Suggestions for the Clinical Use of Medications for Tobacco Dependence Treatment
| Pharmacotherapy | Precautions/ Contraindications |
Side Effects |
Dosage | Duration | Availability |
|---|---|---|---|---|---|
| Nicotine Patch | Local skin reaction Insomnia |
21 mg/24 hours 14 mg/24 hours 7 mg/24 hours |
4 weeks then 2 weeks then 2 weeks |
Prescription and OTCb | |
| Nicotine Gum | Mouth soreness Dyspepsia |
1-24 cigs/day-2 mg gum 25+cigs/day-4 mg gum |
Up to 12 weeks | OTCb only | |
| Nicotine Nasal Spray | Nasal irritation | 8-40 doses/day | 3-6 months | Prescription only | |
| Nicotine Inhaler | Local irritation of mouth and throat | 6-16 cartridges/day | Up to 6 months | Prescription only | |
| Nicotine Lozenge | Local irritation of throat Hiccups Heartburn/Indigestion Nausea |
First a.m. cigarette after 30 minutes from waking: 2 mg (up to 20 pcs/day) First a.m. cigarette before 30 minutes from waking: 4 mg (up to 20 pcs/day) |
12 weeks | OTCb only | |
| Bupropion SR | History of seizure History of eating disorders Use of MAO inhibitors in past 14 days |
Insomnia Dry mouth |
150 mg every morning for 3 days then 150 mg twice daily (Begin treatment 1-2 weeks pre-quit) |
7-12 weeks maintenance up to 6 months |
Prescription only |
| Varenicline | Monitor for changes in mood, behavior, psychiatric symptoms, maintenance up to and suicidal ideation | Nausea Trouble sleeping |
0.5 mg once daily for days 5-7 before quit date 0.5 mg twice daily for days 1-4 before quit date 1 mg twice daily starting on quit date |
3 months maintenance up to 6 months |
Prescription only |
a. The information contained within this table is not comprehensive. Please see medication package inserts for additional information.
b.OTC refers to over the counter.
