Nicotine

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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

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