Brand and Other Names:Nicotrol NS
- Classes: Smoking Cessation Aids
Dosing & Uses
Dosage Forms & Strengths
Nicotine replacement therapy to reduce withdrawal symptoms during smoking cessation
1 spray/nostril (ie, 2 sprays to provide 1 mg/dose); typically 10-12 sprays/day in each nostril PRN
Initiate with 1-2 doses/hr; for greatest success, instruct patient to use at least 8 doses/day initially
Depending on individual addiction; may increase up to maximum dose of 40 mg (80 sprays/day)
Tilt head back when administering
Do not sniff, swallow, or inhale through the nose as the spray is being administered
Safety and efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Local irritation (94%)
Somnolence and fatigue
Irritating to nasal mucosa
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
Pregnancy & Lactation
Pregnancy Category: D
Lactation: Distributed in breast milk; milk to plasma ratio is 2.9
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
Peak plasma time: 4-15 minutes
Peak plasma concentration: 2-12 ng/mL
Absorption half-life: 3 minutes
Protein bound: <5%
Vd: 2-3 L/kg
Metabolized primarily in the liver; some metabolism also takes place in kidney and lungs
More than 20 metabolites of nicotine identified, all are less active than the parent compound
The primary urinary metabolite is cotinine (15% of the dose)
Half-life: 1-2 hr (nicotine); 15-20 hr (cotinine)
Plasma clearance: 1.2 L/min
Excretion: Urine (10-30% unchanged)
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|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
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