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Product

Tobacco Treatment Medication Dosing Chart
Nicotine Patch
Nicotine Gum
Nicotine Lozenge
Nicotine Nasal Spray
Nicotine Inhaler
Bupropion SR
Varenicline
Name/Generic
Available
Strength
Time to peak
Plasma level
Possible
Reactions
*Additional
*Additional warnings:
warnings: see back
Instructions
Cost (Average)
For Maximum
indications
Cautions
Pregnancy, unstable coronary syndrome (ischemia, serious arrhythmia, angina) or peptic ulcer (gum and lozenge), under age 18. Rx Duration Treatment is recommended for at least 3 months but may be up to 6 months or longer, depending on confidence of individual. Consult physician if considering a longer duration.
Medication Dosing Guidelines for the Treatment of Smokeless Tobacco and Cigars
Patch: 21 mg QD x 4-6 weeks Gum or Lozenge: 4mg
1 Can/week or more (note: one can is roughly equal to 4 The PHS Clinical Practice Guideline 2008 update does not recommend use of tobacco treatment medications for smokeless tobacco use due to lack of sufficient evidence of Patch: 14 mg x 4-6 weeks Gum or Lozenge: 2mg If used, suggested dosing is based on rough equivalence of The PHS Clinical Practice Guideline 2008 update does not recommend use of tobacco treatment medications for cigar use due to lack of sufficient evidence of its efficacy. Patch: 21 mg patch x 4 weeks Gum or Lozenge: 4mg
If used, suggested dosing is based on rough equivalence of Then 14 mg patch x 2 weeks Inhaler: 6 – 16
Consumers of small and/or little cigars often smoke in similar pattern to those who smoke cigarettes. Patch: 21 mg patch x 4 weeks Gum or Lozenge: 4mg Then 14 mg patch x 2 weeks Inhaler: 6 – 16
The variety of products and patterns of use make it difficult to suggest dosing guidelines. Suggest assessing number of cigars smoked and time to first cigar smoked in the a.m. as possible guidelines. With use of gum, lozenge, inhaler and nasal spray patient can self-titrate based on experience of withdrawal symptoms. Discuss symptoms of possible nicotine overdose. Review risks and benefits. This chart is strictly for the convenience of consumers and providers. Consumers are advised to consult a physician, nurse or tobacco treatment specialist for more information regarding individual circumstances. Providers are advised to consult the Physician’s Desk Reference or manufacturer for complete product information. Prices are approximations based on those fougust 2009. Prices may change over time and vary according to area. By comparison, the average price of cigarettes in Maine as of 02/09 is $6-$7 per pack. *Note concerning use of bupropion and varenicline:
• The FDA advises that a person taking varenicline or bupropion who experiences the following should stop taking it and contact a healthcare provider immediately.
-Agitation -Hostility -Depressed Mood - Changes in behavior or thinking that are not typical for the person
-Suicidal thoughts or behavior See for updates.
• Also note: Serious allergic or inflammatory reaction: Some allergic reactions have been reported that should be referred for immediate medical help. This has been
noted in the varenicline post-marketing monitoring, but can occur with any medication:
-Swelling - especially of the face, lips, tongue, throat, neck - Hives -Breathing difficulties -Blistering rash in the mouth or on the skin

Source: https://ctiprogram.info/pdfs/Med%20chart%20updated%202009reformatted1.pdf