Nicorette

(redirected from Habitrol)

nicotine


nicotine inhaler

Nicotrol Inhaler

nicotine nasal spray

Nicotrol NS

nicotine polacrilex

Commit, Nicorette, Nicotinell (UK)

nicotine transdermal system

Clear Nicoderm CQ, Nicoderm CQ, Nicopatch (UK), Nicorette Patch (UK), NiQuitin (UK), Prostep

Pharmacologic class: Cholinergic

Therapeutic class: Smoking deterrent

Pregnancy risk category C (gum), D (inhalation, nasal, transdermal)

Action

Supplies nicotine during controlled withdrawal from cigarette smoking. Binds selectively to nicotinic-choliner-gic receptors in central and peripheral nervous systems, autonomic ganglia, adrenal medulla, and neuromuscular junction. At low doses, has a stimulating effect; at high doses, a reward effect.

Availability

Chewing gum: 2 mg, 4 mg

Inhalation: 42 cartridges/system, each containing 10 mg nicotine (delivers 4 mg)

Nasal spray: 10 mg/ml (0.5 mg/spray) in 10-ml bottles (100 doses)

Transdermal patch: 7 mg/day, 11 mg/day, 14 mg/day, 15 mg/day, 21 mg/day, 22 mg/day

Indications and dosages

Adjunctive therapy (with behavior modification) for nicotine withdrawal Transdermal system-

Adults: 21 mg/day transdermally (Habitrol) for 4 to 8 weeks, then 14 mg/day for 2 to 4 weeks, then 7 mg/day for 2 to 4 weeks, for a total of 8 to 16 weeks; patient must wear system 24 hours/day. Or 21 mg/day transdermally (Nicoderm CQ) for 6 weeks, then 14 mg/day for 2 weeks, then 7 mg/day for 2 weeks, for a total of 10 weeks; patient must wear system 24 hours/day. Or 15 mg/day transdermally (one Nicotrol patch) for 6 weeks; patient must wear system 16 hours/day, removing it at bedtime.

Adults, adolescents, and children weighing less than 45 kg (100 lb) who smoke fewer than 10 cigarettes daily or have underlying cardiovascular disease: 14 mg/day transdermally (Habitrol) for 4 to 8 weeks, then 7 mg/day for 2 to 4 weeks, for a total of 6 to 8 weeks; patient must wear system 24 hours/day. Or 14 mg/day transdermally (Nicoderm CQ) for 6 weeks, then 7 mg/day for 2 weeks, for a total of 8 weeks; patient must wear system 24 hours/day. Nasal spray-

Adults: One spray intranasally in each nostril once or twice per hour, up to five times per hour or 40 times per day, for no longer than 6 months Inhalation-

Adults: For optimal response, at least six cartridges inhaled daily for first 3 to 6 weeks, to a maximum of 16 cartridges daily for up to 12 weeks. Patient self-titrates dosage to required nicotine level (usually 6 to 16 cartridges daily), followed by gradual withdrawal over 6 to 12 weeks.

Chewing gum-

Adults: Use as needed depending on smoking urge or chewing rate, or use on fixed schedule q 1 to 2 hours. Initial requirement may range from 18 to 48 mg/day, not to exceed 60 mg/day.

Contraindications

• Hypersensitivity to drug or its components or to menthol (inhaler only)

• Allergy to adhesive (transdermal forms only)

Precautions

Use cautiously in:

• cardiovascular disease, hypertension, bronchospastic disease, diabetes mellitus, pheochromocytoma, peripheral vascular disease, hyperthyroidism, peptic ulcer disease, hepatic disease

• immediately after myocardial infarction, severe arrhythmia, or severe or worsening angina (use not recommended)

• skin disorders (transdermal form)

• dental disorders, esophagitis, pharyngitis, stomatitis (gum form)

• females of childbearing age

• pregnant or breastfeeding patients.

• children under age 18 (safety and efficacy not established).

Administration

• Apply patch when patient awakens and remove patch (as prescribed) at same time each day.

• Administer nasal spray regularly during first week, to help patient get used to irritant effects.

• With inhalation use, give at least six cartridges daily for first 3 to 6 weeks.

• Encourage patient to titrate dosage to level required, followed by gradual withdrawal.

Adverse reactions

CNS: headache, dizziness, drowsiness, poor concentration, nervousness, weakness, paresthesia, insomnia, abnormal dreams

CV: chest pain, hypertension, tachycardia, atrial fibrillation

EENT: sinusitis; pharyngitis (with gum); mouth and throat irritation (with inhaler); nasopharyngeal irritation, rhinitis, sneezing, watering eyes, eye irritation (with nasal spray)

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dry mouth, dyspepsia; increased salivation, sore mouth (with gum)

GU: dysmenorrhea

Musculoskeletal: joint pain, back pain, myalgia; jaw ache (with gum)

Respiratory: increased cough (with nasal spray or inhaler), bronchospasm

Skin: burning at patch site, erythema, pruritus, cutaneous hypersensitivity, rash, sweating (all with transdermal patch)

Other: abnormal taste, increased appetite (with gum), allergy, hiccups

Interactions

Drug-drug. Acetaminophen, adrenergic antagonists (such as prazosin, labetalol), clozapine, furosemide, imipramine, oxazepam, pentazocine, propranolol and other beta-adrenergic blockers, theophylline: increased effects of these drugs

Bupropion: treatment-emergent hypertension

Insulin: decreased insulin requirement

Isoproterenol, phenylephrine: increased requirements for these drugs

Propoxyphene: decreased nicotine metabolism

Drug-food. Caffeine-containing foods and beverages: increased nicotine effects

Drug-behaviors. Cigarette smoking: increased nicotine metabolism and effects

Patient monitoring

• Assess for signs and symptoms of nicotine withdrawal (irritability, drowsiness, fatigue, headache).

Watch for bronchospasm and evidence of nicotine toxicity (nausea, vomiting, diarrhea, increased salivation, headache, dizziness, visual disturbances).

Patient teaching

Caution patient against any type of smoking during therapy. Urge him to immediately report chest tightness or difficulty breathing.

• If patient uses gum, advise him to chew one piece whenever nicotine craving occurs. Instruct him to chew it slowly until he feels a tingling sensation, then store it between cheek and gum until tingling disappears.

• Instruct patient to apply transdermal patch to clean, dry skin of upper arm or torso when he awakens; to keep it in place when showering, bathing, or swimming; and to remove it at same time each day.

• If patient uses nasal spray, instruct him to tilt head back slightly when spraying. Remind him not to sniff, swallow, or inhale through nose.

• If patient uses inhalation form, teach him to puff continuously for 20 minutes and to use at least six cartridges daily for first 3 to 6 weeks.

• As appropriate, review all significant and life-threatening adverse reactions and interactions, especially those related to the drugs, foods, and behaviors mentioned above.

Nicorette

(nĭk′ə-rĕt′)
A trademark for an over-the-counter preparation of chewing gum containing nicotine, used to treat nicotine dependence.

Nicorette

a trademark for a nicotine resin complex (nicotine polacrilex).

Nicorette®

See Nicotine gum.

Nicorette

A brand name for under-the-tongue tablets, chewing gum or artificial cigarettes containing NICOTINE. This is intended to make the abandonment of cigarette smoking a less painful procedure. Such measures are no real substitute for simple resolution and the acceptance of a brief period of suffering.
References in periodicals archive ?
Although GlaxoSmithKline had the potential to further boost its position in NRT, the FTC required that Novartis divest its Habitrol brand of NRT patches before the consumer health joint venture could be completed.
Reddy's Laboratories acquires Habitrol Brand from Novartis
5% interest in the joint venture, and without the divestitures required by the proposed order it would continue to own the Habitrol business, which had U.
At presently, GSK has its own nicotine replacement patch, Nicoderm CQ, a direct competitor of Habitrol.
27 November 2014 - Swiss healthcare group Novartis AG (VTX:NOVN) has agreed to offload its nicotine patch unit, Habitrol, to obtain clearance by the Federal Trade Commission (FTC) for its joint venture with UK peer GlaxoSmithKline plc (LON:GSK), the regulator said.
The contest is funded by the Government of Ontario with prize support provided by the makers of Thrive and Habitrol quit-smoking aids.
2) Transdermal patch formulation previously marketed as Habitrol.
There's the V-Chip, the Habitrol nicotine patch, an electronic hearing implant, and Google.
The plaintiff's federal appellate brief in a Habitrol case where the Oklahoma trial court held that that an exception to the learned intermediary rule exists where the FDA requires direct consumer warnings on prescription products.
The Institute for Safe Medication Practices (ISMP) issued the warning in the wake of an incident involving a patient who entered a MR scanner wearing a Habitrol smoking-cessation patch.
Following the plaintiff's reasoning, the Oklahoma Supreme Court held that the FDA mandate of a direct patient warning created an exception to the learned intermediary doctrine, and imposed a common law duty on the Habitrol manufacturer to provide an adequate warning to the patient directly.