Cytisine (Desmoxan, Tabex, Recigar) - how the 25-day course works and when to stop smoking

A course of cytisine lasts 25 days, and one pack containing 100 tablets, capsules or doses is enough for the whole course. For the first three days of the course, you take one tablet every 2 hours, but no more than 6 tablets a day. In the following stages, the intervals between doses gradually get longer. In the last five days of the course, you take 1-2 tablets a day. You need to stop smoking by day 5 of the course at the latest and not smoke a single cigarette from that day on. Desmoxan, Tabex and Recigar contain the same substance at a dose of 1.5 mg and have the same dosing schedule. However, the warnings described for each product differ. This article is based on the summaries of product characteristics (SmPCs) available in Poland's official Register of Medicinal Products (accessed 8 October 2026). The information here does not replace an individual consultation with a doctor or pharmacist.

In brief

• A course of cytisine lasts 25 days and has five stages: from 6 tablets a day on days 1-3 to 1-2 tablets a day on days 21-25. Take the tablets at the intervals given in the dosing schedule. Do not exceed the maximum number of tablets allowed per day.
• You need to stop smoking by day 5 of the course at the latest. Smoking during treatment can make the side effects of nicotine worse.
• Desmoxan, Tabex and Recigar each contain 1.5 mg of cytisine per tablet or capsule and have an identical dosing schedule. However, they differ in their excipients and recommendations. Cutting down on smoking from day 1 is recommended only for Desmoxan capsules. Recigar contains aspartame, and the Tabex SmPC has no warnings about contraception or about medicines whose levels rise after quitting smoking.
• Cytisine is not used in pregnancy, while breastfeeding, in unstable angina, after a recent heart attack or stroke, or in significant heart rhythm disorders. If you have heart disease, high blood pressure, diabetes or a mental illness, or take certain medicines, the decision about the course needs to be made with a doctor.

What does the 25-day cytisine course look like day by day?

A course of cytisine has five stages. At each successive stage, you take fewer tablets a day and leave longer intervals between doses. The same dosing schedule applies to Desmoxan (tablets and capsules), Tabex, Recigar and Recigar Active.

In this article, "tablet" also means a capsule or a dose of the medicine delivered by a pump. The last column of the table gives only example times for taking the medicine, worked out from the intervals between doses for someone who takes their first tablet at 7:00. If you start at a different time, shift all the times accordingly.

Take the tablets at the intervals given in the dosing schedule. Do not exceed the maximum number of tablets allowed per day. On days 1-3, do not take another tablet after the sixth, even if 2 hours have passed since the previous one. Take the next tablet only on the following day. Tablets and capsules are swallowed with water. Recigar Active is a solution in a pack with a pump: before first use, press the pump 5 times, and after that each press delivers 1.5 mg of cytisine into the mouth. You can wash the dose down with a drink, but you do not have to.

How many tablets are left for days 21-25?

According to the schedule, you take 91 tablets over the first 20 days: 18 on days 1-3, 45 on days 4-12, 16 on days 13-16 and 12 on days 17-20. This leaves 9 tablets in the pack for the last five days. That is enough, for example, for 2 tablets a day on days 21-24 and 1 tablet on day 25, which matches the recommended dose of 1-2 tablets a day. Any doubts about dosing in the last days of the course can be discussed with a doctor or pharmacist.

What should you do if you miss a dose of cytisine?

If you miss a tablet of Desmoxan, Tabex or Recigar, do not take a double dose. A missed Desmoxan capsule should be taken as soon as possible, and the next one at the usual time. Whichever product you take, you must not exceed the daily limit given in the table. If you have missed several doses, you need to discuss whether to continue taking the medicine with a doctor or pharmacist.

What happens after day 25, and when can the course be repeated?

The course ends after 25 days. The approved treatment schedule does not provide for extending it. If the treatment is not working, the course should be stopped, and another one can be started after 2-3 months.

It is better to decide with a doctor whether to stop the course and when to try again. During the break before a second course, you can work out with a doctor or an addiction therapist why the first course did not work. The urge to smoke may keep coming back for weeks after the last tablet. Our articles on nicotine cravings and on what happens in the weeks after you stop smoking describe how to get through these moments.

When should you stop smoking during a cytisine course?

You stop smoking by day 5 of the cytisine course at the latest. This recommendation applies to all five products. The detailed recommendations on smoking differ between the products:

• Desmoxan tablets: you need to stop smoking by day 5 of the course at the latest. Do not smoke during treatment, as this can make side effects worse.
• Recigar: the same recommendations apply as for Desmoxan tablets, and the warning also covers the use of other products containing nicotine.
• Recigar Active: you need to stop smoking by day 5 of the course at the latest, and after that you must not smoke even a single cigarette.
• Tabex: you need to stop smoking by day 5 of the course at the latest, and after that you must not smoke even a single cigarette, because the long-term success of treatment depends on it.
• Desmoxan capsules: from the first day of treatment, gradually reduce the number of cigarettes you smoke, and stop smoking completely by day 5 at the latest. The recommendation to cut down from the first day applies only to this product. After that, as with Tabex, you must not smoke even a single cigarette.

Before you take the first tablet, it is best to set your quit day, no later than day 5 of the course, and mark it in your calendar. It helps to prepare for this day: get rid of cigarettes at home and in the car, and plan your first smoke-free days so that they include as few situations as possible in which you used to smoke. The National Cancer Institute also advises changing your routines around coffee and after meals (1).

Why should you not combine cytisine with smoking or other sources of nicotine?

Smoking during a course of any of the five products can make the side effects of nicotine worse. For Desmoxan tablets, Recigar and Recigar Active, the warning also covers the use of other nicotine products. These include e-cigarettes, nicotine pouches, and nicotine patches and gum. If someone starts smoking again after their quit day, they should not extend the course or increase the doses on their own. The most common reasons and next steps are described in our article on why cytisine does not work and what to do then.

How do Desmoxan, Tabex and Recigar differ?

Desmoxan, Tabex and Recigar contain the same active substance at the same dose of 1.5 mg and have the same 25-day dosing schedule. They differ in the form of the medicine, the excipients and how detailed the warnings in their documentation are.

Cytisinicline is a newer name for the same substance. As of 8 October 2026, Poland's Register of Medicinal Products listed 17 products containing 1.5 mg of cytisine. Of these, 11 are available without a prescription, including both forms of Desmoxan, Tabex, Recigar and Recigar Active, and the remaining 6 are prescription-only.

The active substance in every product is the same cytisine, so the warnings in the more detailed SmPCs, for example about contraception, also matter for people taking Tabex. The price of a pack depends on the pharmacy. We compare the cost of the course with spending on cigarettes in our article cytisine from the pharmacy or a course with a doctor.

When must cytisine not be used, and when do you need a consultation?

Cytisine is not used in pregnancy or while breastfeeding, in unstable angina, after a recent heart attack or stroke, in clinically significant heart rhythm disorders or in people allergic to any ingredient of the product. These contraindications apply to all five products. You need to discuss with a doctor when you can start the course after a heart attack or stroke. A woman who could become pregnant must use effective contraception during the course. Most of the products discussed are not recommended for people under 18 or over 65 years of age, or for people with impaired kidney or liver function. If you have heart disease, high blood pressure, diabetes or a mental illness, or take medicines regularly, you need to discuss the course with a doctor first. The conditions and medicines that require a consultation with a doctor before starting cytisine are listed in our article on when you need a consultation before a cytisine course.

At Nasz Gabinet, the 3-month nicotine dependence treatment plan starts with a medical interview, and the doctor issues an e-prescription for a medicine chosen after assessing whether the treatment is suitable for you. The app reminds you of every dose, counts your smoke-free days and includes a diary, and consultations with a psychologist are paid separately.

How effective is cytisine in studies?

Compared with a placebo, cytisine increases the proportion of people who stop smoking, but in the studies most participants did not stay abstinent. Study results cannot tell you how the medicine will work for you.

In a study conducted in Poland, 740 smokers took cytisine or a placebo for 25 days and received only minimal counselling. Over the 12 months after the end of treatment, 8.4% of people in the cytisine group and 2.4% in the placebo group did not smoke, and abstinence was confirmed with a biochemical test (2). Gastrointestinal complaints were reported more often by people taking cytisine.

In New Zealand, 1310 people who called a quitline for smokers received either cytisine for a 25-day course or nicotine replacement therapy for 8 weeks. Both groups received brief telephone support. After one month, 40% of people in the cytisine group and 31% in the nicotine replacement therapy group reported continuous abstinence. People taking cytisine reported more side effects, mainly nausea, vomiting and sleep disturbances (3).

A 2023 Cochrane review brought together 4 studies comparing cytisine with a placebo, with a total of 4623 participants. Cytisine helped more people quit smoking than a placebo (risk ratio 1.30; 95% CI 1.15-1.47), and the authors rated the certainty of this evidence as moderate. No difference was shown in the number of serious adverse events, although the certainty of this finding was low (4). Cytisine is also listed among the medicines recommended for adults in the 2024 WHO guidelines (5).

In people taking stop-smoking medicines, additional support, given in person or by telephone, increased the proportion of non-smokers at follow-up lasting at least six months (risk ratio 1.15; 65 studies, 23,331 participants). The studies in this review involved nicotine replacement therapy, bupropion, nortriptyline and varenicline, not cytisine (6).

When should you stop taking cytisine and seek help?

If symptoms of an overdose appear, stop taking the medicine and contact a doctor. These symptoms include nausea, vomiting, a faster heart rate, fluctuating blood pressure, breathing problems, visual disturbances and seizures. Desmoxan tablets, Tabex and both Recigar products must be stopped if even one of these symptoms appears, or a symptom that is not listed in the leaflet. Breathing problems or seizures require urgent medical help, even if it is not clear whether the medicine caused them.

Most side effects appear at the start of the course and are mild or moderate. From 6% to 15.5% of patients stopped treatment because of them; in controlled trials, this proportion was similar to that in the placebo groups. Some of these symptoms are caused by nicotine withdrawal, not by the medicine. Our article on cytisine side effects explains which of them go away on their own and which mean you should stop the course. Weight gain is listed among the very common side effects of Desmoxan tablets. The reasons for this weight gain are explained in our article on weight gain after quitting smoking.

Frequently asked questions

Does cytisine contain nicotine?

Cytisine does not contain nicotine. It is a plant alkaloid found, among other places, in the seeds of the laburnum tree. Its structure resembles that of nicotine, and it acts on the same receptors in the brain, but more weakly. Cytisine eases nicotine withdrawal symptoms and makes smoking a cigarette less satisfying. After your quit day, it should not be combined with smoking or with other nicotine products.

How do you take Desmoxan?

Desmoxan is taken in the same way as the other cytisine products: for 25 days, starting with 1 tablet every 2 hours (no more than 6 tablets a day) on days 1-3 and ending with 1-2 tablets a day on days 21-25. Swallow the tablet with water. You need to stop smoking by day 5 at the latest, and if you take Desmoxan capsules, you need to cut down the number of cigarettes from the first day.

Can cytisine be taken for longer than 25 days?

Cytisine is not taken for longer than 25 days. The approved schedule for Desmoxan, Tabex and Recigar covers only treatment of this length, and one pack is enough for the whole course. If the treatment is not working, it should be stopped, and it can be started again after 2-3 months. Longer or different treatment is a decision for the doctor.

Can you drink alcohol during a course of cytisine?

The SmPCs for Desmoxan, Tabex and Recigar do not describe any interaction between cytisine and alcohol. Alcohol often goes together with smoking and, during the course, makes it more likely that you will reach for a cigarette. If you also have a drinking problem, the treatment plan needs to be discussed separately. We cover all these issues in our article on cytisine and alcohol.

Do you need a prescription for cytisine?

Desmoxan, Tabex, Recigar and Recigar Active can be bought at a pharmacy without a prescription. According to Poland's Register of Medicinal Products as of 8 October 2026, 11 of the 17 cytisine products are available without a prescription, and the remaining 6 are prescription-only. Before starting the course, you need to read the information on contraindications. Cytisine is not used in pregnancy or while breastfeeding. People with heart disease or a mental illness, and people who take medicines regularly, must agree the course with a doctor.

Sources

1. National Cancer Institute. Handling Nicotine Withdrawal and Triggers When You Decide To Quit Tobacco. cancer.gov
2. West R, Zatonski W, Cedzynska M et al. Placebo-controlled trial of cytisine for smoking cessation. N Engl J Med. 2011;365(13):1193-1200. PMID 21991893, DOI
3. Walker N, Howe C, Glover M et al. Cytisine versus nicotine for smoking cessation. N Engl J Med. 2014;371(25):2353-2362. PMID 25517706, DOI
4. Livingstone-Banks J, Fanshawe TR, Thomas KH et al. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev. 2023;5(5):CD006103. PMID 37142273, DOI
5. World Health Organization. WHO clinical treatment guideline for tobacco cessation in adults. 2024. NCBI Bookshelf
6. Hartmann-Boyce J, Hong B, Livingstone-Banks J et al. Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database Syst Rev. 2019;6(6):CD009670. PMID 31166007, DOI
7. Charakterystyka Produktu Leczniczego Desmoxan 1,5 mg, tabletki, Aflofarm Farmacja Polska, pozwolenie nr 24354, zmiana tekstu 31.10.2025. Rejestr Produktów Leczniczych
8. Charakterystyka Produktu Leczniczego Desmoxan 1,5 mg, kapsułki twarde, Aflofarm Farmacja Polska, pozwolenie nr 20790. Rejestr Produktów Leczniczych
9. Charakterystyka Produktu Leczniczego i ulotka Tabex 1,5 mg, tabletki powlekane, Sopharma Warszawa, pozwolenie nr R/3425. ChPL, ulotka
10. Charakterystyka Produktu Leczniczego Recigar 1,5 mg, tabletki powlekane, Adamed Pharma, pozwolenie nr 25108. Rejestr Produktów Leczniczych
11. Charakterystyka Produktu Leczniczego Recigar Active 1,5 mg/dawkę, roztwór doustny, Adamed Pharma, pozwolenie nr 29181. Rejestr Produktów Leczniczych