May cause insomnia, dry mouth, headache, tremors, nausea, or anxiety

Pregnancy category B

Avoid in patients with seizure disorders, bulimia or anorexia nervosa, or history of head trauma and in patients currently using bupropion or an MAOI.

150 mg per day for three days, then twice per day for seven to 12 weeks. Start treatment one to two weeks before quit date.

No food or drink 15 minutes before use; frequent dosing

May cause jaw pain, mouth soreness, dyspepsia, or hiccups

Pregnancy category D; may use in pregnant women if nonpharmacologic measures fail and if the benefit outweighs the risk

Avoid in patients with dental problems or temporomandibular joint syndrome.

Cardiovascular precautions†

Patients who smoke < 15 cigarettes per day: one 2-mg piece of gum every one to two hours

Patients who smoke ≥15 cigarettes per day: one 4-mg piece of gum every one to two hours

Frequent dosing necessary

May cause mouth and throat irritation

Pregnancy category D

Cardiovascular precautions†

Six to 16 10-mg (only delivers 4 mg of nicotine) cartridges per day for three months; taper dosages over six to 12 weeks.

May cause mouth soreness or dyspepsia

Frequent dosing necessary; no food or drink 15 minutes before use

Pregnancy category D

Cardiovascular precautions†

Weeks 1 to 6: one lozenge every one to two hours

Weeks 7 to 9: one lozenge every two to four hours

Weeks 10 to 12: One lozenge every four to eight hours

Patients who smoke their first cigarette of the day within 30 minutes of awakening should use the 4-mg dose; others should use the 2-mg dose.

Less flexible dosing; slow delivery of nicotine

May cause skin irritation or sleep problems if worn at night

Pregnancy category D

Cardiovascular precautions†

Patients who smoke more than 10 cigarettes per day: 21 mg every 24 hours for six to eight weeks, step down to 14 mg every 24 hours for two to four weeks, then to 7 mg every 24 hours for two to four weeks

Patients who smoke 10 cigarettes or less per day: 15 mg every 16 hours for six weeks

Frequent dosing necessary

May cause nose and eye irritation or cough

Most addictive of the NRTs

Pregnancy category D

Cardiovascular precautions†

One or two 0.5-mg doses in each nostril every hour for three to six months; taper doses over four to six weeks