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TRANSDERMAL
|
|
Habitrol (Novartis
Consumer Health)
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R
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Nicotine
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21mg/24hr 14mg/24hr
7mg/24hr
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Usual: One 21mg/24hr
patch daily for 4-8 wks, then one 14mg/24hr patch daily
for 2-4 wks, then one 7mg/24hr patch daily for 2-4 wks;
then discontinue. Low-dose regimen: One 14mg/24hr patch
daily for 6 wks, then one 7mg/24hr patch daily for 2-4 wks:
then discontinue
|
Apply to clean,
dry, nonhairy site on trunk or upper outer arm. Rotate sites.
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|
Nicoderm CQ (Smithkline
Beecham Consumer Healthcare)
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OTC
|
Nicotine
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21mg/24hr 14mg/24hr
7mg/24hr
|
Usual: One 21mg/24hr
patch daily for 6 wks, then one 14mg/24hr patch daily for
2 wks, then one 7mg/24hr patch daily for 2 wks; then discontinue.
Low-dose regimen: One 14mg/24hr patch daily for 6 wks, then
one 7mg/24hr patch daily for 2 wks: then discontinue
|
Apply to clean,
dry, nonhairy site on trunk or upper outer arm. Rotate sites.
Remove after 16-24hrs.
|
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Nicotrol Transdermal
(McNeil Consumer)
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OTC
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Nicotine
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15mg/16hr
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One Patch worn for
16 hrs daily for 6 wks: then discontinue
|
Apply to clean,
dry, nonhairy site on hip or upper outer arm. Remove at
bedtime. Rotate sites. Not for use in light smokers
|
|
CHEWING GUM
|
|
Nicorette (Smithkline
Beecham Consumer Healthcare
|
OTC
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Nicotine (as polacrilex)
|
2mg
4mg
|
Chew*** one piece
every 1-2 hrs (at least 9/day) for 6 wks, the one piece
every 2-4 hrs for 3 wks, then one piece every 4-8 hrs for
3 wks: then discontinue
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Avoid food and acidic
drinks for 15 min before and during chewing. Use 4mg strength
for highly nicotine-dependent** patients, or if failed with
2mg
|
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NASAL SPRAY
|
|
Nicotrol NS (McNeil
Consumer)
|
R
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Nicotine
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0.5mb/spray (aqueous
nasal spray)
|
Initial: 1-2 doses/hr;
may stop abruptly if needed. Max 5 doses/hr, 40 doses/day.
Max 3 months treatment. 2 sprays is one dose (one spray/nostril)
|
Do not sniff, swallow,
or inhale spray. Nasal vasoconstrictors may delay absorption
|
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INHALER
|
|
Nicotrol Inhaler
(McNeil Consumer)
|
R
|
Nicotine inhalation
system
|
10mg/cartridge (4mg
delivered)
|
Use at least 6 and
up to 16 cartridges/day for up to 12wks, then (if needed)
reduce gradually over 12 more wks; then discontinue. Max
6 months treatment.
|
20 minutes of active
puffing releases 4mg of nicotine (about 2mg absorbed, equivalent
to about 2 cigarettes).
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ORAL DOSAGE FORMS
|
|
Zyban (Glaxo Wellcome)
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R
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Bupropion HCI
|
150mg sustained-release
tablets
|
Patients >8yrs:
150mg once daily for 3 days, then 150mg twice daily (at
least 8hrs apart); max 150mg twice daily for 7-12wks. Patients
<18yrs: not recommended (insufficient data). Reduce dose
in renal or hepatic impairment.
|
May be used with
nicotine replacement. Do no crush, chew, or divide tablets.
Stop smoking within 1-2 wks of starting Zyban. Avoid bedtime
dosing. Do not use with other forms of bupropion.
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Footnotes
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R=Prescription only
OTC=Available Over The Counter
* Low-dose regimens are usually recommended for patients
weighing <100lbs, light smokers (<10 cigarettes/day),
and those with cardiovascular disease.
** Highly nicotine dependent is defined in the guidelines
as those smoking >20 cigarettes/day (product labeling
uses 24 cigarettes/day), those who smoke within 30min of
awakening, and those who find it difficult to refrain from
smoking where it is forbidden.
***Slowly chew gum until a "peppery" taste emerges, then
"park" between cheek and gum. "Chew and park" gum slowly
and intermittently for about 30 minutes.
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Adapted from Clinical Practice Guidelines
No. 18, AHCPR Publication #96-0692, 4/96 and relevant product
labeling.
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