nicotine (nasal, inhalation)

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

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

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?

Tell your doctor if you have ever had:

• heart disease, irregular heartbeats;
• high blood pressure;
• chest pain, heart attack or stroke;
• blood circulation problems;
• a blood vessel disorder such as Buerger's disease, Prinzmetal angina, or Raynaud's syndrome;
• insulin-dependent diabetes;
• overactive thyroid;
• asthma or other breathing disorder;
• sinus problems, nasal polyps, allergies that affect your nose;
• liver or kidney disease;
• a stomach ulcer; or
• pheochromocytoma (tumor of the adrenal gland).

Do not give this medicine to a child or teenager without medical advice.

How should I use nicotine nasal or inhalation?

This medicine 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.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Tell your doctor if you feel an increased urge to use more of this medicine.

Start using nicotine nasal or inhalation on the same day you stop (quit) smoking or using tobacco products.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Nicotine nasal is generally used for up to 8 weeks, and then gradually reduced over the following 4 to 6 weeks. Nicotine inhalation is generally used for up to 12 weeks, and then gradually reduced over the following 12 weeks. Follow your doctor's instructions for tapering your dose.

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

As you quit smoking, you may have nicotine withdrawal symptoms, such as: dizziness, drowsiness, trouble concentrating, mood changes (feeling restless, anxious, or irritable), headache, muscle pain, trouble sleeping, increased appetite, constipation, or weight gain.

What happens if I miss a dose?

Since this medicine is used when needed, you may not be on a dosing schedule. Skip any missed dose if it's almost time for your next dose. Do not use two doses at one time.

Do not use the nasal spray more than 5 times per hour or 40 times in 24 hours. Do not use more than 16 nicotine inhaler cartridges per day.

What happens if I overdose?

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

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.

What should I avoid while using nicotine nasal or inhalation?

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?

• 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:

• burning or irritation in your nose, mouth, throat, or eyes;
• cough, sore throat, hoarse voice;
• numbness or tingling in your nose, mouth, or head;
• nosebleed;
• runny or stuffy nose, sneezing, watery eyes;
• changes in your sense of taste or smell;
• flushing in your face (sudden warmth, redness, or tingly feeling);
• chest tightness, shortness of breath;
• ear pain, pain in your neck or jaw;
• hiccups, upset stomach, nausea, diarrhea, gas;
• tooth problems; or
• withdrawal symptoms.

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?

When you start or stop using nicotine, your doctor may need to adjust the doses of any other medicines you take on a regular basis.

Tell your doctor about all your other medicines, especially:

• acetaminophen;
• insulin;
• oxazepam;
• pentazocine;
• theophylline;
• an antidepressant such as amitriptyline, imipramine, or nortriptyline;
• cold or cough medicine that contains phenylephrine (a decongestant);
• heart or blood pressure medication;
• ergot medicine --dihydroergotamine, ergotamine, ergonovine, methylergonovine; or
• other smoking cessation medicine --bupropion, varenicline, Chantix, Zyban, Wellbutrin.

This list is not complete. Other drugs may affect nicotine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

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