Varenicline and Pheochromocytoma
Authors: Janne Hukkanen
Journal: Annals of Internal Medicine (2010)

Letters2 March 2010Varenicline and PheochromocytomaJanne Hukkanen, MD, PhD, Olavi Ukkola, MD, PhD, and Neal L. Benowitz, MDJanne Hukkanen, MD, PhDFrom Oulu University Hospital, Oulu, FI-90029, Finland; and University of California, San Francisco, San Francisco, CA 94143.Search for more papers by this author, Olavi Ukkola, MD, PhDFrom Oulu University Hospital, Oulu, FI-90029, Finland; and University of California, San Francisco, San Francisco, CA 94143.Search for more papers by this author, and Neal L. Benowitz, MDFrom Oulu University Hospital, Oulu, FI-90029, Finland; and University of California, San Francisco, San Francisco, CA 94143.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-5-201003020-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail 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 ...References1. Mousavi M, Hellström-Lindahl E, Guan ZZ, Bednar I, Nordberg A. Expression of nicotinic acetylcholine receptors in human and rat adrenal medulla. Life Sci. 2001;70:577-90. [PMID: 11811902] CrossrefMedlineGoogle Scholar2. Di Angelantonio S, Matteoni C, Fabbretti E, Nistri A. Molecular biology and electrophysiology of neuronal nicotinic receptors of rat chromaffin cells. Eur J Neurosci. 2003;17:2313-22. [PMID: 12814364] CrossrefMedlineGoogle Scholar3. Mehrani H, Golmanesh L. Changes in mRNA and protein levels of nicotinic acetylcholine receptors in Diazoxon exposed pC12 cells. Toxicol In Vitro. 2008;22:1257-63. [PMID: 18513920] CrossrefMedlineGoogle Scholar4. Rezvani K, Teng Y, De Biasi M. The ubiquitin-proteasome system regulates the stability of neuronal nicotinic acetylcholine receptors. J Mol Neurosci. 2010;40:177-84. [PMID: 19693707] CrossrefMedlineGoogle Scholar5. Mihalak KB, Carroll FI, Luetje CW. Varenicline is a partial agonist at alpha4beta2 and a full agonist at alpha7 neuronal nicotinic receptors. Mol Pharmacol. 2006;70:801-5. [PMID: 16766716] CrossrefMedlineGoogle Scholar6. Rollema H, Chambers LK, Coe JW, Glowa J, Hurst RS, Lebel LA, et al. Pharmacological profile of the alpha4beta2 nicotinic acetylcholine receptor partial agonist varenicline, an effective smoking cessation aid. Neuropharmacology. 2007;52:985-94. [PMID: 17157884] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Oulu University Hospital, Oulu, FI-90029, Finland; and University of California, San Francisco, San Francisco, CA 94143.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByTherapeutic concentrations of varenicline increases exocytotic release of catecholamines from human and rat adrenal chromaffin cells in the presence of nicotineHuman nicotinic receptors in chromaffin cells: characterization and pharmacologyInappropriate Sexual Behaviors Associated with Donepezil; Metformin-Induced Vitamin B 12 Deficiency; Metformin Stinks, Literally; Varenicline-Triggered Pheochromocytoma Crisis; Ranolazine-Related Dyspnea on Exertion; Severe Opioid Withdrawal Due to Misuse of a New Combined Narcotic Agonist/Antagonist Product; A Nearly Overlooked Case of Ziprasidone-Induced Lingual Dystonia 2 March 2010Volume 152, Issue 5Page: 335-336KeywordsHypertensionNicotinePheochromocytomaSepsisStable coronary artery diseaseSympathetic nervous systemThoraxThyroxineUrine ePublished: 2 March 2010 Issue Published: 2 March 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...