nicotine (nasal, inhalation)

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Pronunciation: NIK oh teen

Brand: Nicotrol Inhaler, Nicotrol NS

What is the most important information I should know about nicotine nasal or inhalation?

You should not use this medicine if you are pregnant.

Do not smoke or use other nicotine products while you are using nicotine nasal spray or inhalation.

Keep this medicine out of the reach of children or pets.

What is nicotine?

Nicotine is the primary ingredient in tobacco products.

Nicotine nasal spray and inhalation are medical products used to help you stop smoking and help reduce nicotine withdrawal symptoms as you quit smoking.

Nicotine nasal or inhalation may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using nicotine nasal or inhalation?

You should not use this medicine if you are allergic to nicotine.

To make sure this medicine is safe for you, tell your doctor if you have:

  • high blood pressure, heart disease, or a heart rhythm disorder;
  • a history of chest pain, stroke, or heart attack;
  • a blood vessel disorder such as Buerger's disease, Prinzmetal angina, or Raynaud's syndrome;
  • asthma or other breathing disorder;
  • nasal or sinus problems, including nasal polyps or hay fever;
  • type 1 diabetes;
  • liver or kidney disease;
  • overactive thyroid;
  • a stomach ulcer; or
  • pheochromocytoma (tumor of the adrenal gland).

Nicotine from cigarette smoking is known to cause low birth weight and can also increase the risk of miscarriage, stillbirth, or death in a newborn baby. The nicotine in this medicine may have these same effects when used during pregnancy. You should not use nicotine nasal or inhalation if you are pregnant. Talk with your doctor about the best way for you to stop smoking if you are pregnant.

Nicotine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Using a nicotine replacement product may be safer than smoking during pregnancy or while nursing. However, you should try to stop smoking without using a nicotine replacement product if you are pregnant or breast-feeding a baby.

Nicotine nasal or inhalation products are not approved for use by anyone younger than 18 years old.

How should I use nicotine nasal or inhalation?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

To use the nasal spray:

  • Blow your nose if needed. Tilt your head back slightly and insert the tip of bottle into your nostril. Breathe through your mouth while spraying gently into your nostril. Do not inhale or sniff while spraying. If your nose runs, gently sniff to keep the nasal spray from leaking out.
  • Do not use the nasal spray more than 5 times per hour or 40 times in 24 hours.
  • Avoid getting the spray in your eyes or mouth, or on your skin. If this does happen, rinse with water.
  • Do not blow your nose for at least 2 minutes after using the nasal spray. Recap the bottle after each use.
  • If the nasal spray has not been used for longer than 24 hours, prime it by spraying 1 or 2 times into a tissue.

Nicotine nasal spray may not work as well if you have a cold or allergy symptoms and a runny nose.

Nicotine inhalation is given in two treatment phases: initial treatment (up to 12 weeks) and gradual reduction (up to 12 weeks). During the first 3 to 6 weeks of initial treatment, use at least 6 inhaler cartridges per day. You may use up to 16 cartridges per day, depending on how much nicotine you feel you need. After initial treatment, start your gradual reduction by using fewer cartridges per day or using them less often for up to 12 more weeks.

To use nicotine inhalation:

  • Insert an inhaler cartridge into the mouthpiece as directed in the patient instructions.
  • Inhale deeply or puff in short breaths for 5 minutes at a time. One inhaler cartridge may be used for about 20 minutes of active puffing time.
  • Use the inhaler at temperatures above 60 degrees Fahrenheit. Using it in the cold will reduce the amount of nicotine you inhale.
  • Remove an empty inhaler cartridge from the mouthpiece and throw it away in a safe place.
  • Clean the inhaler mouthpiece regularly with soap and water. Store the mouthpiece in the locked position in its storage case when not in use.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Call your doctor if you are unable to stop smoking after using nicotine nasal for 4 weeks. This medicine may be habit-forming if you use it for too long. Do not use nicotine nasal or inhalation for longer than 6 months.

Nicotine nasal or inhalation is only part of a complete program of treatment that may also include counseling, group support, and behavior changes. Your success will depend on your participation in all aspects of your smoking cessation program. As you quit smoking, you may have nicotine withdrawal symptoms, such as dizziness, trouble concentrating, weight gain, drowsiness, increased sweating, trouble sleeping, or feeling restless, anxious, or irritable.

Store at room temperature away from moisture, heat, and light. Keep the nasal spray bottle tightly closed when not in use. Store inhaler cartridges away from open flame or high heat, such as in a car on a hot day.

Keep this medicine out of the reach of children or pets. The amount of nicotine in a used or unused bottle or cartridge can cause serious harm to a child who accidentally sucks or chews on it. Throw away a used nasal spray bottle with the child-proof cap attached, in a place where children and pets cannot get to it.

What happens if I miss a dose?

Since nicotine is used as needed, you are not likely to miss a dose. Do not use more than 16 nicotine inhaler cartridges or 40 sprays of nasal nicotine per day.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. The amount of nicotine in a used or unused bottle or cartridge can cause serious harm to a child who accidentally sucks or chews on it. Seek emergency medical attention if this happens.

Overdose symptoms may include severe dizziness, vomiting, diarrhea, stomach pain, confusion, problems with hearing or vision, weakness, pale skin, cold sweat, fainting, seizure (convulsions), or slow breathing (breathing may stop).

What should I avoid while using nicotine nasal or inhalation?

Do not smoke or use other nicotine products (including snuff, chewing tobacco, or nicotine patches, gum, or lozenges). Using many forms of nicotine together can be dangerous.

Ask a doctor before using any other nasal sprays, especially a decongestant spray that contains xylometazoline (such as Triaminic Decongestant).

What are the possible side effects of nicotine nasal or inhalation?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if you have:

  • bronchospasm (wheezing, tightness in your chest, trouble breathing);
  • pounding heartbeats or fluttering in your chest;
  • severe stinging, burning, or other irritation in your nose, mouth, or throat; or
  • blistering, ulcerations, or bleeding in your nose.

Use nicotine nasal regularly during the first week to help you adjust to some of the common side effects, such as irritation in your nose or throat.

Common side effects may include:

  • a hot peppery feeling in your nose or throat;
  • chest tightness;
  • hoarse voice, cough;
  • runny or stuffy nose, sneezing, watery eyes;
  • blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;
  • changes in your sense of smell;
  • numbness or tingling in your nose, mouth, head, or other parts of your body;
  • pain in your jaw or neck, tooth problems;
  • earache; or
  • constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect nicotine?

Tell your doctor about all your current medicines and any you start or stop using. You may need to change your dose of certain other medicines while you are using a nicotine nasal or inhalation product, especially:

  • acetaminophen (Tylenol);
  • insulin;
  • oxazepam;
  • pentazocine;
  • theophylline;
  • an antidepressant such as imipramine;
  • cold or allergy medicine that contains phenylephrine; or
  • drugs to treat high blood pressure or a prostate disorder, such as labetalol, prazosin, or propranolol.

This list is not complete. Other drugs may interact with nicotine nasal or inhalation, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about nicotine nasal or inhalation.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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