II. Indications

III. Efficacy

  1. One year quit rate 25% (12% for Placebo)
  2. Best in obese heavy smokers and non-white patients
    1. Lerman (2004) Ann Intern Med 140:426-33 [PubMed]

IV. Mechanism

  1. Rapidly absorbed via nasal mucosa

V. Preparations

  1. Available only by prescription in the United States
  2. Concentration 10 mg/ml and provides 0.5 mg/spray
  3. Each bottle contains 10 ml

VI. Dosing

  1. One dose is 1 spray each nostril (1 mg Nicotine)
  2. Start 1-2 doses per hour while awake for 8 weeks
    1. Do not exceed 5 doses per hour (or more than 40 doses per day)
  3. Taper over the next month
  4. Minimum recommended: 8 doses (8 mg) per day
  5. Maximum: 40 doses (40 mg) per day
  6. Do not use more than 6 months total

VII. Contraindications

  1. Same as Nicotine Patch
  2. Bronchospasm

VIII. Adverse Effects

  1. Nasal Irritation (90%): Rhinorrhea or sneezing
    1. Symptoms may be severe
    2. Often continues throughout course of use
  2. Throat irritation
  3. Nausea
  4. Watery eyes
  5. Cough

IX. Precautions

  1. Pregnancy Category D
  2. Greater abuse potential than Nicotine Patch or gum

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Cost: Medications

nicotrol ns (on 6/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
NICOTROL NS 10 MG/ML SPRAY $9.61 per ml

Ontology: Nicotrol NS (C0939401)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
English Nicotrol NS

Ontology: Nicotine Nasal Inhaler (C1249285)

Concepts Clinical Drug (T200)
English Nicotine Nasal Inhaler