Which quit-smoking medications can be prescribed online here?
Combination nicotine replacement, meaning a daily patch (21 mg stepping down to 14 mg then 7 mg, starting at 14 mg for lighter smokers) plus a 2 mg or 4 mg lozenge or gum for cravings; bupropion SR 150 mg; and varenicline (0.5 mg titrated up to 1 mg twice daily over 12 weeks, dose-adjusted for reduced kidney function). All three are first-line, guideline-supported treatments; varenicline can also be physician-combined with the nicotine patch when specifically indicated. Other prescription quit medications are not offered in this visit.
How do the check-ins and refills work?
Every supply covers 4 weeks, and a short secure-message check-in is required before every refill: smoking status, side effects, a repeat 2-question mood screen, and a fresh blood-pressure number if you take bupropion. A refill request without a completed check-in is always routed back to the check-in first. Your first check-in comes 1 to 2 weeks after starting.
Why does the intake ask mood questions?
Bupropion carries a warning about mood changes, and nicotine withdrawal itself can affect mood, so this visit screens mood at intake and again at every check-in. If either screening question is positive, bupropion is not prescribed and the physician builds a nicotine-replacement-only plan instead. Anyone having thoughts of self-harm should call or text 988 right away. That always comes before a quit aid.
Why do I need a blood-pressure reading for bupropion?
Bupropion can raise blood pressure, so a dated reading from the last 3 months (a home cuff, a pharmacy machine, or a clinic visit) is required before it is prescribed, and it is re-checked at every check-in. A reading of 160/100 or higher means nicotine replacement only, and 180/110 or higher needs same-day blood-pressure care before any quit medication.
Can this visit help me quit vaping?
Not on its own. National guidance (USPSTF) found the evidence for prescribing cessation medication for vaping-only use insufficient, so vaping-only requests aren't treated in this visit and are pointed to primary care and the free quitline at 1-800-QUIT-NOW. If you both smoke and vape, the physician treats the smoking and counsels on the vaping.
How long does treatment last?
The nicotine taper typically runs 8 to 12 weeks, bupropion 7 to 12 weeks, and varenicline a fixed 12 weeks, all timed so the oral option starts 1 to 2 weeks before your quit date. Bupropion beyond 12 weeks or varenicline beyond its 12-week course requires a physician re-evaluation to continue, and the entire online course is capped at 6 months, after which a full re-assessment of quit status, mood, and blood pressure is required. Pairing medication with free quitline coaching (1-800-QUIT-NOW) gives the best odds.
What should I know about starting varenicline?
Varenicline is started 1 week before your quit date and titrates from 0.5 mg once daily up to 1 mg twice daily over 12 weeks (a slower, capped titration is used if you have significant kidney disease). Nausea and vivid dreams are common and usually improve: taking it with food helps. Watch for mood changes, agitation, or unusual behavior and stop the medication and contact us right away if they occur; call or text 988 for any thoughts of self-harm. Report chest pain, palpitations, or new shortness of breath immediately. It can be combined with the nicotine patch, but only when your physician specifically recommends it.