Trade Names:Commit- Lozenges 2 mg- Lozenges 4 mg
Trade Names:Habitrol- Transdermal system 17.5 mg- Transdermal system 35 mg- Transdermal system 52.5 mg
Trade Names:Nicoderm- Transdermal system 36 mg- Transdermal system 78 mg- Transdermal system 114 mg
Trade Names:Nicorette- Chewing gum 2 mg/square
Trade Names:Nicorette DS- Chewing gum 4 mg/square
Trade Names:Nicotrol- Transdermal system 8.3 mg- Transdermal system 16.6 mg- Transdermal system 24.9 mg
Trade Names:Nicotrol NS- Spray pump 0.5 mg nicotine/actuation
Trade Names:Nicotrol Inhaler- Inhaler 4 mg delivered (10 mg/cartridge)
Trade Names:ProStep- Transdermal system 15 mg- Transdermal system 30 mgNicorette Plus (Canada)
Reduces nicotine withdrawal symptoms by providing nicotine levels lower than those associated with smoking.
Aid to smoking cessation. Part of comprehensive behavioral smoking-cessation program.
Nonsmokers; during immediate post-MI period; life-threatening arrhythmias; severe or worsening angina pectoris; active temporomandibular joint disease (nicotine polacrilex gum).
Advise patient to stop smoking completely when beginning to use smoking cessation therapy.Nicotine GumAdults
PO If patient smokes less than 25 cigarettes/day, chew 2 mg gum (max, 24 pieces/day) for up to 12 wk. If patient smokes at least 25 cigarettes/day, chew 4 mg gum (max, 24 pieces/day) for up to 12 wk.Nicotine LozengesAdults
PO If patient smokes first cigarette more than 30 min after waking up, start with the 2 mg lozenge. If patient smokes first cigarette within 30 min after waking up, start with the 4 mg lozenge. Week 1 to 6, slowly dissolve 1 lozenge in the mouth every 1 to 2 h; week 7 to 9, slowly dissolve 1 lozenge in the mouth every 2 to 4 h; week 10 to 12, slowly dissolve 1 lozenge in the mouth every 4 to 8 h.Nicotine InhalerAdults
Inhaler 6 to 16 cartridges/day for up to 6 mo.Nicotine Transdermal PatchesAdults Habitrol
Topical If patient smokes at least 10 cigarettes/day, start with 21 mg/day for first 4 wk, then decrease dose to 14 mg/day for next 2 wk, then decrease dose to 7 mg/day for last 2 wk. If patient smokes less than 10 cigarettes/day, start with 14 mg/day for 6 wk then decrease dose to 7 mg/day for last 2 wk.Nicoderm
Topical If patient smokes at least 10 cigarettes/day, start with 21 mg/day for first 6 wk then decrease dose to 14 mg/day for next 2 wk, then decrease dose to 7 mg/day for last 2 wk. If patient smokes less than 10 cigarettes/day, start with 14 mg/day for 6 wk then decrease dose to 7 mg/day for last 2 wk.Nicotrol
Topical Use 15 mg/16 h for 6 wk.Nicotine Nasal SprayAdults
Spray (Each actuation delivers 50 mcL spray containing 0.5 mg nicotine.) 8 to 40 doses/day for 3 to 6 mo.
Store cartridge at 77°F or below. Protect from light.Lozenge
Store at controlled room temperature (68° to 77°F). Protect from light.Nicotine chewing gum
Store at controlled room temperature (68° to 77°F). Protect from light.Transdermal system
Store at controlled room temperature (68° to 77°F). Do not store out of pouch.
Smoking tends to increase metabolism and may lower blood levels of these drugs or others. Smoking cessation, with or without nicotine medication, may reverse these effects.Food
Effective absorption of nicotine gum depends on mildly alkaline saliva. Coffee, cola, and other drinks or food may reduce salivary pH and should probably be avoided 15 min before and during chewing of gum.
None well documented.
Edema; flushing; hypertension; palpitations; tachyarrhythmias; tachycardia; MI; CHF; cardiac arrest; cerebrovascular accident.
Insomnia; dizziness; lightheadedness; irritability; headache; impaired concentration; confusion; convulsions; depression; paresthesia; abnormal dreams.
Erythema; rash; itching; urticaria.
Buccal cavity irritation; mouth or throat soreness or dryness. With gum chewing: traumatic injury to oral mucosa or teeth; jaw ache; changes in taste perception.
GI distress; belching; indigestion; nausea; vomiting; excess salivation; hiccoughs; anorexia; constipation; diarrhea.
Alterations of LFTs.
Increased cough; pharyngitis; sinusitis; difficulty breathing; hoarseness; sneezing.
Pain; myalgia; arthralgia; dysmenorrhea.
Category C (nicotine polacrilex gum); Category D (inhaler, spray, transdermal nicotine).
Excreted in breast milk.
Safety and efficacy not established.
May be more susceptible to adverse reactions.
Hepatic function impairment may reduce nicotine Cl.
Transference of nicotine dependence from smoking to deterrent product exists. If patient continues to smoke while on nicotine therapy, severe effects caused by higher nicotine levels may be experienced.
Patients with coronary heart disease, serious cardiac arrhythmias, systemic hypertension, or vasospastic disease need to be carefully evaluated and monitored closely because of cardiac effects.
May be more susceptible to adverse reactions.
Might be exacerbated by chewing nicotine gum.
Use with caution in patients with hyperthyroidism, pheochromocytoma, or insulin-dependent diabetes because of action of nicotine on adrenal medulla.
May delay healing in patients with peptic ulcer disease.
Nausea, salivation, abdominal pain, vomiting, diarrhea, cold sweat, headache, dizziness, disturbed hearing and vision, mental confusion, marked weakness, faintness, prostration, hypotension, difficult breathing, rapid, weak, irregular pulse, respiratory collapse.
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