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AMERICAN THORACIC SOCIETY SERIES ON TOBACCOPrescription Medications to Congratulations! Making the decision to stop smoking is the most important thing you can do to improve and protect your health, as well as the health of those around you. Trying to quit on your own, sometimes called “cold turkey”, may be difficult and uncomfortable. Tobacco users are sometimes more successful in quitting if they use medications and attend a quit smoking program. Using FDA approved medications can help make your quit attempt more comfortable and more successful.
Are there medications to help me stop vider if you would like to take the bupropion
smoking/using tobacco?
in combination with nicotine replacement There are several different medications to help you stop tobacco use. Four of these medica- What is varenicline (Chantix®)?
tions are available only with a prescription. Varenicline is a pill you take once a day. Two of these medications are pills (bupropion Varenicline works by blocking the areas of and varenicline) and two are nicotine replace- the brain that are affected by nicotine. Start ment products (inhalers and nasal spray). Each taking varenicline about 7-10 days before your
of these medications are only approved for quit date. Usually, you will be asked to take a those 18 years of age and older. Below is in- smaller dose for a few days then increase to a formation about these four medications, how higher dose. Varenicline is taken for 12 weeks. they are taken and some of the possible side If you have successfully quit at 12 weeks, you can continue taking it for an additional 12 What is bupropion (Zyban®)?
Bupropion is a pill that you take once or twice Although many people have quit successfully a day. It is the same drug as the antidepres- with varenicline, some have experienced side sant Wellbutrin. Bupropion works by making effects with this medication such as: nausea, smoking less desirable to you. Start taking this vomiting and unusual, vivid or upsetting medication about 7-10 days before your quit
dreams. If you have kidney problems, talk to date. Most people take bupropion for a total of your doctor before using varenicline. People taking varenicline should be aware that it may Although many people have quit successfully cause depression, agitation, suicidal thoughts with this medication, some have experienced and suicidal actions. People taking varenicline side effects such as: an increase in blood pres- should use caution when driving or operating sure or allergic reactions. You should not take heavy machinery until they know how this bupropion if you have a history of seizures or have an eating disorder (anorexia, bulimia What are nicotine inhalers?
etc.). While most people tolerate this medi- Nicotine inhalers are plastic mouthpieces cation well, some have experienced depres- with replaceable nicotine cartridges. Nicotine sion, agitation, suicidal thoughts and suicidal replacement products such as this contain actions. People taking bupropion should use the nicotine you would normally get with a tobacco product. For best results, puff on the machinery until they know how this drug will mouthpiece, and do not take large inhala- tions. Large inhalations can cause coughing You can take other nicotine replacement prod- and throat irritation. You can use up to 16 ucts (e.g. nicotine gum, nasal spray, etc.) along cartridges per day when you first quit smok- with bupropion. Consult your health care pro- ing. Do not start using this product until you AMERICAN THORACIC SOCIETY SERIES ON TOBACCO Prescription Medications to Help You Stop Using Tobacco (cont.) have quit smoking (or quit using other tobacco ■ Any quit attempt will be improved by the products). If you smoke and also use nicotine replacement products, you may develop seri- ■ Seek medical help immediately if you ous side effects from an overdose of nicotine (see below). Talk to your health care provider before using the nicotine inhaler in combina- ■ Don’t get discouraged with any setbacks in tion with other nicotine replacement products.
your attempts to quit. Your goal of quitting What is nicotine nasal spray?
Nicotine nasal spray is a liquid you spray in Authors: Tobacco Control Committee of the American
your nose. To avoid nasal irritation, do not Thoracic Society, Patricia Folan RN, MS, Diane inhale the spray deeply into your nose. In order to avoid the side effects of an overdose Reviewer: Suzanne C Lareau RN, MS
of nicotine, do not smoke and also use nico-tine replacement products. Talk to your health Resources:
care provider before using the nasal spray in Fiore MC, Jaen CR, Baker TB, et al. Treating To- combination with other nicotine replacement bacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Ser- Which tobacco cessation medications
are the right ones for you?
FDA (Food and Drug Administration) Consumer Sometimes combining the nicotine replace- Health Information. Accessed June 22, 2011 ment products (such as using the patch/gum/ lozenge or nasal spray at the same time) or U.S. Food and Drug Administration. FDA 101: Smok- using them together with bupropion can make ing Cessation Products. January 2010.
you more comfortable and more successful in quitting. Talk to your health care provider who Signs and symptoms of nicotine poison. http:// can help you decide which products are best www.nlm.nih.gov/medlineplus/ency/article/002510.
What are the side effects of too much
U.S. National Library of Medicine. Pub Med Health. nicotine?
Medications for quitting tobacco use.
You can get too much nicotine by taking nicotine replacement products and continu-ing your tobacco use. You should seek medical help if any of the following develop as they may be a sign of an overdose of nicotine: nau-sea, vomiting, agitation, rapid breathing, fast or irregular heartbeat, or an increase in your blood pressure. ■ If you are having trouble quitting tobacco products “cold turkey”, speak with your health care provider about other ways to help you become successful.
■ Prescription medications may help you

Source: http://patients.thoracic.org/information-series/en/resources/ATS%20Tobacco%20Miniseries%20Prescription.pdf