Drug

 Formulation(s)

 Adult Dosage

 Nicotinic Receptor Agonists (Nicotine-Replacement Therapy)

 Transdermal nicotine patches (OTC)

NicoDerm CQ, generics

 Patch delivering 7, 14, or 21 mg per 24 hours

 >10 cigarettes/day:

• One 21-mg patch/day X 6 weeks
• One 14-mg patch/day X 2 weeks
• One 7-mg patch/day X 2 weeks

 <10 cigarettes/day (or <45 kg)

• One 14-mg patch/day X 6 weeks
• One 7-mg patch/day X 2 weeks

 Intranasal nicotine spray (Rx)

Nicotrol NS

 10-mL bottles containing 10 mg/mL solution

 Each 50 microliter spray contains 0.5 mg of nicotine. One dose is 1 mg of nicotine (2 sprays, one in each nostril).

• Start with 1 or 2 doses per hour, which may be increased up to a maximum recommended dose of 40 mg (i.e., 80 sprays, which is somewhat less than 1/2 bottle) per day (maximum duration of therapy 3 months)

Nicotine oral inhaler (Rx)

Nicotrol Inhaler

 10-mg cartridges

• 6 to 12 cartridges per day X 6–12 weeks
• Gradual taper (if necessary) over next 6–12 weeks

Nicotine polacrilex gum (OTC)

Nicorette Gum generics

 2 or 4 mg per piece of gum

Smokes within 30 minutes of waking up:

• 4-mg gum, one piece every 1 to 2 hours X 6 weeks
• 4-mg gum, one piece every 2 to 4 hours X 3 weeks
• 4-mg gum, one piece every 4 to 8 hours X 3 weeks

Smokes after 30 minutes of waking up:

• 2-mg gum, one piece every 1 to 2 hours X 6 weeks
• 2-mg gum, one piece every 2 to 4 hours X 3 weeks
• 2-mg gum, one piece every 4 to 8 hours X 3 weeks

Nicotine polacrilex lozenges (OTC)

Nicorette Lozenges,generics
Nicorette Mini Lozenges,generics

 2 or 4 mg per lozenge or mini lozenge

Smokes within 30 minutes of waking up:

• One 4-mg lozenge/mini lozenge every 1 to 2 hours X 6 weeks
• One 4-mg lozenge/mini lozenge every 2 to 4 hours X 3 weeks
• One 4-mg lozenge/mini lozenge every 4 to 8 hours X 3 weeks

Smokes after 30 minutes of waking up:

• One 2-mg lozenge/mini lozenge every 1 to 2 hours X 6 weeks
• One 2-mg lozenge/mini lozenge every 2 to 4 hours X 3 weeks
• One 2-mg lozenge/mini lozenge every 4 to 8 hours X 3 weeks

 Dopaminergic-Noradrenergic Reuptake Inhibitor

Bupropion SR (Rx)

Zyban, generics

 150 mg tablets

Treatment should be initiated before the planned quit day, while the patient is still smoking, because it takes approximately 1 week of treatment to achieve steady-state blood levels of bupropion. The patient should set a “target quit date” within the first 2 weeks of treatment with the drug.

• Begin dosing with one 150-mg tablet per day for 3 days.
• Increase dose to 300 mg per day given as one 150-mg tablet twice each day with an interval of at least 8 hours between each dose.
• Do not exceed 300 mg per day

Nicotinic Receptor Partial Agonist

Varenicline tartrate (Rx)

Chantix

 0.5 or 1 mg tablets

Treatment should be initiated before the planned quit day, while the patient is still smoking. The patient should set a date to stop smoking and begin varenicline dosing one week before this date.

• Begin dosing with 0.5 mg once daily for 3 days. 
• Days 4 to 7, increase dose to 0.5 mg twice daily.
• From day 8 through the end of treatment, dosage is 1 mg twice daily