Table 2: Medications for the Treatment of Tobacco Use Medication
Dosage/ Maximum Usage
Duration of Use
U.S. Availability OTC only: • Generic. • Commit.
(Dosages Available)
Cautions/Warnings
Side Effects
3-6 months.
Lozenge dosage keyed to level of nicotine dependency: • If smoke ≥ 30 minutes after waking: 2 mg. • If smoke ≤ 30 minutes after waking: 4 mg. Lozenge use frequency: • Weeks 1-6: 1 every 1-2 hrs. • Weeks 7-9: 1 every 2-4 hrs. • Weeks 10-12: 1 every 4-8 hrs. One patch per day, dosage/duration keyed to daily cigarette use/level of nicotine dependence: If ≥ 15 cigs/day: • Weeks 1-4: 21 mg. • Weeks 5-6: 14 mg. • Weeks 7-8: 7 mg. 80 puffs deliver 4 mg nicotine, up to 400 puffs per cartridge: • Weeks 1-12: 6-16 cartridges/day. • Weeks 13-24: gradual tapering off. • May save partially used cartridge for next day. 1-mg dose = 1 squirt per nostril (2 squirts): • Weeks 1-8: 1 to 2 doses per hour. • Weeks 9-14: gradual tapering off. • Maximum 40 mg/40 doses per day. • Do NOT inhale. • Concomitant pharmaceuticals may require adjustment of dosage.
• Hiccups. • Cough. • Heartburn, nausea. • Headaches, dizziness.
Nicotine lozenge (2 mg or 4 mg)
Not for use with: • Active peptic ulcer disease. • Severe sore throat. Use guidelines: • Do not chew or swallow lozenge. • Do not eat or drink during use, or 15 minutes before or after use. • One lozenge at a time. • Limit 20 in 24 hours.
OTC or prescription: • Generic. • NicoDerm CQ. • Nicotrol.
8-12 weeks (use may be extended if necessary to prevent relapse).
Nicotine patch (7 mg, 14 mg, 21 mg)
Not for use with: • Severe eczema or psoriasis.
• Local skin reaction. • Sleep • Headache, dizziness. • Nausea, diarrhea. • Local mouth and throat irritation that lessens with use. disturbance.
Up to 6 months; taper at end.
Prescription, brand-name only: • Nicotrol
Not for use with: • Hypersensitivity to nicotine or menthol. • Use with caution with asthma, pulmonary disease.
Nicotine inhaler (10 mg/ cartridge; 4
mg of nicotine delivered, but only 2 mg of
• Nausea, diarrhea. • Hiccups. • Taste alteration. • Jaw, neck pain. • Sinusitis.
nicotine is absorbed)
Prescription, brand-name only: • Nicotrol NS.
3-6 months; taper at end (use may be extended to 6 months to prevent relapse).
• Nasal
Nicotine nasal spray (0.5 mg/spray per nostril)
Not for use with: • Asthma or severe
irritation.
• Cough. • Tachycardia.
reactive airway disease. • Chronic nasal disorders. Use with caution with: • Hyperthyroidism, pheochromocytoma, or insulin-dependent diabetes. • May cause dependence.
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