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Nicotrol InhalerPronounced: NICK-o-trole
Generic name: Nicotine inhalation system
Why is this drug prescribed: A quit-smoking aid, the Nicotrol Inhaler provides a substitute source of nicotine when you first give up cigarettes. A sudden decline in nicotine levels can cause such withdrawal symptoms as nervousness, restlessness, irritability, anxiety, depression, dizziness, drowsiness, concentration problems, sleep disturbances, increased appetite, weight gain, headache, constipation, fatigue, muscle aches, and a craving for tobacco. Nicotrol Inhaler prevents these symptoms and, through a familiar hand-to-mouth ritual, acts as a replacement for cigarettes. (Most of the nicotine in the product is, however, deposited in the mouth instead of the lungs.)
Most important fact about this drug: To get the most from this system, you must be genuinely committed to quitting, and should give up smoking completely before you begin using the inhaler. It should be employed as part of an overall stop-smoking program that includes behavior modification, counseling, and support. The goal is to become a total non-smoker. If you find that you are still smoking after 4 weeks with the inhaler, you should probably stop treatment and try again when you are really ready to quit.
How should you take this medication: Each Nicotrol Inhaler package includes a mouthpiece and 42 cartridges of nicotine. Treatment takes place in two stages. During the first stage (up to 12 weeks) you should use as many Nicotrol cartridges as needed (at least 6, but no more than 16 daily) to quell the craving for cigarettes. During the second stage (6 to 12 weeks) you should gradually reduce your daily consumption until you are nicotine-free. For best effect, puff frequently on each cartridge for about 20 minutes. Remember to clean the mouthpiece regularly with soap and water. --If you miss a dose... Use the inhaler no more than needed to control the urge to smoke. --Storage instructions... Store at room temperature away from light. Keep the mouthpiece in its plastic storage case.
What side effects may occur: Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue using the Nicotrol Inhaler. Side effects may include: Acid indigestion, allergies, back pain, coughing, diarrhea, fever, flu-like symptoms, gas, headache, hiccups, jaw and neck pain, mouth and throat irritation, nasal inflammation, nausea, pain, sinus inflammation, taste disturbances, tingling skin sensation, tooth disorders
Why should this drug not be prescribed: Nicotrol Inhaler should not be used by anyone allergic to nicotine or menthol.
Special warnings about this medication: Nicotine from any source can be toxic and addictive, and you can become dependent on the Nicotrol Inhaler. To minimize this risk, it's important to gradually cut back on use of the inhaler after the first 3 months. Its use for more than 6 months is not recommended. Do not smoke while using the inhaler. The added nicotine will increase your risk of developing nicotine toxicity. Nicotrol Inhaler may not be your best quit-smoking option if you have angina, heartbeat irregularities, Raynaud's phenomenon (periodic loss of circulation in the fingers), Buerger's disease (a dangerous decline in circulation in the hands and feet) or a history of heart attack. If you develop an irregular heartbeat or palpitations, stop using the product and call your doctor immediately. Nicotrol Inhaler should also be used with caution if you have a respiratory disease, an overactive thyroid, pheochromocytoma (adrenal tumors), insulin-dependent diabetes, an ulcer, severe high blood pressure, or advanced kidney disease. The nicotine in Nicotrol cartridges can be fatal if inhaled or swallowed by children or pets. Keep used and unused cartridges in a safe place.
Possible food and drug interactions when taking this medication: If you have been taking certain medications regularly, their effects may increase, decrease, or change when you stop smoking. It is especially important to check with your doctor if you have been taking the following drugs: Antidepressants such as Anafranil, Elavil, Norpramin, Pamelor, Sinequan, and Tofranil Theophylline (Theo-Dur, Theo-24, Slo-bid)
Special information if you are pregnant or breastfeeding: Cigarette smoking during pregnancy is associated with low birth weight, an increased risk of stillbirth, and a greater chance of miscarriage, so it's extremely important to quit. The Nicotrol Inhaler system may be less harmful than cigarettes, since it does not contain the hydrogen cyanide and carbon monoxide present in cigarette smoke. Nevertheless, nicotine alone can cause fetal harm in lab animals, and your best course is to avoid nicotine in any form. Quitting with the aid of a nicotine-replacement system such as Nicotrol Inhaler should be considered only if all other quit-smoking strategies fail. Discuss the problem thoroughly with your doctor. Nicotine passes into breast milk and ideally should not be taken in any form during breastfeeding. However, use of the Nicotrol Inhaler system could be preferable to smoking, since it may reduce the level of nicotine in your system. If you are breastfeeding, discuss with your doctor the relative pros and cons of quitting with the Nicotrol Inhaler.
Recommended dosage: Dosage varies with the stage of treatment. Initial Treatment (Up to 12 Weeks): Use at least 6 cartridges a day for the first 3 to 6 weeks. Additional doses may be needed to control the urge to smoke, up to a maximum of 16 cartridges a day. The average number of doses falls between these extremes. Gradual Reduction of Dose (Up to 12 Weeks): Start using Nicotrol Inhaler less frequently. You may find it helpful to keep a tally of daily usage, set a steadily diminishing target, or plan a fixed quit date. Some people find that they can stop abruptly with success.
Overdosage: Excessive doses of nicotine can cause severe symptoms, and may even be fatal. If you suspect an overdose, seek medical attention immediately. Symptoms of nicotine overdose may include: Abdominal pain, breathing abnormalities, cold sweat, confusion, diarrhea, dizziness, exhaustion, headaches, hearing difficulties, increased salivation, low blood pressure, nausea, pallor, tremor, vision problems, vomiting, weakness