• See Also
  1. Tobacco Abuse
  2. Nicotine Replacement
  • Indications
  1. Tobacco Cessation
  • Efficacy
  1. One year quit rate 25% (12% for Placebo)
  2. Best in obese heavy smokers and non-white patients
    1. Lerman (2004) Ann Intern Med 140:426-33 [PubMed]
  • Mechanism
  1. Rapidly absorbed via nasal mucosa
  • Preparations
  1. Available only by prescription in the United States
  2. Concentration 10 mg/ml and provides 0.5 mg/spray
  3. Each bottle contains 10 ml
  • Dosing
  1. One dose is 1 spray each nostril (1 mg Nicotine)
  2. Start 1-2 doses per hour while awake for 8 weeks
    1. Do not exceed 5 doses per hour (or more than 40 doses per day)
  3. Taper over the next month
  4. Minimum recommended: 8 doses (8 mg) per day
  5. Maximum: 40 doses (40 mg) per day
  6. Do not use more than 6 months total
  • Contraindications
  1. Same as Nicotine Patch
  2. Bronchospasm
  • Adverse Effects
  1. Nasal Irritation (90%): Rhinorrhea or sneezing
    1. Symptoms may be severe
    2. Often continues throughout course of use
  2. Throat irritation
  3. Nausea
  4. Watery eyes
  5. Cough
  • Precautions
  1. Pregnancy Category D
  2. Greater abuse potential than Nicotine Patch or gum
  • References
  1. Larzelere (2012) Am Fam Physician 85(6):591-8 [PubMed]