantix warnings:

• Chantix has a boxed warning of serious neuropsychiatric events. Depression, suicidal ideation, suicide attempt, and completed suicide have been reported in patients taking Chantix. You should stop taking Chantix and contact your healthcare provider immediately if you develop agitation, hostility, depressed mood, or changes in behavior or thinking that are not typical, or if you experience suicidal thoughts. Patients on Chantix should be closely monitored.
• There is a risk of hypersensitivity or angioedema, which is swelling of the face, mouth, extremities, and neck. Stop Chantix and seek emergency medical attention if these symptoms occur.
• As with Wellbutrin, Stevens-Johnson syndrome could Contact your healthcare provider immediately if you develop a skin rash.
• There may be a slightly increased chance of cardiovascular events—notify your healthcare provider of new or worsening symptoms of cardiovascular disease.
• Use caution driving until you know how Chantix affects you. Accidental injuries have occurred due to sleepiness or dizziness from Chantix.

Chantix may cause harm to the fetus if used during pregnancy, and generally should not be used. In animal studies, Chantix caused decreased fetal weight and decreased fertility in offspring. As with Wellbutrin, pregnant smokers should be encouraged to stop smoking through behavioral techniques.

In 2016, the FDA reported that the risk of serious mental health side effects from Zyban and Chantix may be lower than previously thought and that the benefits of smoking cessation outweigh the risks of using these medications. Even though the report refers to Zyban, Wellbutrin contains the same active ingredient, bupropion. Regardless, the drug information still contains the same warnings and patients should be closely monitored while on Wellbutrin or Chantix.

Frequently asked questions about Wellbutrin vs. Chantix

What is Wellbutrin?

Wellbutrin is an antidepressant prescription medication that is used off-label (with or without nicotine replacement therapy) to help patients stop smoking.

What is Chantix?

Chantix is a prescription medication that is used to help patients stop smoking.

Are Wellbutrin and Chantix the same?

No, they are not the same. Wellbutrin is an antidepressant that helps reduce nicotine cravings, while Chantix works specifically on nicotine receptors. They have other differences too, outlined above.

Is Wellbutrin or Chantix better?

Both drugs are effective in helping patients stop smoking. If you want to use nicotine replacement therapy in addition to prescription medication, Wellbutrin would be a better choice since it can be taken along with NRT, and Chantix should not be taken along with NRT. Ask your doctor if Wellbutrin or Chantix may be better for you.

Can I use Wellbutrin or Chantix while pregnant?

No. If you are pregnant, consult your healthcare provider. Wellbutrin and Chantix are not typically used in pregnant women. If you are already taking Wellbutrin or Chantix and find out that you are pregnant, contact your OB-GYN immediately for guidance.

Can I use Wellbutrin or Chantix with alcohol?

No. Wellbutrin with alcohol can increase the risk of seizures.

What is better to quit smoking, Chantix or Wellbutrin?

Both drugs have helped patients quit smoking, but it is best to talk to your doctor and discuss if Chantix or Wellbutrin may be an appropriate drug for you, taking into account your medical condition(s), history, and other medications you take.

How long does it take Chantix to start working?

It may take a few weeks for Chantix to start working. Your doctor may tell you to take Chantix for about 12 weeks. You’ll start with the starting month pack, and then continue with a continuing month pack. After 12 weeks, your doctor will decide if you need to take Chantix for another 12 weeks.

How quickly does Wellbutrin start to work?

It may take a few weeks of taking Wellbutrin (with or without NRT) until you notice a difference. Consult your doctor to find out how long you should take Wellbutrin.