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Division of Periodontology

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DDS Curriculum

Advanced Education

Tobacco Cessation




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Home > Tobacco Use Cessation Program > Didactic Components > Nicotine Replacement Products

Nicotine Replacement Products

Developed to reduce or eliminate withdrawal symptoms so we can help individuals interested in quitting to plan for and deal with the psychological and behavioral (social) components of their addiction.

Contraindications for nicotine replacement products: under age 18, women who are pregnant or nursing (nicotine gum is FDA approved for use in pregnancy), immediate post-myocardial infarction period, severe arrhythmias, severe or worsening angina. Use caution: hyperthyroidism, insulin-dependent diabetes, and active peptic ulcers. Stable coronary artery disease is not a contraindication.

Nicotine Transdermal Patch

Nicoderm CQ    (OTC)    24 hr.......... 21, 14, 7mg......................6 wks / 2 wks / 2 wks
Generic (OTC) 24 hr...........21, 14, 7mg..........4-8 wks / 2-4 wks / 2-4 wks
Patch Contraindications: skin disorders; Side effects: itching, burning and/or
erythema at the site of application, abnormal dreams, joint or muscle pain
Cost: $3-4 a patch; Generic $2-3 a patch

Nicotine Gum

Nicorette polacrilex   (OTC)     2mg if smoke <25 cigarettes per day; 4mg if smoke >25 per day
Generic (OTC)
      Wk 1-6: (1) piece q 1-2 hrs; Wks 7-9 (1) piece q 2-4 hrs; Wks 10-12 (1) piece q 4-8 hrs
Gum Contraindications: TMJ dysfunction; Side effects: GI distress, jaw soreness, burning in throat, hiccups
Cost: $135-225 / month for 12 pieces per day

Nicotine Nasal Spray

Nicotrol NS (Rx) 10 ml bottles (10mg / ml)
      .5 mg each nostril..(do not inhale while spraying - nicotine absorbed in the nasal mucosal)
1-2 doses/hr (up to 5) for 4-8 wks, 4-6 wks gradual reduction or abrupt; Bottle = 100 doses - lasts about 1 wk
Spray Contraindications: chronic respiratory problems; Side effects: coughing, sneezing, nose running, eyes water
Cost: $45-50 / bottle

Nicotine Inhaler

Nicotrol Inhaler (Rx) Kit with 42 cartridges...
      6-16 cartridges/day, gradual reduction after 12 wks..Nicotine is absorbed in the mouth - not the lungs
Puff 1 cartridge for 5 minutes x 4
      Inhaler Contraindications: allergy to menthol; Side effects: throat irritation, coughing, headaches
Cost: $45-50 for kit and 42 cartridges

Nicotine Lozenge

Commit nicotine lozenge (OTC) Kit with 72 lozenges
      2mg if first tobacco used 30 min. after waking; 4mg if first tobacco used within 30 min. of waking
For first 6 wks use at least 9 lozenges per day. Let dissolve in mouth slowly (don't chew or swallow it)
Move occasionally. Dissolves in 20-30 min. Do not eat or drink 15 min. before or during use.
Lozenge Contraindication and Side effects are the same as for nicotine gum (except for jaw soreness)
Cost: $ 145 / month for 9 pieces per day

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