FDA-approved
Medications to Help Patients Quit Smoking
The 2008 United States Public Health Service guidelines for quitting smoking or chewing tobacco recommend a combination of counseling and medication. The following seven medications are approved by the FDA for that purpose. For a suggested dose
treatment chart,
click here (PDF). See FDA packaging for more complete information.
Varenicline (Chantix)
(Package insert)
This is the latest medication approved by the FDA for smoking cessation. Marketed by Pfizer, Inc. under the brand name Chantix, this prescription-only medication is intended to help smokers quit in two ways. It blocks some of the rewarding effects of nicotine (acts as an antagonist) and at the same time stimulates the receptors in a way that reduces withdrawal (acts as an agonist). The FDA on July 1, 2009 added a "black-box" warning for healthcare providers to use caution prescribing Chantix for patients with pre-existing psychiatric conditions, and to monitor all patients using Chantix for psychological symptoms. FDA Boxed Warning: See the FDA Web Site for more information
LA Times: Chantix May Work Better If Taken Before Quitting
On June 16, 2011, the FDA notified the public and health-care providers that Chantix (varenicline) may be associated with a small, increased risk of certain cardiovascular adverse events in patients who have pre-existing cardiovascular disease. This safety information will be added to the Warnings and Precautions section of the Chantix labeling. The patient Medication Guide will also be revised to inform patients about this possible risk.
For more information on varenicline,
click here.
Bupropion (Zyban or Wellbutrin)
(
Package insert)
Bupropion SR is a prescription pill marketed under the brand name Zyban. It is also available generically. It is designed to help reduce cravings for nicotine. It can also relieve symptoms of depression for some patients. This is not for use if you have a history of seizures or eating disorders or are currently using a monoamine oxidase (MAO) inhibitor or any other form of bupropion (such as Zyban or Wellbutrin). Treatment is recommended for seven to 12 weeks. FDA Boxed Warning:
See the FDA Web Site for more information
Nicotine Replacement Therapies (NRT)
- Patch. Patches are designed to provide a steady stream of nicotine through your skin over a designated time (16-24 hours, depending on the product). The patch is available by prescription or over the counter (OTC). It’s designed to give you enough nicotine to ease cravings. Treatment is typically recommended for six to eight weeks.
- Gum. This OTC product is recommended for smokers who want something to turn to when experiencing urges to smoke. Chew up to 20-30 pieces a day for six to eight weeks. Use the 4 mg gum if you’re smoking 25 cigarettes or more per day or using chewing tobacco. Use the 2 mg gum if you’re smoking less than 24 cigarettes a day.
- Inhaler. (Package Insert) Patients "puff" small doses of nicotine through this prescription product that looks similar to a cigarette. Unlike a cigarette, it doesn't contain any of the 4,000 harmful chemicals, including carbon monoxide. Treatment usually lasts eight to 12 weeks, depending on the patient.
- Nasal spray. (Package Insert) This prescription product delivers nicotine through your nose. Recommended use is up to two sprays an hour for as many as three months.
- Lozenge.This OTC medication is usually used eight to 12 weeks. If you typically have your first cigarette or dip within 30 minutes of awakening, use the 4 mg dose. Otherwise use the 2 mg dose. Patients are urged to use at least 6 to 12 lozenges per day.
For a suggested
dose treatment chart, click
here (PDF).
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