AdultPediatricDosage Forms & Strengths transdermal patch 7mg/day 14mg/day 21mg/day Smoking Cessation >10 cigarettes/day 21/14/7-mg regimen: 21-mg patch once daily for 6 weeks, then 14-mg patch once daily for 2 weeks, then 7-mg patch once daily for 2 weeks ≤10 cigarettes/day 14/7-mg regimen: 14-mg patch once daily for 6 weeks, then 7-mg patch once daily for 2 weeks Administration Apply to clean, dry, nonhairy area of skin (typically upper arm or shoulder) Apply new patch upon awakening and wear patch for 24 hours, unless vivid dreams or insomnia occur (then remove patch before bedtime) Do not cut patch There are no significant safety concerns associated with using more than 1 over-the-counter (OTC) nicotine replacement therapy (NRT) simultaneously or at same time as another nicotine-containing product (including cigarettes) Patients who use OTC NRT while trying to quit smoking but slip up and smoke should not stop using NRT but should keep trying to quit NRT users should still pick "quit day" and begin using OTC NRT product on that day even if they are not immediately able to stop smoking It is important for patients to complete the full program, but some may need to use NRT for longer periods to keep from smokingSafety and efficacy not established Frequency Not Defined Acne Anorexia Arthralgia Back pain Bronchitis Cough Diarrhea Dizziness Dysmenorrhea Dyspepsia Headache Hiccups Increased blood pressure Increased salivation Indigestion Insomnia Irritability Irritation at application site Jaw or neck pain Migraine Nausea Rhinitis Sinusitis Tachycardia Taste disturbance Tooth abrasions Vomiting Xerostomia Contraindications Hypersensitivity to drug or excipients Cautions Weigh risk versus benefits in patients with cardiovascular or peripheral vascular disease, including history of myocardial infarction, serious cardiac arrhythmia, or vasospastic diseases (eg, Prinzmetal angina, Raynaud phenomena) Use caution in patients with oropharyngeal inflammation, peptic ulcer disease, or history of esophagitis Use with caution in patients with insulin-dependent diabetes, pheochromocytoma, or hyperthyroidism Extensively metabolized in liver; hepatic impairment may decrease clearance Peptic ulcer formation and delayed wound healing associated with nicotine replacement therapies Poisoning or fatality may occur in children if agent is inhaled, ingested, or buccally absorbed Use caution in patients with angina, recent myocardial infarction, or hypertension Before using consider the following Heart disease, recent heart attack, or irregular heartbeat; nicotine can increase heart rate High blood pressure not controlled with medication; nicotine can increase blood pressure An allergy to adhesive tape or have skin problems because you are more likely to get rashes Diabetes History of seizures Stop use if the following occur Skin redness caused by the patch does not go away after four days, or if skin swells, or get a rash Irregular heartbeat or palpitations Experience symptoms of nicotine overdose such as nausea, vomiting, dizziness, weakness, and rapid heartbeat Symptoms of an allergic reaction (such as difficulty breathing or rash) Pregnancy category: D; tobacco smoke is known to cause low birth weight, spontaneous abortion, increased perinatal mortality, decreased placental perfusion; however, nicotine replacement is believed to be safer during pregnancy than smoking Lactation: Nicotine and metabolite (cotinine) pass into breast milk after maternal smoking; risk of exposing infant to 2nd-hand smoke may be more detrimental than that posed by NRT; nicotine may increase infant heart rate Pregnant or breastfeeding patients should seek advice of healthcare professional before using OTC drugsPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Systemically absorbed; binds to nicotine receptors; reduces withdrawal symptoms (including nicotine craving) associated with smoking cessation Absorption Absorption: 68% Duration: 24 hr Peak plasma time: 8-9 hr Peak plasma concentration: 5-17 ng/mL (average) Elimination Half-life: 3-4 hr Excretion: Urine BRAND FORM. UNIT PRICE PILL IMAGE nicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 7 mg/24 hr transdermal systemnicotine transdermal- 14 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 14 mg/24 hr transdermal systemnicotine transdermal- 21-14-7 mg/24 hr transdermal systemnicotine transdermal- 7 mg/24 hr transdermal systemnicotine transdermal- 7 mg/24 hr transdermal systemnicotine transdermal- 14 mg/24 hr transdermal systemnicotine transdermal- 14 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 14 mg/24 hr transdermal systemnicotine transdermal- 7 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 14 mg/24 hr transdermal systemnicotine transdermal- 7 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 14 mg/24 hr transdermal systemnicotine transdermal- 7 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemnicotine transdermal- 21 mg/24 hr transdermal systemNicoderm CQ transdermal- 21 mg/24 hr transdermal systemNicoderm CQ transdermal- 14 mg/24 hr transdermal systemNicoderm CQ transdermal- 21 mg/24 hr transdermal systemNicoderm CQ transdermal- 7 mg/24 hr transdermal systemNicoderm CQ transdermal- 7 mg/24 hr transdermal systemNicoderm CQ transdermal- 21 mg/24 hr transdermal systemNicotrol inhalation- 10 mg solutionNicotrol NS nasal- 10 mg/mL liquidCopyright © 2010 First DataBank, Inc.Select a drug:nicotine nasalnicotine inhalationnicotine transdermalPrint Patient Educationnicotine nasal NICOTINE SPRAY - NASAL (NICK-oh-teen) COMMON BRAND NAME(S): Nicotrol NS USES: This medication can help you quit smoking by replacing the nicotine in cigarettes. The nicotine in tobacco is an important part of cigarette addiction. When you stop smoking, your nicotine levels drop quickly. This drop can cause withdrawal symptoms such as craving tobacco, nervousness, irritability, headache, weight gain, and difficulty concentrating.Stopping smoking is hard and your chance of success is best when you are ready and have made a commitment to quit. Nicotine replacement products are part of a total stop-smoking program that includes behavior change, counseling, and support. Smoking causes lung disease, cancer, and heart disease. Stopping smoking is one of the most important things you can do to improve your health and live longer. HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start using your nicotine nasal spray and each time you get a refill. Follow all the directions for use carefully. If you have any questions, consult your doctor or pharmacist.It is very important to stop smoking completely while using this nicotine product. Tilt your head back and use 1 spray in each nostril or as directed by your doctor. Do not sniff, swallow, or inhale through the nose as you use the spray. Follow all instructions and learn proper technique for use.When you quit smoking, start using your nicotine nasal spray whenever you crave a cigarette, using 2 to 4 sprays per hour. Usually, you will use at least 8 doses (16 sprays) each day when you first start or as directed by your doctor. Do not use more than 40 doses total (80 sprays) in a day. Your doctor may direct you to use this product on a regular schedule as well as at times when you have the urge to smoke. Regular use during the first week can help your body get used to the medication and decrease side effects such as nose irritation. The best dose for you is the dose that decreases the urge to smoke without side effects from too much nicotine. Follow your doctor's orders carefully. Your dose will need to be adjusted to your needs, including smoking history and medical condition.If this drug touches the skin, lips, mouth, or ears, rinse the affected area right away with water. Do not use soap. If this medication gets into your eyes, flush your eyes with clear water for 20 minutes. Discard used containers with the child-resistant cap on and away from the reach of children and pets.After you have stopped smoking and you have reached the best dose and schedule for you, continue at that dose. Usually, after about 8 weeks, your doctor will help you gradually reduce your dose until you are no longer smoking and no longer need nicotine replacement. Treatment for longer than 6 months is usually not recommended, but consult your doctor.If you suddenly stop using this medication, you may have withdrawal symptoms (such as tobacco cravings, nervousness, irritability, headache). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used nicotine for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.Tell your doctor if you have not been able to quit smoking after using this product for 4 weeks. Some smokers are unsuccessful the first time they try to quit. You may need to stop using this product and try again later. Many people who cannot quit the first time are successful the next time. SIDE EFFECTS: Nasal irritation/blistering/tingling, runny or bloody nose, throat irritation, watering eyes, sneezing, cough, heartburn, or a change in taste or smell may occur. Common nicotine withdrawal symptoms can occur when you stop smoking and include: dizziness, anxiety, depression, or trouble sleeping, among others. If any of these withdrawal symptoms or side effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Serious side effects are more likely if you continue to smoke while using this product. Do not smoke while you are using this medication.Stop using this medication and tell your doctor right away if you have any serious side effects, including: dizziness, mental/mood changes (such as irritability, trouble sleeping, vivid dreams), numbness/tingling in hands/feet, swelling hands/ankles/feet.Stop using this medication and get medical help right away if you have any very serious side effects, including: chest pain, confusion, severe headache, fast/irregular/pounding heartbeat, trouble speaking, weakness on one side of the body.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Before using this product, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood vessel disease (such as Raynaud's disease, stroke), breathing problems (such as asthma, emphysema), diabetes, heart disease (such as chest pain, heart attack, irregular heartbeat), high blood pressure, liver disease, kidney disease, esophagus problems (such as esophagitis), chronic nasal disorders (such as nasal allergies, nasal polyps, sinusitis), stomach/intestinal sores (peptic ulcers), certain adrenal problem (pheochromocytoma), overactive thyroid (hyperthyroidism), seizures.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Nicotine and smoking may harm an unborn baby. If you are pregnant, try to stop smoking without using a nicotine replacement product if possible. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.Nicotine from smoking and from this medication passes into breast milk and could have undesirable effects on a nursing infant. Smoking near an infant can also harm the infant. Consult your doctor before breast-feeding. DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs