Dosing & Uses
Dosage Forms and Strengths
- 10mg/cartridge (4 mg delivered)
Indicated to reduce withdrawal symptoms during smoking cessation
Best effect observed with frequent, continuous puffing over 20 minute periods throughout the day
6 or more cartridges/day PRN [4 mg/cartridge]; do not exceed 16 cartridges/day
Use at least 6 cartridges/day for the first 3-6 weeks for improved success at quiting
Before initiating nicotine replacement reatment, patient must have desire to stop smoking
Most effective as part of comprehensive smoking cessation plan
See product user's guides for details
Serious - Use Alternative
Significant - Monitor Closely
Mouth/throat irritation (66%)
Back pain (6%)
Gum problems (4%)
Nicotine withdrawal (irritability, dizziness, headache, insomnia)
Cardiac dysrhythmia (rare)
Immune hypersensitivity reaction (rare)
Hypersensitivity to nicotine or components
Active smokers following the postmyocardial period
Patients with life-threatening arrhythmias or worsening of angina pectoris if severe
Not studied in reactive airway disease; may cause bronchospasm
Caution with hypertension, cardiovascular, or peripheral vascular disease
Caution with hyperthyroidism, pheochromocytoma, or insulin-dependent diabetes, since nicotine causes the release of catecholamines by the adrenal medulla
Delays healing of peptic ulcer disease
Use caution in patients with oropharyngeal inflammation, peptic ulcer, or history of esophagitis
Caution in severe renal impairment
Pregnancy & Lactation
Pregnancy Category: D
Lactation: Unknown whether excreted in breast milk; use caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Agonist at nicotinic receptors; potent ganglionic and central nervous stimulant
Peak plasma time: 15 minutes
Protein binding: <5%
Vd: 2-3 L/kg
Metabolism: liver (some renal, lung)
Metabolites: over 20, less active
Clearance: 1.2 L/min
Excretion: urine (30%)
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.