Nicotine Replacement Therapies and Medications
Depending on your preferences, you can choose to stop using tobacco through medicines containing nicotine or not containing nicotine. Both types of treatments have certain benefits and drawbacks. It is up to you and your doctor to determine which method is right for you.
Nicotine Replacement Therapy
Prior to using any smoking cessation product that contains nicotine, it is very important to stop smoking and stop using any other nicotine-containing products. Carefully read the labels of these medicines for directions on product use and other pertinent information. Consult with your physician or pharmacist before using any over-the-counter nicotine replacement therapy to make sure these treatments are compatible with your current medications and medical conditions. Store all medications out of the reach of children and pets. A brief summary of smoking cessation products is provided below.
Nicotine Gum and Lozenges
Nicorette® gum and Commit® lozenges are available without a prescription in 2- and 4-mg doses. The dose for nicotine gum is based on how much the patient smokes per day. Patients who smoked 25 or more cigarettes per day should use the 4-mg gum; those who smoked fewer than 25 cigarettes per day should use the 2-mg gum.
Eating or drinking (except water) should be avoided 15 minutes before or after using the gum or lozenges. Acidic beverages can reduce the absorption of nicotine and should not be consumed while chewing the gum.
Transdermal Nicotine Patches
Nicotine patches are available without a prescription. Nicoderm® CQ and generic nicotine patches come in 21-, 14- and 7-mg strengths while Nicotrol® patches are available as 15-, 10- and 5-mg patches. The recommended dosing of these products is based on the patient's prior cigarette use. Nicoderm® CQ and generic nicotine patches should be worn for 16 to 24 hours (24 hours for patients who crave a cigarette upon waking in the morning). Nicotrol® patches should be worn for 16 hours (removed at bedtime). Do not wear more than one patch at a time and do not cut the patches in half.
Nicotine Nasal Spray
Nicotrol® NS is available by prescription only and is supplied as 10 ml bottles containing 10 mg/ml of nicotine with a metered spray pump. The dose of Nicotrol® NS should be individualized based on the patient's nicotine dependence. For best results use at least 8 doses per day. Do not use more than 5 doses per hour or 40 doses per day.
Nicotrol® inhaler is available only by prescription as cartridges containing 10 mg of nicotine. The nicotine released from the inhaler is absorbed in the mouth. Use of this inhaler mimics the hand-to-mouth routine of cigarette smoking.
Several non-nicotine prescriptions are approved for smoking cessation as well. Learn more by reading the descriptions listed below.
Bupropion is a non-nicotine prescription drug approved for smoking cessation. It is available as a 150 mg tablet, and usually takes 2 weeks for the drug to be effective. Therefore, the patient should plan to stop smoking within 2 weeks after Zyban® is initiated.
Varenicline is another non-nicotine prescription medication available as either a 0.5 or 1 mg tablet. Chantix® should be started 1 week before an established smoking stop date. Make sure to take Chantix® after eating and with a full glass of water to reduce upset stomach.