There are several options of prescription and non-prescription
medications that aid in smoking cessation. We have outlined a few of the most commonly used options
to help you decide if medication is right for you. Studies have shown that medications can greatly
enhance your chances of quitting. As we’ve said, this list is not exhaustive and if you
have questions about other options such as the nicotine inhaler, talk with your health care provider.
Bupropion HCL (generic name)
(Zyban, Wellbutrin, Wellbutrin SR)
Bupropion HCL (Zyban) is a prescription
medication originally developed and marketed to treat depression under
the name Wellbutrin. This medication can help people who want to stop
smoking without using nicotine patches or gum. Zyban is believed to stimulate
dopamine, a brain chemical that causes a "feel-good" response
similar to that produced by nicotine and other drugs of addiction.
This medication does not contain nicotine and is not addicting. Studies suggest
that this medication may be as effective as nicotine patches in aiding people who want to stop
smoking.
Tips on Use
This medication does not contain nicotine. You should not use this medication
if you are already taking Wellbutrin, Wellbutrin Sr or any other medicines containing bupropion
HCL; have had an eating disorder; have a history of seizure; are pregnant or breast-feeding; or
are currently taking or have recently taken a monoamine oxidase (MAO) inhibitor. Tell your physician
the name and dosage of every medication you are taking.
The starting dose for Zyban is usually 150 mg once a day for 3-7 days. The dose
is increased to 150 mg twice per day. The evening dose should be taken before 5 pm to reduce the
likelihood of insomnia or sleep disturbances. Doses should be taken at least 8 hours a part.
If you forget to take a dose, do not take an extra tablet to “catch up”
for the dose you forgot. Wait and take your next tablet at the regular time.
Possible Side Effects and Warnings
The most common side effects include dry mouth, headache, and difficulty
sleeping. These side effects are generally mild and often disappear after a few weeks.
There is a chance that approximately 1 out of every 1,000 people taking bupropion
will have a seizure. The chance of this happening increases if you: have a seizure disorder, have
or have had an eating disorder, take more than the recommended dose, or take other medications
with the same ingredient (Wellbutrin, Wellbutrin SR, Zyban).
It is recommended to not drink alcohol at all, or to drink very little, while
taking ZYBAN. People who consume a lot of alcohol and then suddenly stop drinking may increase
their risk of seizure. Some people have reported lower alcohol tolerance during treatment with
ZYBAN. Be sure to discuss this matter with your healthcare professional before you begin taking
ZYBAN.
While this medication can be an effective tool to help you stop smoking, it works
best when used as a part of a treatment program that includes the support of healthcare professionals.
Nicotine Gum
(Nicorette)
Nicotine gum is a form of nicotine replacement therapy
(NRT) available without prescription. It is a gum-like product that delivers nicotine through
the lining of your cheeks to lessen the symptoms of nicotine withdrawal like cravings and irritability.
Although Nicorette will not give you the same amount
of nicotine as cigarettes or spit tobacco, it will let you focus on changing
your behaviors that go with tobacco use. You will probably have an urge
to smoke or chew at times, so having a plan to cope is important. Our
health educators can work with you on developing a personalized plan to
help you cope.
Tips on Use
Nicorette is available in 2mg and 4mg dosages.
The nicotine in a 2mg dose is equal to about one cigarette. Before using
Nicorette, read the instructions on the package carefully.
- Use Nicorette on a regular schedule, such as one piece
per hour.
- Bite Nicorette a few times until you feel a tingling
sensation or you taste nicotine. However, do NOT chew Nicorette like
gum.
- Hold the Nicorette between your cheek and gum, toward
the front of your mouth.
- When the tingling stops, bite the gum again until the tingling or taste returns
(chew and park method).
- Continue biting and holding the Nicorette until only
a mint flavor remains. This takes about 30 minutes.
- Avoid acidic beverages such as soda or juice, 15 minutes
before using Nicorette. The acidity in the beverages can cause less
of the nicotine to be absorbed causing the gum to be less effective.
If consumed, rinse your mouth with water prior to using the gum.
- Do not eat or drink anything while using Nicorette.
Any nicotine that is swallowed with saliva or liquid will NOT be effective
and may cause side effects such as heartburn or nausea.
- To receive the greatest benefit chew approximately the same number of pieces
of gum as you would smoke cigarettes per day and gradually decrease the dose.
Possible Side Effects
The most common side effects are mouth soreness, hiccups, indigestion, and jaw ache.
If you become nauseous or have other problems, contact your provider. It
is possible that you are receiving more nicotine than you need for NRT. Other symptoms include
cold sweat, diarrhea, blurred vision, vomiting, dizziness and headaches.
Warnings
- Do not smoke while using Nicorette.
- The safety of using Nicorette during pregnancy is
unknown.
- If you have heart disease, inform your provider before beginning NRT.
- Keep this and all medication out of reach of children and pets.
- Do NOT swallow Nicorette.
Nicotine Patch
(Nicoderm CQ, Nicotrol)
The nicotine patch is a form of nicotine replacement
therapy (NRT) available at pharmacies without a prescription. It delivers a steady dose of nicotine
through your skin to lessen the symptoms of nicotine withdrawal like cravings and irritability.
Although the nicotine patch will not give you
the same levels of nicotine as smoking or chewing, it will let you focus on changing your behaviors
that go with tobacco use. You probably will have an urge to smoke or chew at times, so having
a plan to cope with these times is important.
Tips on Use
Patches produced by different manufacturers contain different amounts of nicotine, measured in
milligrams (mg), which deliver nicotine through the skin. The nicotine in one 21-mg patch is equal
to approximately 15-20 cigarettes. Your health-care provider may start you on a lower dose patch
if you smoke less than one pack of cigarettes per day. Over a period of weeks the dose is lowered.
Before using the patch, read the instructions on the package carefully. Apply
the patch on the first day you stop smoking. After that, apply a new patch each day – in
the morning. The patch should remain attached at all times so if it comes off, apply a new patch.
Most brands are intended to be worn 24 hours per day. The patch may be placed anywhere on your
upper body – including your arms, chest, back and abdomen. Non-hairy sites, not rubbed by
clothing, are best. Rotate the patch site on your upper body each time a new patch is applied.
Possible Side Effects
Problems with the patches often relate to skin irritation and usually don’t occur until
several weeks after use. If irritation occurs, apply hydrocortisone cream to the area each time
you remove a patch. Hydrocortisone cream can be purchased without a prescription at a drugstore.
If you become nauseous or have other problems with the patch, stop using
the patch and contact your health care provider. It is possible that you are receiving more nicotine
than you need for NRT. Other symptoms include cold sweat, diarrhea, blurred vision, vomiting,
dizziness and headaches.
Warnings
- Do not smoke while using the nicotine patch.
- The safety of using the nicotine patch during pregnancy is unknown.
- If you have heart disease, inform your provider before beginning NRT.
- Keep this and all medication out of reach of children and pets.
Nicotine Lozenge
(Commit™)
The Nicotine lozenge is a form of nicotine replacement
therapy (NRT) available without prescription that is similar to nicotine gum. The nicotine lozenge
was approved by the FDA for use as a tobacco cessation aid in October of 2002. It is a lozenge
that delivers nicotine through the lining of your cheeks to lessen the symptoms of nicotine withdrawal
like cravings and irritability.
Although the nicotine lozenge will not give you the
same amount of nicotine as cigarettes or spit tobacco, it will let you focus on changing the behaviors
that go with tobacco use. You will probably have an urge to smoke or chew at times, so having
a plan to cope is important. Our health educators can work with you on developing a personalized
plan to help you cope.
Tips on Use
- Commit is available in 2 mg and 4 mg dosages. Before
using Commit read the instructions on the package carefully.
- Place a Commit Lozenge in your mouth and allow it to dissolve slowly. Don’t
chew or swallow it – you won’t absorb the correct dose of medication if you do.
Consuming the nicotine lozenge too fast could also lead to heartburn or indigestion.
- You may feel a warm or tingling sensation as nicotine is released and makes
contact with your mouth tissues.
- Occasionally move the nicotine lozenge from one side of your mouth to the
other, just like you would any lozenge. It will take about 20-30 minutes for the stop-smoking
lozenge to dissolve completely.
- Avoid acidic beverages such as soda or juice, 15
minutes before using Commit. The acidity in the beverages can cause
less of the nicotine to be absorbed causing the lozenge to be less effective.
If beverages are consumed, rinse your mouth with water prior to using
the lozenge.
- Do not use more than one lozenge at a time or continuously use one lozenge
after the other. Doing so may cause hiccups, heartburn, nausea or other side effects.
- Do not use more than 5 lozenges in 6 hours, or more than 20 lozenges total
per day.
SIDE EFFECTS
The most common side effects are insomnia, nausea, hiccups, coughing, heartburn, headache and
flatulence. Side effects are generally mild.
If you become nauseous or have other problems, contact your provider. It
is possible that you are receiving more nicotine than you need for NRT. Other symptoms include
cold sweat, diarrhea, blurred vision, vomiting, dizziness and headaches.
WARNINGS
- Do not smoke while using Commit
- The safety of using Commit during pregnancy is unknown.
- If you have heart disease, inform your provider before beginning NRT.
- Keep this and all medication out of reach of children and pets.
- Do NOT swallow Commit.
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