NIK-o-teen
REMS
Absorption: Gum, lozenge: Slowly absorbed from buccal mucosa during chewing/sucking. Nasal spray: 53% absorbed from nasal mucosa. Transdermal: 70% of nicotine released from the system is absorbed through the skin.
Distribution: Enter breast milk.
Half-Life: 1–2 hr.
(plasma concentrations)
| ROUTE | ONSET | PEAK | DURATION |
|---|---|---|---|
| Gum | rapid | 15–30 min | unknown |
| Lozenge | unknown | unknown | unknown |
| Nasal spray | rapid | 4–15 min | unknown |
| Transdermal | rapid | 2–4 hr | unknown |
Contraindicated in:
Use Cautiously in:
CV: tachycardia, chest pain, hypertension
Derm:
transdermal
burning at patch site, erythema, pruritus, cutaneous hypersensitivity, rash, sweatingEENT: sinusitis,
gum
pharyngitis,nasal spray
nasopharyngeal irritation, sneezing, watering eyes, change in smell, earache, epistaxis, eye irritation, hoarsenessEndo: dysmenorrhea
GI: abdominal pain, abnormal taste, constipation, diarrhea, dry mouth, dyspepsia, hiccups, nausea, vomiting,
gum
belching, ↑appetite, ↑salivation, oral injury, sore mouthMS: arthralgia, back pain, myalgia,
gum
jaw muscle acheNeuro: paresthesia, headache, insomnia, abnormal dreams, dizziness, drowsiness, impaired concentration, nervousness, seizures, weakness
Resp:
Nasal spray
cough, dyspneaDrug-drug:
Gum
(Adults ): If first cigarette is desired >30 min after awakening, start with 2 mg gum; if first cigarette is desired <30 min after awakening, start with 4 mg gum. Patients should chew one piece of gum every 1–2 hr for 6 wk, then one piece of gum every 2–4 hr for 3 wk, then one piece of gum every 4–8 hr for 3 wk, then discontinue. Should not exceed 24 pieces of gum/day.Lozenge
(Adults ): If first cigarette is desired >30 min after awakening, start with 2 mg lozenge; if first cigarette is desired <30 min after awakening, start with 4 mg lozenge. Patients should use one lozenge every 1–2 hr for 6 wk, then one lozenge every 2–4 hr for 3 wk, then one lozenge every 4–8 hr for 3 wk, then discontinue. Should not exceed 20 lozenges/day or more than 5 lozenges in 6 hr.Toxicity and Overdose:
nicotine chewing gum: Nicorette,
nicotine lozenge: Nicorette,
nicotine nasal spray: Nicotrol NS,
nicotine transdermal patch: Habitrol, Nicoderm CQ
NDC Code