Table 9. Suggestions for the clinical use of pharmacotherapies for smoking cessationa


First-line Pharmacotherapies (Approved for use for smoking cessation by the FDA)


Pharmacotherapy: Bupropion SR

Precautions/Contraindications
History of seizure
History of eating disorder

Side Effects
Insomnia
Dry mouth

Dosage
150 mg every morning for 3 days, then 150 mg twice daily (Begin treatment 1-2 weeks pre-quit)

Duration
7-12 weeks maintenance up to 6 months

Availability
Zyban (prescription only)

Cost/dayb
$3.33


Pharmacotherapy: Nicotine Gum

Side Effects
Mouth soreness
Dyspepsia

Dosage
1-24 cigs/day-2 mg gum (up to 24 pcs/day)
25+ cigs/day-4 mg gum (up to 24 pcs/day)

Duration
Up to 12 weeks

Availability
Nicorette, Nicorette Mint (OTC only)

Cost/dayb
$6.25 for 10, 2-mg pieces
$6.87 for 10, 4-mg pieces


Pharmacotherapy: Nicotine Inhaler

Side Effects
Local irritation of mouth and throat

Dosage
6-16 cartridges/day

Duration
Up to 6 months

Availability
Nicotrol Inhaler (prescription only)

Cost/dayb
$10.94 for 10 cartridges


Pharmacotherapy: Nicotine Nasal Spray

Side Effects
Nasal irritation

Dosage
8-40 doses/day

Duration
3-6 months

Availability
Nicotrol NS (prescription only)

Cost/dayb
$5.40 for 12 doses


Pharmacotherapy: Nicotine Patch

Side Effects
Local skin reaction
Insomnia

Dosage: Duration
21 mg/24 hours: 4 weeks
14 mg/24 hours: then 2 weeks
7 mg/24 hours: then 2 weeks

Dosage: Duration
15 mg/16 hours: 8 weeks

Availability
Nicoderm CQ (Over the Counter [OTC] only), Generic patches (prescription and OTC), Nicotrol (OTC only)

Cost/dayb
Brand name patches $4.00-$4.50c


Second-line Pharmacotherapies (Not approved for use for smoking cessation by the FDA)


Pharmacotherapy: Clonidine

Precautions/Contraindications
Rebound hypertension

Side Effects
Dry mouth
Drowsiness
Dizziness
Sedation

Dosage
0.15-0.75 mg/day

Duration
3-10 weeks

Availability
Oral Clonidine-generic, Catapres (prescription only)
Transdermal Catapres (prescription only)

Cost/dayb
Clonidine: $0.24 for 0.2 mg
Catapres (transdermal): $3.50


Pharmacotherapy: Nortriptyline

Precautions/Contraindications
Risk of arrythmias

Side Effects
Sedation
Dry mouth

Dosage
75-100 mg/day

Duration
12 weeks

Availability
Nortriptyline HCI-generic (prescription only)

Cost/dayb
$0.74 for 75 mg


a The information contained within this table is not comprehensive. Please see package insert for additional information.

b Prices based on retail prices of medication purchased at a national chain pharmacy, located in Madison, WI, April 2000.

c Generic brands of the patch recently became available and may be less expensive.

Return to Document