Nicotine

Nicotine Brand Names

Commit | Habitrol | Nicoderm CQ | NICOrelief | Nicorette | Nicotrol

What is Nicotine

Nicotine is a naturally occurring alkaloid with complex pharmacology that has been long used by pharmacologists to investigate the autonomic nervous system.

Nicotine is primarily used to help smokers quit smoking, ideally combined with behavioral modification and support, although use alone, independent of psychosocial support, can help patients quit.

The benefit of nicotine in helping smokers quit tobacco smoking has been demonstrated in over 150 clinical studies spanning several decades.

Smoking cessation can decrease age-related declines in FEV1 in patients with COPD; therefore, nicotine (using FDA-approved nonprescription for smoking cessation) can assist with the preservation of lung function when it is successful in helping patients quit smoking.

While nicotine has been studied for its use in various medical conditions due to its unique pharmacology, but few indications for its use have been demonstrated.

For example, in Tourette’s syndrome, studies have not been positive; transdermal nicotine did not improve motor or vocal tics by the end of 1 to 3 weeks of treatment in children, adolescents, and young adults, and there were increased rates of nausea and vomiting.

Commercially, nicotine is available in a multitude of popular dosage formulations to help patients quit smoking, including chewing gum, oral lozenges, and transdermal systems (patches).

Nicotine in electronic cigarettes and vaping solutions are not regulated in the same way as nonprescription and prescription FDA-approved dosage forms.

Nicotine smoking cessation products were first introduced in 1984 as prescription products; the FDA allowed the nonprescription (OTC) sale of nicotine in 1996 with selected products.

Prescription-only products include a nicotine nasal spray and a nicotine oral inhalation system. In 2013, the FDA determined that no significant safety concerns are associated with a patient using more than one OTC nicotine replacement therapy (NRT) at the same time, or using an OTC NRT at the same time as another nicotine-containing product (including a cigarette).

If a patient tries to quit smoking but is not successful and has a cigarette, they can keep using an OTC NRT and keep trying to quit.

Indications

• nicotine withdrawal
• tobacco cessation

For use as an adjunct to psychosocial interventions for tobacco cessation (smoking cessation), including the treatment of nicotine withdrawal

non-prescription products for the treatment of tobacco cessation

Side Effects

1. abdominal pain
2. acne vulgaris
3. amnesia
4. anaphylactoid reactions
5. anxiety
6. aphasia
7. appetite stimulation
8. arthralgia
9. back pain
10. bronchospasm
11. chest pain (unspecified)
12. confusion
13. contact dermatitis
14. cough
15. dental pain
16. depression
17. diarrhea
18. dizziness
19. dysgeusia
20. dysmenorrhea
21. dysosmia
22. dyspepsia
23. dysphagia
24. dyspnea
25. emotional lability
26. epistaxis
27. erythema
28. fatigue
29. flatulence
30. flushing
31. headache
32. hiccups
33. hoarseness
34. hyperhidrosis
35. hypertension
36. insomnia
37. irritability
38. lacrimation
39. menstrual irregularity
40. migraine
41. myalgia
42. nasal congestion
43. nasal irritation
44. nausea
45. ocular irritation
46. oral ulceration
47. otalgia
48. palpitations
49. paresthesias
50. pharyngitis
51. physiological dependence
52. pruritus
53. psychological dependence
54. purpura
55. rash
56. restlessness
57. rhinitis
58. rhinorrhea
59. sinus tachycardia
60. sinusitis
61. sneezing
62. throat irritation
63. tremor
64. urticaria
65. weight gain
66. withdrawal
67. xerostomia

Monitoring Parameters

• laboratory monitoring not necessary

Contraindications

• accidental exposure
• acute bronchospasm
• angina
• asthma
• breast-feeding
• cardiac arrhythmias
• children
• dental disease
• depression
• diabetes mellitus
• eczema
• esophagitis
• gastroesophageal reflux disease (GERD)
• geriatric
• hepatic disease
• hiatal hernia
• hypertension
• hyperthyroidism
• infants
• magnetic resonance imaging (MRI)
• myocardial infarction
• nasal polyps
• peptic ulcer disease
• pheochromocytoma
• potential for overdose or poisoning
• pregnancy
• renal failure
• renal impairment
• seizure disorder
• seizures
• sodium restriction
• soya lecithin hypersensitivity
• thyroid disease
• thyrotoxicosis
• tobacco smoking

Interactions

• Acarbose
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Pseudoephedrine
• Acetohexamide
• Acrivastine; Pseudoephedrine
• Adenosine
• Albiglutide
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-blockers
• Alpha-glucosidase Inhibitors
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amphetamine
• Amphetamine; Dextroamphetamine
• Amphetamine; Dextroamphetamine Salts
• Articaine; Epinephrine
• Atazanavir; Cobicistat
• Benzphetamine
• Bromocriptine
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Phenylephrine
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Brompheniramine; Pseudoephedrine
• Bupropion
• Bupropion; Naltrexone
• Canagliflozin
• Canagliflozin; Metformin
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbetapentane; Pseudoephedrine
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carbinoxamine; Phenylephrine
• Carbinoxamine; Pseudoephedrine
• Cetirizine; Pseudoephedrine
• Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
• Chlophedianol; Guaifenesin; Phenylephrine
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Chlorpropamide
• Clomipramine
• Cobicistat
• Codeine; Phenylephrine; Promethazine
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Desipramine
• Desloratadine; Pseudoephedrine
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dextroamphetamine
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin; Phenylephrine
• Dextromethorphan; Guaifenesin; Pseudoephedrine
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Phenylephrine
• Dobutamine
• Donepezil; Memantine
• Dopamine
• Doxazosin
• Doxepin
• Doxorubicin
• Dulaglutide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Epinephrine
• Ergot alkaloids
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Exenatide
• Fexofenadine; Pseudoephedrine
• food
• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guaifenesin; Phenylephrine
• Guaifenesin; Pseudoephedrine
• Heparin
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydroxyprogesterone
• Ibuprofen; Pseudoephedrine
• Imipramine
• Incretin Mimetics
• Insulin Degludec; Liraglutide
• Insulin Glargine; Lixisenatide
• Insulins
• Isoproterenol
• Linagliptin
• Linagliptin; Metformin
• Liraglutide
• Lixisenatide
• Loperamide
• Loperamide; Simethicone
• Loratadine; Pseudoephedrine
• Meglitinides
• Memantine
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methamphetamine
• Midodrine
• Miglitol
• Naproxen; Pseudoephedrine
• Nateglinide
• Norepinephrine
• Nortriptyline
• Oxymetazoline
• Perphenazine; Amitriptyline
• Phenoxybenzamine
• Phentolamine
• Phenylephrine
• Phenylephrine; Promethazine
• Pioglitazone
• Pramlintide
• Prazosin
• Prilocaine; Epinephrine
• Protriptyline
• Pseudoephedrine
• Regadenoson
• Repaglinide
• Ritodrine
• Rosiglitazone
• Saxagliptin
• Semaglutide
• Simvastatin; Sitagliptin
• Sitagliptin
• Sulfonylureas
• Terazosin
• Tetrahydrozoline
• Thiazolidinediones
• Thiotepa
• tobacco
• Tolazamide
• Tolbutamide
• Tricyclic antidepressants
• Trimipramine
• Vemurafenib