Nicotine Replacement Therapy, CI: N/A

Effect: reduce nicotine withdrawal/craving

Conditions: Smoking (RF) cessation

CI: N/A

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MOA: agonist of nicotinic cholinergic receptors

Admin: NOT oral, patches, nasal/sublingual

Transdermal patch (long acting) available in different strengths.
Gum, lozenges, inhaler and nasal spray (all short acting) for cravings

Side effects:

Insomnia, bad dreams
Vomiting
Cholinergic poisoning: salivation
Hypertension

Nicotine Dosing	Patch Dose	Gum Dose (Adjunct to patch)	Gum Dose (Monotherapy)
<5 cigarettes per day, or if unable to tolerate NRT	7mg daily	2mg piece q1-2h PRN (max 15 pieces)	2mg piece q1-2h PRN (max 20 pieces)
5-10 cigarettes daily	14mg daily	Same as above	2mg piece q1-2h PRN (max 20 pieces)
10-25 cigarettes daily	21mg daily	Same as above	4mg (FOUR) piece q1-2h PRN (max 20 pieces)
>25 cigarettes daily	21mg x 2 daily	Same as above	4mg (FOUR) piece q1-2h PRN (max 20 pieces)

Reminders: (1) Nicotine patches are the mainstay of withdrawal therapy and should be maximized first! (2) When using the gum, remember to: chew, chew, park