Treatment Recommendations: Medications (Continued)
Clinical guidelines for prescribing medication for treating tobacco
use and dependence (continued)
|When should second-line agents be used for treating tobacco dependence?
||Consider prescribing second-line agents (clonidine and nortriptyline) for patients unable to use first-line medications because of contraindications or for patients for whom the group of first-line medications has not been helpful. Assess patients for the specific contraindications, precautions, other concerns, and side effects of the second-line agents. Please refer to FDA package inserts for this information and to the individual drug tables in this document.
|Which medications should be considered with patients particularly concerned about weight gain?
||Data show that bupropion SR and nicotine replacement therapies, in particular 4 mg nicotine gum and 4 mg nicotine lozenge, delay, but do not prevent, weight gain.
|Are there medications that should be especially considered in patients with a past history of depression?
||Bupropion SR and nortriptyline appear to be effective with this population but nicotine replacement medications also appear to help individuals with a past history of depression.
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