Suggestions for the Clinical Use of Medications for Tobacco Dependence Treatmenta
| Pharmacotherapy |
Precautions/
Contraindications |
Side
Effects |
Dosage |
Duration |
Availability |
| Nicotine Patch |
|
Local skin reaction
Insomnia |
21 mg/24 hours
14 mg/24 hours
7 mg/24 hours |
4 weeks
then 2 weeks
then 2 weeks
|
Prescription and OTCb |
| Nicotine Gum |
|
Mouth soreness
Dyspepsia |
1-24 cigs/day-2 mg gum
(up to 24 pcs/day)
25+cigs/day-4 mg gum
(up to 24 pcs/day) |
Up to 12 weeks |
OTCb only |
| Nicotine Nasal Spray |
|
Nasal irritation |
8-40 doses/day |
3-6 months |
Prescription only |
| Nicotine Inhaler |
|
Local irritation of mouth and throat |
6-16 cartridges/day |
Up to 6 months |
Prescription only |
| Nicotine Lozenge |
|
Local irritation of
throat
Hiccups
Heartburn/Indigestion
Nausea |
First a.m. cigarette after 30 minutes from waking:
2 mg (up to 20 pcs/day)
First a.m. cigarette before 30 minutes from waking:
4 mg (up to 20 pcs/day) |
12 weeks |
OTCb only |
| Bupropion SR |
History of seizure
History of eating disorders
Use of MAO inhibitors in past 14 days |
Insomnia
Dry mouth |
150 mg every morning for 3 days then 150 mg twice daily
(Begin treatment 1-2 weeks pre-quit) |
7-12 weeks
maintenance up to 6 months |
Prescription only |
| Varenicline |
Monitor for changes in mood,
behavior, psychiatric symptoms, maintenance up to
and suicidal ideation |
Nausea
Trouble sleeping |
0.5 mg once daily for days 5-7 before quit date
0.5 mg twice daily for days 1-4 before quit date
1 mg twice daily starting on quit date |
3 months
maintenance up to
6 months |
Prescription only |
a. The information contained within this table is not comprehensive. Please see medication package inserts for additional information.
b.OTC refers to over the counter.
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