Smoking Cessation Medications Medication Dosing Adverse Effects NICOTINE REPLACEMENT THERAPY Gum 1st cigarette minutes after waking: ≤30 soreness 4mg Hiccups 1st cigarette >30 minutes after waking: Dyspepsia 2mg Hypersalivation Weeks 1-6: 1 piece q1-2 hours Weeks 7-9: 1 piece q2-4 hours Effects associated with Weeks 10-12: 1 piece q4-8 hours incorrect chewing technique: Lightheadedness Maximum 24 pieces/day Nausea/vomiting 24 pieces/day Throat and mouth irritation and park Chew and pa Chew and park Lozenge 1st cigarette minutes after waking: ≤30 Nausea 4mg Hiccups 1st cigarette >30 minutes after waking: 2 Cough mg Heartburn Weeks 1–6: 1 lozenge q1–2 hours Headache Weeks 7–9: 1 lozenge q2–4 Flatulence hours Weeks 10–12: 1 lozenge q4–8 Insomnia hours Maximum, 20 lozenges/day Maximum, 20 lozenges/day Transdermal >10 cigarettes/day: - skin reactions (erythema, -21 mg/day x 4 pruritus, burning) -14 mg/day x 2 weeks - Headache -7 mg/day x 2 - Sleep disturbances (insomnia, abnormal/vivid dreams): associated cigarettes/day: ≤10 with nocturnal nicotine absorption -14 mg/day x 6 *May wear patch for 16 hours if -7 mg/day x 2 weeks patient experiences sleep disturbances (remove at bedtime) 1–2 doses/hour Nasal Spray Nasal and/or throat (8–40 irritation (hot, peppery, or *One dose = 2 sprays (one in each nostril) burning sensation) - Maximum: 5 doses/hour or 40 Rhinitis doses/day Tearing - Duration: 3–6 months Sneezing - Cough Headache Duration:
Smoking Cessation Medications Medication Dosing Adverse Effects NICOTINE REPLACEMENT THERAPY Gum 1st cigarette ≤30 minutes after waking: 4mg 1st cigarette >30 minutes after waking: 2mg Weeks 1-6: 1 piece q1-2 hours Weeks 7-9: 1 piece q2-4 hours Weeks 10-12: 1 piece q4-8 hours Maximum 24 pieces/day 24 pieces/day and park Chew and pa Chew and park soreness Hiccups Dyspepsia Hypersalivation Effects associated with incorrect chewing technique: Lightheadedness Nausea/vomiting Throat and mouth irritation Lozenge 1st cigarette ≤30 minutes after waking: 4mg 1st cigarette >30 minutes after waking: 2 mg Weeks 1–6: 1 lozenge q1–2 hours Weeks 7–9: 1 lozenge q2–4 hours Weeks 10–12: 1 lozenge q4–8 hours Maximum, 20 lozenges/day Maximum, 20 lozenges/day Nausea Hiccups Cough Heartburn Headache Flatulence Insomnia Transdermal >10 cigarettes/day: -21 mg/day x 4 -14 mg/day x 2 weeks -7 mg/day x 2 ≤10 cigarettes/day: -14 mg/day x 6 -7 mg/day x 2 weeks - skin reactions (erythema, pruritus, burning) - Headache - Sleep disturbances (insomnia, abnormal/vivid dreams): associated with nocturnal nicotine absorption *May wear patch for 16 hours if patient experiences sleep disturbances (remove at bedtime) Nasal Spray 1–2 doses/hour (8–40 *One dose = 2 sprays (one in each nostril) - Maximum: 5 doses/hour or 40 doses/day - Duration: 3–6 months Duration: Nasal and/or throat irritation (hot, peppery, or burning sensation) Rhinitis Tearing Sneezing - Cough Headache
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