Categorized | Health

Nicotine Replacement Therapy

The American Food and Drug Administration (FDA) has approved 5 types of nicotine replacement therapy:

Nicotine patches (transdermal nicotine systems)

Patches give a measured dose of nicotine through the skin. You are weaned off nicotine by switching to lower-dose patches over a course of weeks. Patches can be bought with or without a prescription. Many types and different strengths are available.

Some possible side effects of the nicotine patch include: skin irritation such as redness and itching, dizziness, racing heartbeat, sleep problems or unusual dreams, headache, nausea, vomiting, muscle aches and stiffness.

Nicotine gum (nicotine polacrilex)

Nicotine gum is a fast-acting form of replacement in which nicotine is taken in through the mucous membrane of the mouth. You can buy it over the counter without a prescription. If you have sensitive skin, you may prefer the gum to the patch.

An advantage of nicotine gum is that it allows you to control the nicotine doses. The gum can be chewed as needed or on a fixed schedule during the day. The most recent research has shown that scheduled dosing works better. A schedule of 1 to 2 pieces per hour is common. On the other hand, with an as-needed schedule, you can chew when you need it most — when you have cravings.

Some possible side effects of nicotine gum: bad taste, throat irritation, mouth sores, hiccups, nausea, jaw discomfort, racing heartbeat. The gum can also damage dentures and dental work.

Nicotine nasal spray

The nasal spray delivers nicotine to the bloodstream as it is quickly absorbed through the nose. It is available only by prescription.

The nasal spray relieves withdrawal symptoms very quickly and lets you control your nicotine cravings. Smokers usually like the nasal spray because it is easy to use. But the FDA warns users that since this product contains nicotine, it can allow the addiction to continue. The FDA recommends that the spray be prescribed for 3-month periods and that it not be used for longer than 6 months.

The most common side effects last about 1 to 2 weeks and can include the following: nasal irritation, runny nose, watery eyes, sneezing, throat irritation, coughing.

There is also the danger of using more than is needed. If you have asthma, allergies, nasal polyps, or sinus problems, your doctor may suggest another form of NRT.

Nicotine inhalers

Inhalers are available only by prescription. The nicotine inhaler is a thin plastic tube with a nicotine cartridge inside. When you take a puff from the inhaler, the cartridge puts out a nicotine vapor. Unlike other inhalers, which deliver most of the medicine to the lungs, the nicotine inhaler delivers most of the nicotine vapor to the mouth. Nicotine inhalers are the FDA-approved nicotine replacement method that is most like smoking a cigarette, which some smokers find helpful.

The most common side effects, especially when first using the inhaler, include: coughing, throat irritation, upset stomach

At this time, inhalers are the most expensive forms of NRT available.

Nicotine lozenges

Nicotine-containing lozenges as an over-the-counter aid to stop smoking are the newest form of NRT on the market. As with nicotine gum, the lozenge is available in 2 strengths: 2 mg and 4 mg. Smokers choose their dose based on how long after waking up they normally have their first cigarette.

Possible side effects of the nicotine lozenge include:trouble sleeping, nausea, hiccups, coughing heartburn, headache, flatulence (gas).


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