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Nicotine (Inhalation route)

Pronunciation:

NIK-oh-teen

Brand Names:

  • Nicotrol
  • Nicorette Inhaler

Dosage Forms:

  • Aerosol Powder
  • Device
  • Aerosol Liquid

Classifications:

Therapeutic—

Smoking Cessation Agent

Pharmacologic—

Cholinergic

Uses of This Medicine:

Nicotine, in an inhaler is used to help you stop smoking. It is used for up to 6 months as part of a stop-smoking program. This program may include counseling, education, specific behavior change techniques, or support groups.

With the inhaler, nicotine is inhaled through the mouth and is absorbed in the mouth and throat, but not in the lungs. Eight to ten puffs on the inhaler provide about the same amount of nicotine as one puff on an average cigarette. This nicotine takes the place of the nicotine that you would otherwise get from smoking. In this way, the withdrawal effects of not smoking are less severe. Then, as your body adjusts to not smoking, the use of the nicotine inhaler is decreased gradually over several weeks. Finally, use is stopped altogether.

Children, pregnant women, and nonsmokers should not use nicotine inhaler because of harmful effects.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of nicotine inhaler in the pediatric population. Safety and efficacy have not been established.

Older adults—

Although appropriate studies on the relationship of age to the effects of nicotine inhaler have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving nicotine inhaler. .

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding—

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Tegafur

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Asthma or other breathing problems or
  • Heart attack, history of or
  • Heart or blood vessel disease or
  • Heart rhythm problems or
  • Hypertension (high blood pressure) or
  • Overactive thyroid or
  • Pheochromocytoma (an adrenal problem) or
  • Stomach ulcer or
  • Type 1 diabetes mellitus (sugar diabetes)—Use with caution. Nicotine may make these conditions worse.
  • Drug abuse or
  • Drug dependence—Dependence may be more likely to develop.
  • Kidney disease or
  • Liver disease—Use with caution. Effects may be increased because of slower removal of the medicine from the body.

Proper Use of This Medicine:

Nicotine inhaler usually comes with patient directions. Read the directions carefully before using this medicine. Ask your doctor if you have any questions.

The nicotine inhaler should be used at or above room temperature (60 °F [16 °C]). Cold temperatures decrease the amount of nicotine you inhale.

You should stop smoking completely before you start using this medicine. If you continue to smoke during treatment, you may have an increased risk of nicotine overdose.

Use this medicine exactly as directed by your doctor. Remember that it is important to participate in a stop-smoking program during treatment. This may make it easier for you to stop smoking.

Wash the mouthpiece of the inhaler with soap and water regularly after each use.

To decrease the risk of becoming dependent on the nicotine inhaler, your doctor may instruct you to stop treatment gradually. This may be done by keeping track of, and steadily reducing, use of the nicotine inhaler or by setting a planned date for stopping use of the inhaler.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For inhalation dosage form (cartridge):
    • To help you stop smoking:
      • Adults and older teenagers—At first, 6 to 16 cartridges per day for up to twelve weeks. Your dose is gradually reduced over a period of up to twelve weeks.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

Do not smoke during treatment with the nicotine inhaler because of the risk of nicotine overdose.

Do not use the nicotine inhaler for longer than 6 months if you have stopped smoking because continuing use of nicotine in any form can be harmful and addictive.

Nicotine should not be used in pregnancy. If there is a possibility you might become pregnant, you may want to use some type of birth control. If you think you may have become pregnant, stop taking this medicine immediately and check with your doctor.

Nicotine products must be kept out of the reach of children and pets. Even used nicotine inhaler cartridges contain enough nicotine to cause serious harm in children. If a child chews on or swallows a cartridge, contact your doctor or poison control center at once.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
Fast or irregular heartbeat
fever with or without chills
headache
nausea with or without vomiting
runny nose
shortness of breath, tightness in the chest, trouble with breathing, or wheezing
skin rash, itching, or hives
tearing of the eyes

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
Abdominal or stomach pain
cold sweat
confusion
convulsions (seizures)
disturbed hearing and vision
drooling
extreme exhaustion
pale skin
slow heartbeat
tremors

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Acid or sour stomach
belching
coughing
heartburn
indigestion
mouth and throat irritation
stomach discomfort, upset, or pain
stuffy nose
Less common
Anxiety
back pain
change in taste
diarrhea
dizziness
feeling of burning, numbness, tightness, tingling, warmth, or heat
feelings of drug dependence
flu-like symptoms
general pain
hiccups
mental depression
pain in the jaw and neck
pain in the muscles
passing of gas
problems with teeth
trouble with sleeping
unusual tiredness or weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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