• Basic Info
• Top Questions
• Interactions

What is nicotine?
Nicotine is the primary ingredient in tobacco products. Nicotine in medical products is used to aid in smoking cessation. Using a controlled amount of nicotine helps reduce nicotine withdrawal symptoms when you quit smoking. Nicotine may also be used for other purposes not listed in this medication guide.

Back to Top

What are the possible side effects of nicotine?

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

Stop using nicotine and call your doctor at once if you have any of these serious side effects:

• seizures; or

• chest pain or uneven heartbeats.

Less serious side effects may include:

• dizziness;

• belching or hiccups;

• stomach upset or nausea;

• mouth or throat soreness;

• dry or watering mouth;

• watering eyes;

• headache;

• runny or stuffy nose (when using the nasal spray);

• white patches or sores inside your mouth or on your lips (when using the inhaler);

• constipation;

• sneezing and coughing;

• changes in taste; or

• redness, itching, or burning where the patch is worn.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Back to Top

How should I take nicotine?
Use nicotine exactly as it was prescribed for you. Do not use the medication in larger amounts or for longer than recommended by your doctor. This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions. To use the patches: Choose a different place on your body to wear the patch each time you put on a new one. Do not use the same skin area twice within 7 days. Apply the patch to clean, dry, and hairless skin on the outer part of your upper arm or on your chest. Remove the patch after 24 hours and replace it with a new one.

Back to Top

What is the most important information I should know about nicotine?
Do not use this medication if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. You may not be able to use certain forms of this medicine if you have medical conditions that could interfere with use. Nasal or sinus problems (allergies, nasal polyps, sinusitis) could affect safe use of the nasal spray form of nicotine. Mouth or dental problems may affect safe use of nicotine gum or lozenges. A skin condition may affect safe use of nicotine transdermal patches. Talk with your doctor about the best form of nicotine for you to use.

Back to Top

What happens if I miss a dose?
Since nicotine is used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

Back to Top

What other drugs will affect nicotine?
Before using nicotine, tell your doctor if you are using any of the following drugs: imipramine (Tofranil); oxazepam (Serax); propranolol (Inderal), labetalol (Normodyne, Trandate), or prazosin (Minipress); theophylline (Theo-Dur, Theochron, Theolair); pentazocine (Talwin), or insulin. This list is not complete and there may be other drugs that can interact with nicotine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Back to Top

Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Nicotine replacement products have been assigned to pregnancy category C (nicotine gum) and category D (transdermal nicotine products) by the FDA. Cigarette smoking is known to cause spontaneous abortion, low birth weight, and increased perinatal mortality, probably due to nicotine and carbon monoxide. Nicotine has been shown to cause adverse fetal outcome in animals when administered in high doses. The use of nicotine replacement products is only recommended for use during pregnancy when the benefit outweighs risk, noting the possibility the patient may continue to smoke while using a replacement product.

According to the manufacturers of Nicorette gum, one to two pieces of 2- or 4-mg gum had less ability than one to two cigarettes to increase fetal blood flow and heart rate and decrease uterine blood flow and fetal breathing movements. One study of 29 pregnant women showed the short-term use of nicotine gum delivered less nicotine than usual cigarette smoking. The manufacturers of Nicoderm transdermal patch state that spontaneous abortion has been reported during use of a nicotine patch.

Nicotine is excreted into breast milk with a milk to plasma ratio of 2.9. Nicotine and cotinine have been detected in the serum and urine of nursing infants. The effects in the nursing infant are unknown. The manufacturer recommends that caution be used when administering nicotine to nursing women.

Back to Top

What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine, or if anyone has accidentally swallowed it. Overdose symptoms may include nausea; vomiting; diarrhea; stomach pain; cold sweat; headache; dizziness; problems with hearing or vision; confusion; uneven heartbeats; chest pain; seizures; and death.

Back to Top

What should I discuss with my healthcare provider before using nicotine?
You may not be able to use certain forms of this medicine if you have medical conditions that could interfere with use. Nasal or sinus problems (allergies, nasal polyps, sinusitis) could affect safe use of the nasal spray form of nicotine. Mouth or dental problems may affect safe use of nicotine gum or lozenges. A skin condition may affect safe use of nicotine transdermal patches. Talk with your doctor about the best form of nicotine for you to use. Before using this medication, tell your doctor if you have:

Back to Top

Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

Back to Top

I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

Back to Top