Nicotinic Agonist·Addiction Medicine

Nicotine lozenge

Relief of acute nicotine cravings, smoking cessation adjunct

NRTNicabate Minis, Nicorette Lozenges1.5 mgUNSCHEDULEDTGA

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At a glance

Max Dose

15 lozenges/day

Onset

Minutes

Caution: Technique

DO NOT CHEW

High risk: Acidic Drinks

BLOCK ABSORPTION

Cautions

Avoid / Cautions

CONTRAINDICATED - Do not use nicotine lozenges in non-tobacco users, children under 12 years, or patients with hypersensitivity to nicotine or product components. Use medical review for pregnancy/lactation, unstable cardiovascular disease, diabetes, active GI disease, severe renal/hepatic impairment, uncontrolled hyperthyroidism, phaeochromocytoma, or seizure history.

Where it stands

Rapid Summary

Overview

Short-acting, fast-relief Nicotine Replacement Therapy. Absorbs through the buccal mucosa. More discreet than gum and often preferred by patients with dentures.

Clinical Focus

Must be allowed to dissolve slowly. Chewing or swallowing it destroys the drug in the stomach and causes severe hiccups/nausea.

Bottom Line

Nicotine lozenge is an on-demand oral NRT for smoking cessation, but must be dissolved slowly (not chewed or swallowed) and causes hiccups and throat irritation.

Formulation & Access

Brand Names

Nicabate Minis, Nicorette Lozenges

Oral Routes

Lozenges (1.5 mg, 2 mg, 4 mg). Mini-lozenges dissolve faster.

Prescribing & PBS

Over The Counter (OTC).

Indications & Use

Primary

TGA

Relief of acute nicotine cravings, smoking cessation adjunct.

Quick reference

Class & Role

Nicotinic Agonist — Short-acting, fast-relief Nicotine Replacement Therapy.

Route / Formulation

Lozenges (1.5 mg, 2 mg, 4 mg). Mini-lozenges dissolve faster. (Nicabate Minis, Nicorette Lozenges)

Usual Dose & Max

Buccal 2 mg or 4 mg lozenge when cravings occur. Use 4 mg if first cigarette is within 30 minutes of waking or >20 cigarettes/day. Max 15 lozenges/day.

Key Indication Doses

Acute Cravings (> 20 cigs/day or 1st cig within 30 mins of waking): Buccal 4 mg lozenge PRN for cravings. Max 15/day. Acute Cravings (< 20 cigs/day): Buccal 2 mg lozenge PRN for cravings. Max 20/day. Combination Therapy: Best used as 'breakthrough' therapy alongside a daily 24h Nicotine Patch.

Best Uses

Nicotine lozenge is an on-demand oral NRT for smoking cessation, but must be dissolved slowly (not chewed or swallowed) and causes hiccups and throat irritation.

Key Risks

Gastrointestinal: Hiccups, severe nausea, heartburn, sore throat (Caused by swallowing nicotine-laden saliva). Cardiovascular: Palpitations.

Key Interactions

Coffee, Juice, Soft Drinks. Acidic drinks lower the pH of the mouth. Nicotine requires an alkaline pH to absorb. If the patient drinks coffee while the lozenge is dissolving, absorption drops to zero. Wait 15 mins after acidic drinks.

Monitoring

Teach the patient to move the lozenge from one side of the mouth to the other occasionally, and to NOT chew it.

Clinical Pearl

Nicotine gum is notoriously difficult for elderly patients with dentures. The lozenge provides the exact same rapid mucosal hit without sticking to dental work.

Access

Nicabate Minis, Nicorette Lozenges1.5 mg

Brand: Nicabate Minis, Nicorette Lozenges
Formulation: Lozenges (1.5 mg, 2 mg, 4 mg). Mini-lozenges dissolve faster.

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Cautions

Avoid / Cautions