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All about: Nicotine nasal spray

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Generic name: Nicotine nasal spray
Brand names: Nicotrol NS

Why is Nicotine nasal spray prescribed?

Nicotrol NS is used to relieve withdrawal symptoms in people who are attempting to give up smoking. It should be used as part of a comprehensive smoking cessation program.

Most important fact about Nicotine nasal spray

If you continue to smoke and take Nicotrol NS at the same time, you may experience side effects due to high nicotine levels in your body.

How should you take Nicotine nasal spray?

You should stop smoking completely before you begin using Nicotrol NS. Tilt your head back slightly when administering the spray and be careful not to sniff, swallow, or inhale through the nose.

The amount of Nicotrol NS you require depends on your individual needs. One dose is made up of 1 spray in each nostril. The recommended starting regimen is 1 or 2 doses per hour. This may be increased to a maximum of 40 doses (80 sprays) per day if you've been a heavy smoker. Take at least 8 doses (16 sprays) per day; anything less is unlikely to be effective.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature, away from children and pets.

What side effects may occur?

Problems experienced by people using Nicotrol NS include nicotine withdrawal symptoms, common complaints of smokers, and local effects of the spray. Most people report some nasal irritation, which usually diminishes with continued use of the product. Other side effects are unpredictable. 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 taking Nicotrol NS.

  • More common side effects may include:
    Abdominal pain, acne, back pain, confusion, cough, dental problems, difficulty breathing, gas, gum problems, headache, itching, joint pain, menstrual pain or disorders, muscle aches, nasal irritation, nausea, palpitations, runny nose, sneezing, throat irritation, watering eyes
  • Rare side effects may include:
    Abnormal vision, allergy, amnesia, asthma, bronchitis, bruises, burning of the nose or eyes, change in sense of smell, diarrhea, dry mouth, earache, eye irritation, facial flushing, hiccups, hoarseness, inability to comprehend words, increased sputum, migraine, nasal congestion, nasal ulcer or blister, nosebleeds, numbness, numbness of the nose or mouth, pain, rash, sinus irritation, sore throat, swelling due to fluid retention, taste alteration

Why should Nicotine nasal spray not be prescribed?

Do not use Nicotrol NS if you are allergic to nicotine or if you have ever had a hypersensitivity reaction to it.

Special warnings about Nicotine nasal spray

Stop smoking completely when you start using Nicotrol NS. The extra nicotine it delivers could lead to a toxic overdose. If you're still smoking after 4 weeks of Nicotrol NS therapy, check with your doctor. You should probably stop using the product.

It is possible to become dependent on Nicotrol NS. The product is less addictive than cigarettes, but nearly a third of the people using it report some feelings of dependence, and 15 to 20 percent use the product for longer than the recommended period. Remember, though, that Nicotrol NS has not been studied for more than 6 months and long-term use is not recommended.

Use Nicotrol NS with caution if you have a heart condition or a circulation problem. Avoid it completely if you're recovering from a heart attack or have severe angina or serious heartbeat irregularities.

Nicotrol NS is not recommended for people with asthma. It can make the condition worse. You should also avoid Nicotrol NS if you have a chronic nasal disorder such as allergy, nasal polyps, nasal inflammation, or sinusitis. Use Nicotrol NS with caution if you have a glandular problem such as hyperthyroidism, pheochromocytoma, or insulin-dependent diabetes. Nicotine affects the glands. Caution is also warranted if you have an ulcer. Nicotine delays healing of ulcers.

Use Nicotrol NS cautiously, too, if you have serious high blood pressure. The product can make this condition worse.

Possible food and drug interactions when taking Nicotine nasal spray

When you quit smoking, the dosage of certain drugs may have to be changed. It is especially important to check with your doctor if you are taking one of the following:

Acetaminophen-containing products such as Tylenol
Drugs classified as beta blockers, such as Inderal, Sectral, and Tenormin
Caffeine-containing products such as No Doz
Certain airway-opening products such as Isuprel, Afrin, and Neo-Synephrine
Imipramine (Tofranil)
Insulin
Labetalol (Normodyne, Trandate)
Oxazepam (Serax)
Pentazocine (Talwin)
Prazosin (Minipress)
Theophylline (Theo-Dur)

Special information if you are pregnant or breastfeeding

Nicotine from any source can harm a developing baby. If you're pregnant, it's best to quit without a nicotine replacement product. Use Nicotrol NS only if you think it will speed the moment that you're nicotine free.

Nicotine makes its way into breast milk. A nursing infant may be exposed to less nicotine from Nicotrol NS than from cigarette smoking, but the best course is to avoid nicotine entirely.

Recommended dosage

ADULTS

A dose is defined as 1 spray in each nostril. When you start Nicotrol NS, one or 2 doses per hour is recommended. Take no more than 5 doses per hour or 40 doses per day. During the treatment period, a minimum of 8 doses per day is usually needed for the drug to be effective.

If you succeed in avoiding cigarettes for 8 weeks of Nicotrol NS therapy, your doctor will instruct you to discontinue the spray over the next 4 to 6 weeks. Recommended strategies for discontinuation include:

Stop "cold turkey"
Cut each dose in half (1 spray instead of 2)
Use the spray less frequently
Keep a tally of daily usage and try to decrease the amount used each day
Skip doses by not medicating every hour
Set a planned quit date for stopping use of the spray

Overdosage

Nicotine can be especially toxic to children and pets. Even the residual nicotine in a used container of Nicotrol NS can be harmful. Keep all bottles of Nicotrol NS, used and unused, out of the reach of children.

If a bottle of Nicotrol NS breaks, the spill should be cleaned up immediately with an absorbent cloth or paper towel. Avoid contact with the skin. The area of the spill should be washed several times. If even a small amount of Nicotrol NS comes in contact with the skin, lips, mouth, eyes, or ears, rinse the affected area with water. Keep pets and children away from the area of the spill.

  • Symptoms of Nicotrol NS overdose may include:
    Abdominal pain, cold sweats, convulsions, diarreha, disturbed hearing and vision, dizziness, headache, heart failure, nausea, pallor, prostration, hypotension, respiratory failure, salivation, tremor, mental confusion, vomiting, weakness

If you suspect an overdose, seek medical attention immediately.

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