Nicotine Cessation Tools
1st line drug options:
- nicotine replacement therapy
- Nicotine patch(Habitrol, Nicoderm)–expensive, skin sensitivity, nightmares, N&V, insomnia
- Nicotine gum(polacrilex, Nicorette)–temporary relief only
- Nicotine inhaler—cough, throat irritation, nightmares, N&V, insomnia
- bupropion 150mg QD x 3days, then 150mg BID x 7-12 weeks
- can cause seizure, liver dysfunction
- least expensive oral medication for smoking cessation, around CAN$100 per month
2nd line drugs:
- nortriptyline: has a lot of interactions with other drugs, herbs.
- Clonidine: causes low BP, dizziness, lightheadedness which may causing falling/faint, can`t be stopped abruptly since that will cause clonidine withdrawal syndrom—hypertension crisis, sometimes even missing a dose can make you end up in ER.
- Varenicline: Nausea and vomiting is a very common SE.