Nicotine lozenge

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A nicotine lozenge is a modified-release dosage tablet (usually flavored) that contains a dose of nicotine polacrilex, which dissolves slowly in the mouth to release nicotine over the course of 20 to 30 minutes. Nicotine lozenges are intended to help individuals quit smoking and are generally an over-the-counter medication. Nicotine lozenges are commonly found in 2 mg and 4 mg strengths, although other strengths may be found. The nicotine is absorbed through the lining of the mouth and enters the blood vessels. It is used as an aid in nicotine replacement therapy (NRT), a process for smoking cessation. [1]

Contents

Side effects

Drug interactions

There are few interactions between nicotine and prescription medications (e.g. adenosine, cimetidine, varenicline), but the act of quitting smoking can impact the effect of other medications. [4] Some of the medications are: [5]

Contraindications and precautions

Nicotine replacement therapy cannot be used in those with any type of nicotine sensitivity. [6] Nicotine lozenge should not be used in those with soy allergies. [4]

Pregnant women or women who are breast feeding should speak with their health care providers and get their approval before using nicotine lozenges.

Nicotine lozenge should be used in caution in those with the following:

Symptoms of overdose

Symptoms of nicotine overdose include the following: [3]

Storage and disposal

It is recommended that nicotine lozenges be kept in the original container, at room temperature and away from excessive heat or moisture. The container should be stored in a secure location away from children or pets. [6]

Unused lozenges should be taken to a medication take-back program or otherwise disposed of in accordance with applicable laws.

See also

Related Research Articles

<span class="mw-page-title-main">Nicotine</span> Mild chemical stimulant naturally found in some plants

Nicotine is a naturally produced alkaloid in the nightshade family of plants and is widely used recreationally as a stimulant and anxiolytic. As a pharmaceutical drug, it is used for smoking cessation to relieve withdrawal symptoms. Nicotine acts as a receptor agonist at most nicotinic acetylcholine receptors (nAChRs), except at two nicotinic receptor subunits where it acts as a receptor antagonist.

<span class="mw-page-title-main">Smoking cessation</span> Process of discontinuing tobacco smoking

Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking. Tobacco smoke contains nicotine, which is addictive and can cause dependence. As a result, nicotine withdrawal often makes the process of quitting difficult.

Nicotine polacrilex is nicotine bound to an ion-exchange resin. It is added to gums and hard lozenges used for nicotine replacement therapy in smoking cessation, particularly in the Nicorette range of products. The use of the polymer as a delivery system maximizes the amount of nicotine released and absorbed by the oral mucosa. 80 to 90 percent of the nicotine released from the gum is absorbed by the mouth. Side effects of the gum include bad taste, nausea, dyspepsia, and stomatitis.

<span class="mw-page-title-main">Snus</span> Moist tobacco product placed under the upper lip, used in the Nordic countries.

Snus is a tobacco product, originating from a variant of dry snuff in early 18th-century Sweden. It is placed between the upper lip and gum for extended periods, as a form of sublabial administration. Snus is not fermented. Although used similarly to American dipping tobacco, snus does not typically result in the need for spitting and, unlike naswar, snus is steam-pasteurized.

<span class="mw-page-title-main">Nicotine replacement therapy</span> Treatment for tobacco use disorder

Nicotine replacement therapy (NRT) is a medically approved way to treat people with tobacco use disorder by taking nicotine through means other than tobacco. It is used to help with quitting smoking or stopping chewing tobacco. It increases the chance of quitting tobacco smoking by about 55%. Often it is used along with other behavioral techniques. NRT has also been used to treat ulcerative colitis. Types of NRT include the adhesive patch, chewing gum, lozenges, nose spray, and inhaler. The use of multiple types of NRT at a time may increase effectiveness.

<span class="mw-page-title-main">Xerostomia</span> Medical condition

Xerostomia, also known as dry mouth, is dryness in the mouth, which may be associated with a change in the composition of saliva, or reduced salivary flow, or have no identifiable cause.

<span class="mw-page-title-main">Nicotine patch</span> Transdermal patch that releases nicotine into the body

A nicotine patch is a transdermal patch that releases nicotine into the body through the skin. It is used in nicotine replacement therapy (NRT), a process for smoking cessation. Endorsed and approved by the U.S. Food and Drug Administration (FDA), it is considered one of the safer NRTs available for the treatment of tobacco use disorder.

Nicotine gum is a type of chewing gum that delivers nicotine to the body. It is used as an aid in nicotine replacement therapy (NRT), a process for smoking cessation and quitting smokeless tobacco. The nicotine is delivered to the bloodstream via absorption by the tissues of the mouth.

Nicorette is the brand name of a number of products for nicotine replacement therapy (NRT) that contain nicotine polacrilex. Developed in the late 1970s in Sweden by AB Leo in the form of a chewing gum, Nicorette was the first nicotine replacement product on the market.

<span class="mw-page-title-main">Metered-dose inhaler</span>

A metered-dose inhaler (MDI) is a device that delivers a specific amount of medication to the lungs, in the form of a short burst of aerosolized medicine that is usually self-administered by the patient via inhalation. It is the most commonly used delivery system for treating asthma, chronic obstructive pulmonary disease (COPD) and other respiratory diseases. The medication in a metered dose inhaler is most commonly a bronchodilator, corticosteroid or a combination of both for the treatment of asthma and COPD. Other medications less commonly used but also administered by MDI are mast cell stabilizers, such as cromoglicate or nedocromil.

<span class="mw-page-title-main">Smokeless tobacco</span> Tobacco product used by means other than smoking.

Smokeless tobacco is a tobacco product that is used by means other than smoking. Their use involves chewing, sniffing, or placing the product between gum and the cheek or lip. Smokeless tobacco products are produced in various forms, such as chewing tobacco, snuff, snus, and dissolvable tobacco products. Smokeless tobacco products typically contain over 3000 constituents. All smokeless tobacco products contain nicotine and are therefore highly addictive. Quitting smokeless tobacco use is as challenging as smoking cessation.

<span class="mw-page-title-main">Varenicline</span> Nicotinic receptor agonist

Varenicline is a medication used for smoking cessation. Varenicline is also used for the treatment of dry eye disease.

<span class="mw-page-title-main">Nicotine withdrawal</span> Process of withdrawing from nicotine addiction

Nicotine withdrawal is a group of symptoms that occur in the first few weeks after stopping or decreasing use of nicotine. Symptoms include intense cravings for nicotine, anger or irritability, anxiety, depression, impatience, trouble sleeping, restlessness, hunger or weight gain, and difficulty concentrating. Withdrawal symptoms make it harder to quit nicotine products, and most methods for quitting smoking involve reducing nicotine withdrawal. Quit smoking programs can make it easier to quit. Nicotine withdrawal is recognized in both the American Psychiatric Association Diagnostic and Statistical Manual and the WHO International Classification of Diseases.

Tobacco harm reduction (THR) is a public health strategy to lower the health risks to individuals and wider society associated with using tobacco products. It is an example of the concept of harm reduction, a strategy for dealing with the use of drugs. Tobacco smoking is widely acknowledged as a leading cause of illness and death, and reducing smoking is vital to public health.

<span class="mw-page-title-main">Nicotine dependence</span> Chronic disease

Nicotine dependence is a state of dependence upon nicotine. Nicotine dependence is a chronic, relapsing disease defined as a compulsive craving to use the drug, despite social consequences, loss of control over drug intake, and emergence of withdrawal symptoms. Tolerance is another component of drug dependence. Nicotine dependence develops over time as a person continues to use nicotine. The most commonly used tobacco product is cigarettes, but all forms of tobacco use and e-cigarette use can cause dependence. Nicotine dependence is a serious public health problem because it leads to continued tobacco use, which is one of the leading preventable causes of death worldwide, causing more than 8 million deaths per year.

Nicotine Anonymous (NicA) is a twelve-step program founded in 1982 for people desiring to quit smoking and live free of nicotine. As of July 2017, there are over 700 face-to-face meetings in 32 countries worldwide with the majority of these meetings occurring in the United States, Iran, India, Canada, Brazil, the United Kingdom, Australia, Russia and in various online community and social media platforms.. NicA maintains that total abstinence from nicotine is necessary for recovery. NicA defines abstinence as “a state that begins when all use of nicotine ceases.

NiQuitin is a range of nicotine replacement products designed to help smokers quit by replacing the nicotine supplied by cigarettes with a lower, steadier level in order to relieve withdrawal. This is to help users wean off nicotine gradually. Nicotine replacement therapy products are indicated as temporary aids for the cigarette smoker who wants to give up smoking. They serve as alternative sources of nicotine and provide relief of nicotine withdrawal symptoms in nicotine-dependent individuals who are acutely withdrawing from cigarette smoking.

The use of electronic cigarettes (vaping) carries health risks. The risk depends on the fluid and varies according to design and user behavior. In the United Kingdom, vaping is considered by some to be around 95% less harmful than tobacco after a controversial landmark review by Public Health England.

The scientific community in United States and Europe are primarily concerned with the possible effect of electronic cigarette use on public health. There is concern among public health experts that e-cigarettes could renormalize smoking, weaken measures to control tobacco, and serve as a gateway for smoking among youth. The public health community is divided over whether to support e-cigarettes, because their safety and efficacy for quitting smoking is unclear. Many in the public health community acknowledge the potential for their quitting smoking and decreasing harm benefits, but there remains a concern over their long-term safety and potential for a new era of users to get addicted to nicotine and then tobacco. There is concern among tobacco control academics and advocates that prevalent universal vaping "will bring its own distinct but as yet unknown health risks in the same way tobacco smoking did, as a result of chronic exposure", among other things.

<span class="mw-page-title-main">Nicotine pouch</span> Nicotine product

Nicotine pouches are white pouches containing nicotine among other ingredients. They do not include tobacco leaf, dust, or stem. The nicotine may either be derived from tobacco plants or may be synthetic. Nicotine pouches are described as either similar to or a tobacco-free version of snus.

References

  1. "Frequently Asked Questions | Nicorette". www.nicorette.com. Retrieved 2019-10-31.
  2. Pack, Quinn R.; Jorenby, Douglas E.; Fiore, Michael C.; Jackson, Thomas; Weston, Patricia; Piper, Megan E.; Baker, Timothy B. (August 2008). "A Comparison of the Nicotine Lozenge and Nicotine Gum An Effectiveness Randomized Controlled Trial". WMJ. 107 (5): 237–243. ISSN   1098-1861. PMC   3174063 . PMID   18777992.
  3. 1 2 "Safety & Side Effects | Nicorette". www.nicorette.com. Retrieved 2019-11-14.
  4. 1 2 Sandhu, Amritpal; Saadabadi, Abdolreza (2019-10-10). Nicotine. StatPearls Publishing. PMID   29630200.
  5. Flowers, Lee (2016-06-01). "Nicotine Replacement Therapy". American Journal of Psychiatry Residents' Journal. 11 (6): 4–7. doi: 10.1176/appi.ajp-rj.2016.110602 .
  6. 1 2 "Nicotine Lozenges: MedlinePlus Drug Information". medlineplus.gov. Retrieved 2019-11-06.

PD-icon.svg This article incorporates public domain material from Dictionary of Cancer Terms. U.S. National Cancer Institute.