Suggestions for the clinical use of pharmacotherapies for smoking cessation

Quit Tobacco Series: Medication Chart‡‡
See FDA package inserts for more information, including more detailed safety information. Ask your doctor if one of these options is right for you. Medication
Cautions/Warnings
Side Effects
Dosage
Use
Availability (check
insurance)
Bupropion
Not for use if you:
* Insomnia
* Days 1-3: 150 mg each
Start 1-2
Prescription Only:
SR 150
* Use monoamine oxidase (MAO) inhibitor
* Dry mouth
* Generic
* Use bupropion in any other form
* Days 4–end: 150 mg
* Have a history of seizures
twice daily
quit date;
* Wellbutrin SR
* Have a history of eating disorders
FDA Boxed Warning:
Nicotine Gum
* Caution with dentures
* 1 piece every 1 to 2 hours
OTC Only:
(2 mg or 4 mg)
* Do not eat or drink 15
soreness
* 6-15 pieces per day
* Generic
minutes before or during use
* Stomach
* If ≤ 24 cigs: 2 mg
* Nicorette
* If ≥ 25 cigs/day: 4 mg
Nicotine Inhaler
* May irritate mouth/throat at
* 6-16 cartridges/day
Prescription Only:
first (but improves with use)
irritation
* Inhale 80 times/cartridge
* Nicotrol inhaler
* May save partially-used
& throat
cartridge for next day
Nicotine Lozenge
* Do not eat or drink 15 minutes before or
* Hiccups
* If smoke ≥ 30 minutes after
OTC Only:
(2 mg or 4 mg)
during use
waking: 2 mg
* Generic
* One lozenge at a time
* Heartburn
* If smoke ≤ 30 minutes after
* Limit 20 in 24 hours
waking: 4 mg
* Weeks 1-6: 1 every 1-2 hrs
* Wks 7-9: 1 every 2-4 hrs
* Wks 10-12: 1 every 4-8 hrs
Nicotine Nasal Spray
* Not for patients with asthma
* 1 “dose” = 1 squirt per nostril
Prescription
* May irritate nose (improves over time)
irritation
* 1 to 2 doses per hour
* May cause dependence
* 8 to 40 doses per day
* Nicotrol NS
* Do NOT inhale
Nicotine Patch
* Do not use if you have severe eczema or
* Local skin
* One patch per day
(7 mg, 14 mg or 21 mg)
psoriasis
reaction
* If ≥ 10 cigs/day: 21 mg 4 wks,
prescription:
* Insomnia
14 mg 2-4 wks, 7 mg 2-4 wks
* Generic
* Nicoderm CQ
* Nicotrol
Varenicline
Use with caution in patients:
* Days 1-3: 0.5 mg every
Prescription only:
* With significant renal impairment
* Insomnia
* Chantix
* With serious psychiatric illness
* Abnormal,
* Days 4-7: 0.5 mg twice daily
* Undergoing dialysis
* Day 8–end: 1 mg twice daily
quit date;
FDA Boxed Warning:
Combinations:
* Only patch + bupropion is currently FDA-
See individual See individual medications above.
See above.
1) Patch + bupropion
approved.
medications
2) Patch + gum
* Follow instructions for individual
3) Patch + [lozenge or inhaler]
medications.
Updated July 2009
ce Guideline Update: Treating Tobacco Use and Dependence, U.S. Public Health Service, May 2008.

Source: http://www.tobaccofreelivingfdl.com/sft818/medicationchart.pdf