Nicotine dependence (Formulary)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

Refer to the BNF and guidance on Smoking cessation interventions. Smoking cessation interventions are a cost-effective way of reducing ill health and prolonging life.  Advise smokers to stop and offer help, with follow-up when appropriate. When possible, smokers should have access to a smoking cessation advisor and/or a pharmacist for behavioural support. Encourage smokers who are not ready to stop smoking or are unable to stop in one step to reduce tobacco use in preparation for a future quit attempt.

NICE guidance recommends that NRT should be prescribed:

  • along with advice, encouragement and support as part of the smoking cessation programme.
  • taking into account the person’s intention and motivation to quit and how likely it is they will follow the course of treatment.
  • Use NRT as a component of a smoking cessation support programme in accordance with SMC advice.

NICOTINE

Therapy notes

Formulation and dosage details

Formulation:

Transdermal patch (Nicotinell® patch, Niquitin® clear patches) 7mg/24 hours, 14mg/24 hours, 21mg/24 hours 

Transdermal patch (Nicorette Invisipatch®), 10mg/16 hours, 15mg/16 hours, 25mg/16 hours

Dosage:

Niquitin® clear patches are reserved for those displaying sensitivity to Nicotinell® patches.

Nicorette Invisipatch® is recommended for pregnant women and those who suffer sleep disturbance with the 24-hour patch.

Formulation and dosage details

Formulation:

Lozenge (Nicotinell Lozenge®) 1mg, 2mg

Lozenge mini (Niquitin Minis Lozenge®) 2mg, 4mg

Formulation and dosage details

Formulation:

Sublingual tablet (Nicorette Microtab®) 2mg

Formulation and dosage details

Formulation:

Chewing gum (Nicotinell Gum®) 2mg, 4mg

Formulation and dosage details

Formulation:

Inhalator (Nicorette Inhalator®) 15mg/cartridge

Formulation and dosage details

Formulation:

Oromucosal spray (Nicorette Quick Mist®) 1mg/metered dose

Formulation and dosage details

Formulation:

Nasal spray (Nicorette Nasal Spray)®) 500 micrograms/metered spray

Dosage:

Sprays are fast-acting and may be particularly targeted for heavy smokers.

VARENICLINE

Therapy notes

  • MHRA advice: Vareicline and suicidal behaviour: cohort study provides some reassurance (December 2014) (www.gov.uk).
  • EMC
  • Cautions: Conditions that may lower seizure threshold; history of cardiovascular disease; history of psychiatric illness (may exacerbate underlying illness including depression); predisposition to seizures.

Formulation and dosage details

Formulation:

Tablets 500 microgram, 1mg

Editorial Information

Document Id: F105