Suggestions for the Clinical Use of Medications for Tobacco Dependence Treatment

Research

^a

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 OTC^b
Nicotine Gum		Mouth soreness Dyspepsia	1-24 cigs/day-2 mg gum (up to 24 pcs/day) 25+cigs/day-4 mg gum (up to 24 pcs/day)	Up to 12 weeks	OTC^b 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	OTC^b 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.

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Current as of December 2012

Internet Citation: Suggestions for the Clinical Use of Medications for Tobacco Dependence Treatment. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/medsmoktab.html