Physician Information About: NICOTINE LOZENGE USE

Commit Nicotine Lozenge – available OTC

*PREPARATION:              

Patients should stop smoking before beginning nicotine lozenge use.

*DOSAGE:

Two doses are available: 2 mg and 4 mg.

2-mg lozenge can be used with PATIENTS WHO SMOKE THEIR FIRST CIGARETTE AFTER 30 MINUTES OF WAKING.

4-mg lozenge can be used with PATIENTS WHO SMOKE THEIR FIRST CIGARETTE WITHIN 30 MINUTES OF WAKING (indicating they are highly dependent on nicotine (e.g., those smoking more than 25 cigarettes daily). Clinicians may also recommend the higher dosage if patients request it or have failed to quit using the 2-mg lozenge.

Patients should use no more than 20 lozenges daily.

*ADMINISTRATION:

Patients should place the lozenge in the mouth and allow the lozenge to slowly dissolve (about 20-30 minutes).

They should be instructed to minimize swallowing, and to not chew or swallow the lozenge.

They should be instructed to occasionally move the lozenge from one side of their mouth to the other until completely dissolved (about 20-30 minutes).

They should not eat or drink 15 minutes before using or while the lozenge is in the mouth.

*DURATION OF THERAPY:

To improve chances of quitting, they should use at least 9 lozenges per day for the first 6 weeks.

They should not use more than one lozenge at a time or continuously use one lozenge after another since this may cause hiccups, heartburn, nausea or other side effects.

They should not use more than 5 lozenges in 6 hours, and should not use more than 20 lozenges per day.

They should stop using the nicotine lozenge at the end of 12 weeks.

*ADVERSE REACTIONS:

Patients using the 2mg lozenge may switch to the 4mg lozenge or use the 2mg lozenge more often if exhibiting withdrawal symptoms, such as: restlessness, irritability, anxiety, difficulty concentrating, or depressed mood.

Patients using the 4mg lozenge may should switch to the 2mg lozenge if exhibiting these symptoms: nausea, vomiting, lightheadedness, or palpitations.

*CONTRAINDICATIONS AND PRECAUTIONS:

-Contraindications:

Patients who have had a recent myocardial infarction, severe or worsening angina, or life threatening arrhythmias. 

-Precautions:

As with the nicotine patch and gum, the nicotine lozenge should be used in pregnancy only if the increased likelihood of smoking cessation, with its potential benefits, outweigh the risk of nicotine replacement and potential concomitant smoking.

**Click here for a Printable Patient Handout**

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