Table 3.

Nicotine replacement therapy: dosage guidelines, safety and other clinical considerations

NICOTINE	Patches	Chewing gum	Tablets		Oral spray
Format	24-hr release: 7, 14 and 21 mg 16-hr release: 10 and 15 mg	2 and 4 mg	1, 2, 1.5 and 4 mg		1 mg
Dosage	> 10 cig/day: 21 mg/day (4–6 weeks) 14 mg/day (2 weeks) 7 mg/day (2 weeks) ≤ 10 cig/day: 14 mg/day (6 weeks) 7 mg/day (2 weeks)	1st cig ≤ 30 min after getting up: 4 mg 1st cig > 30 min after getting up: 2 mg 1-6 weeks: 1/1-2 h 7-9 weeks: 1/2-4 h 10–12 weeks: 1/4-8 h	1st cig ≤ 30 min after getting up: 2 mg 1st cig > 30 min after getting up: 1 mg 1-6 weeks: 1/ 1-2 h 7-9 weeks: 1/2-4 h 10–12 weeks: 1/4-8 h		1-2 sprays in the mouth (6 weeks) if you feel like smoking; reduce progressively afterwards
Precautions	Recent myocardial infarction (≤ 2 weeks); serious arrhythmias; angina pectoris; pregnancy and lactation; adolescents (< 18 years) Temporomandibular dysfunction (with gum) and bronchospasm (with spray)
Most common side effects	Local skin reaction (pruritus, heat, erythema) Sleep disorders associated with nicotine absorption at night (insomnia, vivid dreams)	Oral and pharyngeal irritation Inconvenience Gastrointestinal discomfort (dyspepsia, nausea) Hiccup Jaw muscle pain		Oral and pharyngeal irritation. Gastrointestinal discomfort (dyspepsia, nausea) Hiccup
Advantages	High adherence Can be combined with other therapeutic drugs 24-hour release	Possibility of oral replacement therapy Lower weight gain Individual dosing to control withdrawal and other symptoms Can be combined with other drugs for TUD
Disadvantages	No adjustments allowed in monotherapy. Not suitable for patients with dermatological disorders	Requires adequate dose control Not suitable for patients undergoing dental treatment Requires training in the form of use to achieve adequate effectiveness		Requires adequate dose control