How does this medication work? What will it do for me?

This medication is used to help people over 18 years of age quit smoking.

When a person stops smoking, they go through withdrawal from nicotine, causing symptoms such as irritability, mood swings, restlessness, trouble concentrating, and increased appetite. This medication helps reduce the symptoms of nicotine withdrawal by replacing some of the nicotine that the person is no longer getting through cigarettes. Gradually, the dose is reduced until the person no longer craves nicotine, and they can stop using the medication. This medication works best when used with a comprehensive program to quit smoking.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each inhaler consists of a mouthpiece and a plastic cartridge delivering 4 mg of nicotine. Nonmedicinal ingredients: menthol, ethanol, and a porous plug (which holds the nicotine).

How should I use this medication?

Ask your doctor or pharmacist to teach you how to use the nicotine inhaler effectively and to give you tips on quitting smoking. As you inhale or puff through the mouthpiece, the inhaler releases a vapour containing nicotine, which is absorbed through the lining of your mouth and throat. One cartridge contains enough nicotine for about 20 minutes of continuous puffing.

Dispose of used cartridges in a place where children or pets cannot get to them. Store the cartridges at room temperature and protect them from light and humidity.

The dosage is individualized and depends on how much nicotine is needed to relieve nicotine withdrawal symptoms. For the first 3 to 12 weeks of treatment, a higher dose (6 to 12 cartridges per day) is used, and then the dose is gradually reduced over the next 6 to 12 weeks. Once a dose of 1 to 2 cartridges per day is reached, the medication can be stopped. The maximum dose is 12 cartridges per day.

You must stop smoking completely as you begin using the medication. If you are unable to stop smoking by the fourth week of treatment, your doctor will probably advise you to stop using the medication. The medication should not be used at the same time as nicotine gum, patches, or any form of tobacco.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is very important to take this medication exactly as prescribed by your doctor. If you miss a dose of this medication, take your next scheduled dose. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to nicotine, menthol, ethanol, or any ingredients of the medication
  • are a non-smoker or an occasional smoker
  • are under 18 years of age
  • are pregnant or breast-feeding
  • have just had a heart attack
  • have life-threatening arrhythmias (abnormal heart rhythm)
  • have severe or worsening angina (chest pain)
  • have recently had a stroke

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • chest pain
  • coughing
  • diarrhea
  • dry mouth
  • flatulence
  • headache
  • hiccups
  • indigestion
  • irritation, numbness, redness or swelling of gums, mouth, nose or throat
  • mouth and throat irritation
  • nausea
  • shortness of breath
  • stuffy nose
  • stomach discomfort
  • thirst
  • throat irrititation
  • vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • fast or irregular heartbeat
  • fever with or without chills
  • headache
  • nausea with or without vomiting
  • runny nose
  • shortness of breath, tightness in chest, difficulty breathing, or wheezing
  • skin rash, itching, or hives
  • tearing of eyes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • cold sweat
  • confusion
  • convulsions (seizures)
  • disturbed hearing and vision
  • drooling
  • extreme exhaustion
  • pale skin
  • fast heartbeat
  • symptoms of a severe allergic reaction such as swelling of the mouth or throat, chest tightness, or shortness of breath
  • tremors

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Medical conditions: Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed if you have or have had any of the following:

  • asthma
  • thyroid conditions
  • diabetes
  • stomach ulcers
  • heart disease
  • blood vessel disease

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: Nicotine passes into breast milk. If you are a breast-feeding mother and are taking nicotine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of this medication have not been established for people under 18 years of age. The cartridges and all parts of the nicotine inhaler should be kept away from children, as they may cause poisoning or choking.

What other drugs could interact with this medication?

There may be an interaction between the nicotine inhaler and any of the following:

  • clomipramine
  • clozapine
  • fluvoxamine
  • imipramine
  • olanzapine
  • tacrine
  • theophylline

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.