Medications and Nicotine Replacement Products for Smoking Cessation
Medication | Duration | Selected Adverse Effects* | Comments |
|---|---|---|---|
7–12 weeks initially (may continue up to 6 months) | Insomnia Dry mouth Neuropsychiatric symptoms | Prescription only Contraindicated by history of seizure, eating disorder, or monoamine oxidase inhibitor (MAOI) use within the past 2 weeks | |
Up to 6 months | Mouth soreness Dyspepsia | Over-the-counter only Slow chewing and parking between cheek and gum recommended to maximize blood levels and minimize gastric and esophageal irritation; can be a challenge to use enough gum to adequately address withdrawal; available in different flavors | |
Up to 6 months | Nausea Insomnia Mouth sores | Over-the-counter only; available in different flavors and in a mini version; need for frequent dosing can compromise adherence | |
14 weeks | Nasal and pharyngeal irritation | Prescription only Reaches peak blood levels earlier (in 10 minutes) than other nicotine replacement products | |
10 weeks | Local skin reaction Insomnia Vivid dreams | Over-the-counter and prescription Local skin reactions possibly less likely if location of patch is rotated; can be removed at night if bothered by vivid dreams | |
12–24 weeks‡ | Most commonly, nausea and sleep disturbances Neuropsychiatric symptoms | Prescription only | |
*Refer to a drug information resource for more detailed information regarding dosing, adverse reactions, and other safety considerations. †There have been neuropsychiatric symptoms reported post-marketing, but clinical trial data have not confirmed a causal relationship. A US Food and Drug Administration boxed warning has been removed. | |||