Table 5.

Suggestions for the clinical use of pharmacotherapies for smoking cessation ^*

Pharmacotherapy	Precautions, contraindications	Adverse effects	Dosage	Duration	Availability
First-line
Sustained release bupropion hydrochloride	History of seizure	Insomnia	150 mg every morning for 3 days, then 150 mg twice daily (begin treatment 1–2 weeks pre-quit	7–12 weeks Maintenance up to 6 months	Prescription only
	History of eating disorders	Dry mouth
		Seizures
Nicotine gum		Mouth soreness Dyspepsia	1–24 cigarettes/day: 2mg gum (up to 24 pieces/day	Up to 12 weeks	OTC only
			≥ 25 cigarettes/day: 4 mg gum (up to 24 pieces/day)
Nicotine inhaler		Local irritation of mouth and throat	6–16 cartridges/day	Up to 6 months	Prescription only
Nicotine lozenge		Nausea Heartburn	Time to 1st cigarette > 30 min: 2 mg lozenge	Up to 12 weeks	OTC only
			Time to 1st cigarette ≤ 30 min: 4 mg lozenge
			Between 4–20 lozenges/day
Nicotine nasal spray		Nasal irritation	8–40 doses/day	3–6 months	Prescription only
Nicotine patch		Local skin reaction	Ex. 21 mg/24 hrs	4 weeks	Prescription and OTC
		Insomnia	14 mg/24 hrs	then 2 weeks
			7 mg/24 hrs	then 2 weeks
			Ex. 15 mg/16 hrs	8 weeks
Varenicline	Significant kidney disease	Nausea Trouble sleeping	0.5 mg/day for 3 days	3–6 months	Prescription only
			0.5 mg twice/day for
	Patients on dialysis	Abnormal or vivid/strange dreams	4 days
			Then, 1 mg twice/day
		Depressed mood and other psychiatric symptoms	(Begin treatment one week pre-quit)

^*The information contained in this table is not comprehensive. See package inserts for additional information including safety information.