Nicotine lozenge

NICORETTE

Open Nicotine lozenge in the interactive console ↗

What it isBuccal nicotinic-receptor agonist replacement; smoking cessation.

Why this onePortable and patient-controlled for breakthrough cravings, it dissolves slowly over ~20-30 min and avoids the chewing technique required by gum.

What limits itInstructions — dose by time-to-first-cigarette; no chewing or swallowing, and no food or drink 15 min before. Hiccups, nausea, and mouth irritation follow swallowed saliva.

FDA-approved for

smoking cessation (2002)

FDA label

Read the full label on DailyMed ↗

FDA dosing	Population	Start	Target	Max
Smoking cessation — reduces withdrawal symptoms including nicotine craving	Adults ≥18 yr (under 18: ask a doctor)	Weeks 1–6: 1 lozenge every 1–2 hr (≥9/day)	Weeks 7–9: 1 lozenge every 2–4 hr; Weeks 10–12: 1 lozenge every 4–8 hr	5 lozenges in 6 hr; 20 lozenges/day

Renal Undefined

Hepatic Undefined

Do not use more than 5 lozenges in 6 hours or more than 20 per day; do not use more than one lozenge at a time.

Instructions

Begin on quit day
Use 4 mg lozenge if first cigarette is within 30 min of waking; use 2 mg if first cigarette is more than 30 min after waking
Place lozenge in mouth and let it slowly dissolve (~20–30 min); minimize swallowing; do not chew or swallow; occasionally move from side to side
Do not eat or drink 15 min before or while the lozenge is in your mouth
Use at least 9 lozenges/day for the first 6 weeks; do not use more than one at a time or continuously
Complete the 12-week treatment

Contraindications

Do not use if you are allergic to soya

Cautions

Ask a doctor before use if you have: a sodium-restricted diet; heart disease, recent heart attack, or irregular heartbeat; uncontrolled high blood pressure; stomach ulcer or diabetes; history of seizures
Ask a doctor or pharmacist before use if using a non-nicotine stop-smoking drug or taking prescription medicine for depression or asthma (dose may need adjustment)
Stop use and ask a doctor if mouth problems, persistent indigestion or severe sore throat, irregular heartbeat/palpitations, symptoms of nicotine overdose, or allergic reaction occur
Keep out of reach of children and pets — lozenges may contain enough nicotine to make them sick

Adverse reactions

Hiccups, heartburn, nausea (from using too many or one after another)
Mouth problems; warm or tingling sensation
Nicotine overdose symptoms: nausea, vomiting, dizziness, diarrhea, weakness, rapid heartbeat

Pregnancy If pregnant, use only on the advice of a health care provider; smoking can seriously harm your child.

Lactation If breast-feeding, use only on the advice of a health care provider.

NO BOXED WARNINGS

Principal riskLocal irritation; vivid dreams with the overnight patch