Absorption: Gum, lozenge — Slowly absorbed from buccal mucosa during chewing/sucking. Inhaler — 50% of dose is systemically absorbed; most of nicotine released from inhaler is deposited in the mouth; absorption from buccal mucosa is slow. Nasal spray — 53% absorbed from nasal mucosa. Transdermal — 70% of nicotine released from the system is absorbed through the skin.
Distribution: Enter breast milk.
Metabolism/Excretion: Mostly metabolized by the liver. Small amounts are metabolized by kidneys and lungs; 10–20% excreted unchanged by kidneys.
Half-life: 1–2 hr.
CV: tachycardia, chest pain, hypertension.
Derm: transdermal: burning at patch site, erythema, pruritus, cutaneous hypersensitivity, rash, sweating.
EENT: sinusitis.
gum: pharyngitis.
nasal spray: nasopharyngeal irritation, sneezing, watering eyes, change in smell, earache, epistaxis, eye irritation, hoarseness.
inhaler: local mouth/throat irritation.
Endo: dysmenorrhea.
GI: abdominal pain, abnormal taste, constipation, diarrhea, dry mouth, dyspepsia, hiccups, nausea, vomiting.
gum: belching, ↑appetite, ↑salivation, oral injury, sore mouth.
MS: arthralgia, back pain, myalgia.
gum: jaw muscle ache.
Neuro: paresthesia , headache, insomnia, abnormal dreams, dizziness, drowsiness, impaired concentration, nervousness, seizures, weakness.
Resp: Nasal spray, inhaler: cough, dyspnea.
nicotine chewing gum: Nicorette
nicotine inhaler: Nicotrol
nicotine lozenge: Nicorette
nicotine nasal spray: Nicotrol NS
Nicotine Transdermal Patch: Habitrol, Nicoderm CQ
Therapeutic Classification:
10 cigarettes/day — Begin with Step 2 (14 mg/day) for 6 wk, followed by Step 3 (7 mg/day) for 2 wk, then stop (total of 8 wk) (new patch should be applied every 24 hr).