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Letters |2 March 2010

Varenicline and Pheochromocytoma

Janne Hukkanen, MD, PhD; Olavi Ukkola, MD, PhD; Neal L. Benowitz, MD

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Author, Article, and Disclosure Information
Potential Conflicts of Interest: None disclosed.
  • From Oulu University Hospital, Oulu, FI-90029, Finland; and University of California, San Francisco, San Francisco, CA 94143.
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Potential Conflicts of Interest: None disclosed.
Background: Varenicline is a widely used smoking-cessation therapy. It acts as an α4β2 nicotinic acetylcholine receptor (nAChR) partial agonist to diminish the symptoms of nicotine withdrawal.
Objective: To report a case of varenicline-triggered pheochromocytoma crisis.
Case Report: A 55-year-old woman who smoked about 15 cigarettes a day for decades had hypertension, hypothyroidism, and an 8-year history of palpitations. She was prescribed varenicline. Her medications included stable doses of telmisartan and l-thyroxine.
The patient took one 0.5-mg varenicline tablet without ill effects, but after taking the second varenicline tablet the next day, she experienced diarrhea, stomachache, and palpitations. She described the symptoms as being unlike anything she had had before. They steadily worsened, and she started having chest pain the next morning. She took propranolol for the palpitations that morning; it did not help with the palpitations but did not cause any adverse effects.
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Hukkanen J, Ukkola O, Benowitz NL. Varenicline and Pheochromocytoma. Ann Intern Med. 2010;152:335–336. doi: 10.7326/0003-4819-152-5-201003020-00021

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Published: Ann Intern Med. 2010;152(5):335-336.

DOI: 10.7326/0003-4819-152-5-201003020-00021

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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