AdultPediatricDosage Forms and Strengths oral inhaler 10mg/cartridge (4 mg delivered) Smoking Cessation Indicated to reduce withdrawal symptoms during smoking cessation Best effect observed with frequent, continuous puffing over 20 minute periods throughout the day 6 or more cartridges/day PRN [4 mg/cartridge]; do not exceed 16 cartridges/day Use at least 6 cartridges/day for the first 3-6 weeks for improved success at quiting Administration Before initiating nicotine replacement reatment, patient must have desire to stop smoking Most effective as part of comprehensive smoking cessation plan See product user's guides for detailsNot recommendedInteraction CheckerEnter a drug name and nicotine inhaledNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (1)cabotegravirnicotine inhaled will decrease the level or effect of cabotegravir by increasing metabolism. Contraindicated. Cabotegravir is metabolized by UGT1A1 and UGT1A9. Strong UGT1A1 or UGT1A9 inducers decrease cabotegravir systemic exposure, thereby increasing potential for loss of virologic response.Serious - Use Alternative (0)Monitor Closely (6)adenosinenicotine inhaled increases effects of adenosine by unknown mechanism. Use Caution/Monitor. Adenosine associated tachycardia and chest pain.cimetidinecimetidine increases levels of nicotine inhaled by decreasing renal clearance. Use Caution/Monitor.esketamine intranasalesketamine intranasal, nicotine inhaled. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .green teagreen tea, nicotine inhaled. Other (see comment). Use Caution/Monitor. Comment: Green tea may include caffeine. Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants. Caffeine should be avoided or used cautiously.solriamfetolnicotine inhaled and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.vareniclinevarenicline increases toxicity of nicotine inhaled by Other (see comment). Use Caution/Monitor. Comment: Varenicline is a partial agonist at the nicotinic Ach receptor; concomitant use with nicotine replacement therapy may increase adverse effects.Minor (5)bupropionbupropion, nicotine inhaled. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypertension.dihydroergotaminedihydroergotamine, nicotine inhaled. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.dihydroergotamine intranasaldihydroergotamine intranasal, nicotine inhaled. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.niacinnicotine inhaled increases effects of niacin by pharmacodynamic synergism. Minor/Significance Unknown.rose hipsnicotine inhaled decreases levels of rose hips by increasing elimination. Minor/Significance Unknown.adenosineMonitor Closely (1)nicotine inhaled increases effects of adenosine by unknown mechanism. Use Caution/Monitor. Adenosine associated tachycardia and chest pain.bupropionMinor (1)bupropion, nicotine inhaled. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypertension.cabotegravirContraindicated (1)nicotine inhaled will decrease the level or effect of cabotegravir by increasing metabolism. Contraindicated. Cabotegravir is metabolized by UGT1A1 and UGT1A9. Strong UGT1A1 or UGT1A9 inducers decrease cabotegravir systemic exposure, thereby increasing potential for loss of virologic response.cimetidineMonitor Closely (1)cimetidine increases levels of nicotine inhaled by decreasing renal clearance. Use Caution/Monitor.dihydroergotamineMinor (1)dihydroergotamine, nicotine inhaled. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.dihydroergotamine intranasalMinor (1)dihydroergotamine intranasal, nicotine inhaled. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.esketamine intranasalMonitor Closely (1)esketamine intranasal, nicotine inhaled. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .green teaMonitor Closely (1)green tea, nicotine inhaled. Other (see comment). Use Caution/Monitor. Comment: Green tea may include caffeine. Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants. Caffeine should be avoided or used cautiously.niacinMinor (1)nicotine inhaled increases effects of niacin by pharmacodynamic synergism. Minor/Significance Unknown.rose hipsMinor (1)nicotine inhaled decreases levels of rose hips by increasing elimination. Minor/Significance Unknown.solriamfetolMonitor Closely (1)nicotine inhaled and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.vareniclineMonitor Closely (1)varenicline increases toxicity of nicotine inhaled by Other (see comment). Use Caution/Monitor. Comment: Varenicline is a partial agonist at the nicotinic Ach receptor; concomitant use with nicotine replacement therapy may increase adverse effects. >10% Mouth/throat irritation (66%) Cough (32%) Headache (18-26%) Rhinitis (23%) Dyspepsia (18%) 1-10% Back pain (6%) Arthralgia (5%) Flatulence (4%) Gum problems (4%) Acne (3%) Dysmenorrhea (3%) <1% Nicotine withdrawal (irritability, dizziness, headache, insomnia) Hiccups N/V Anorexia Diarrhea Increased salivation Cardiac dysrhythmia (rare) Hypertension (rare) Tachyarrhythmia (rare) Immune hypersensitivity reaction (rare) Contraindications Hypersensitivity to nicotine or components Active smokers following the postmyocardial period Patients with life-threatening arrhythmias or worsening of angina pectoris if severe Nonsmokers Cautions Not studied in reactive airway disease; may cause bronchospasm Caution with hypertension, cardiovascular, or peripheral vascular disease Caution with hyperthyroidism, pheochromocytoma, or insulin-dependent diabetes, since nicotine causes the release of catecholamines by the adrenal medulla Delays healing of peptic ulcer disease Use caution in patients with oropharyngeal inflammation, peptic ulcer, or history of esophagitis Caution in severe renal impairment Pregnancy Category: D Lactation: Unknown whether excreted in breast milk; use cautionPregnancy 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 Agonist at nicotinic receptors; potent ganglionic and central nervous stimulant Absorption Peak plasma time: 15 minutes Distribution Protein binding: <5% Vd: 2-3 L/kg Metabolism Metabolism: liver (some renal, lung) Metabolites: over 20, less active Elimination Clearance: 1.2 L/min Excretion: urine (30%) 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 inhalationnicotine transdermalnicotine nasalPrint Patient Educationnicotine inhalation NICOTINE INHALER - ORAL INHALATION (NICK-oh-teen) COMMON BRAND NAME(S): Nicotrol 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. Using the inhaler can replace the hand-to-mouth habit of smoking.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 inhaler 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. Insert a cartridge into the mouthpiece and inhale the medication by quickly puffing on the mouthpiece for four 5-minute sessions or continually for about 20 minutes. Although using the inhaler is like smoking a cigarette, you do not need to inhale deeply as you would a cigarette for the medicine to work. The medicine works in the mouth and throat, not in the lungs.Avoid acidic food and drink (such as citrus fruit, coffee, juices, carbonated drinks) for 15 minutes before inhaling this medication.After using the inhaler for a total of 20 minutes, remove the used cartridge and throw it away out of reach of children and pets. The mouthpiece is reusable. Clean with soap and water.When you quit smoking, start using a nicotine cartridge whenever you crave a cigarette. Usually, you will use at least 6 cartridges each day for the first 3 to 6 weeks or as directed by your doctor. Do not use more than 16 cartridges 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 can help your body get used to the medication and decrease side effects such as sore throat. 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.After you have stopped smoking and you have reached the best dose and schedule for you, continue at that dose. Usually, after about 3 months, your doctor will help you gradually reduce your dose until you are no longer smoking and no longer need nicotine replacement.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: Headache, nausea, mouth/tooth/throat pain, cough, runny/stuffy nose, change in taste, heartburn, hiccups, sweating, or diarrhea 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: severe 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), 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