Nicotine Nasal Spray (Nasal)

Nicotine nasal spray helps individuals manage the nicotine withdrawal symptoms by replacing the nicotine from cigarettes.

Overview

Nicotine nasal spray, also known as Nicotrol NS spray is a non-aerosol medication that assists cigarette smokers to quit and helps them manage withdrawal symptoms. Nicotine in tobacco is one of the primary ingredients in cigarettes, and it results in addiction. Smoking has adverse effects on your health like cancer, lung disease, and heart disease. Some of these conditions inform the decision to quit.

However, stopping cigarette use is challenging because when one decides to quit, the blood levels of this substance will drop drastically. As a result, the individual suffers severe withdrawal symptoms akin to that of illness. Some include nervousness, headaches, weight gain, having trouble concentrating and high cravings for tobacco.

Nicotrol NS replaces the nicotine that one would get from cigarettes and manages these symptoms by making them less severe and easing the transition process from addiction to not smoking. The amount of nicotine in the prescription is reduced with time until the individual can stop using it. Nicotrol NS treatment is a crucial part of the rigorous rehabilitation programs for cigarette addicts that includes other parameters like behavioral change, counseling, psychological support and moral support. The eventual goal of such a product is to help you quit altogether.

Conditions it treats

  • Treats withdrawal from regular use or addiction of nicotine
  • Helps control the urge to smoke cigarettes
  • Aids smokers to quit smoking

Type Of Medicine

  • Neurotransmitter substance used in addictive disorders (nicotine dependence)
  • Nicotine replacement product

Side Effects

Taking drugs often means dealing with side effects. There are various undesirable effects that may result from the use of Nicotrol NS. For some, one may need to see a doctor. Others come at the beginning of treatment and are less frequent or stop once the body conditions adjust to the drug. Other effects do not need medical attention at all. In the same way, they are different in frequency of incidence, they may also differ in severity, and they also depend on the patient. The following are some of the side effects that may occur as a consequence of using Nicotine nasal spray.

Among the more frequently occurring side effects of nicotine use are:

  • Nasal irritation, tingling, mild burning and possible blistering
  • Nosebleeds, a runny or stuffy nose
  • Change in smell
  • Sores and blisters in the mouth
  • Irritation at the throat, hoarseness
  • Numbness in the nose, mouth or head parts
  • Sneezing, coughing, flu symptoms
  • Watery eyes
  • Feeling nauseated and vomiting

Other effects are not as common as the above symptoms but may still present.

Below are some of these:

  • Unusual fatigue
  • General body weakness
  • Tightening of limbs
  • Stomach acidity
  • Difference in taste (unpleasant mouth taste)
  • Heartburn
  • Chest congestion
  • Burping and hiccups
  • Diarrhea
  • Lightheadedness
  • Pain in the neck, jaw, teeth and the mouth
  • Indigestion

Due to the diminished amount of nicotine in the body, an individual might still suffer some of the withdrawal symptoms even while using this nicotine replacement therapy. Moreover, if the patient uses Nicotrol in high, frequent doses, over an extended period, they may still present with the withdrawal symptoms. Some of these symptoms include the following:

  • Tobacco cravings
  • Dizziness
  • Anxiety
  • Insomnia or experiencing vivid bad dreams
  • Irritability
  • Headaches
  • Depression
  • Nervousness
  • Blurred vision
  • Pounding in the ears

If these occur suddenly and at high intensities, let your physician know immediately.

Though rare, it is likely that one may have an allergic reaction towards this nasal spray. Most hypersensitivity reactions have marked characteristics including an itchy skin rash breakout (hives), swollen face, mouth, tongue, lips, throat, tightness in the chest, having trouble breathing and severe vertigo (feeling lightheaded).

There are however some severe side effects that require the attention of a doctor as soon as the patient starts experiencing them. During therapy with Nicotrol NS, alert a medical practitioner if you experience severe dizziness, extreme mental changes and unstable mood swings, edema on the feet, swollen hands and ankles, numbness and tingling sensations in the extremities. Some extremely adverse effects may warrant the cessation of the therapy under the advisement of a physician, of course. Intense chest pain, severe migraines, slurred speech, rapid and irregular heart pounding, bronchospasms, and confusion are some of these.

Call your physician to report any severe or persistent side effects and get their professional advice on management. Alternatively, make the report to the Food and Drug Association (FDA). You can reach them online at www.fda.gov/medwatch or phone them at 1-800-FDA-1088 if you are in the United States. Canadians can call 1-888-234-2345 to report these effects to Health Canada or your doctor, and they will give you medical counsel.

The above list does not exhaustively discuss all the side effects that may accompany the use of Nicotine nasal spray. If you experience any others besides those listed above, report to the doctor or the above agencies and get professional help.

Dosage

Your pharmacist and the medication guide have all the directions and instructions you require for the use of the Nicotine nasal spray. For any new prescription or refill, ensure that you follow these instructions with care and precision. Before beginning a dose, one should ensure that they stop smoking.

The proper technique with which to use the product involves administration of the spray once into each nostril with the head slightly tilted backward. One should not sniff, inhale or swallow the spray as it is being administered. Learn the technique right and use it as the doctor instructs. Priming the pump may be necessary at the beginning of the use or if you haven't used the spray for a while.

Dosing is tailored to each patient's needs based on their nicotine dependence levels and the frequency of occurrence of the withdrawal symptoms. Soon as you quit smoking, you may use about 2 to 4 sprays in an hour and at least eight doses each day. That totals to about 16 sprays per day which is ideal for effectiveness. Each time you spray the Nicotrol, it delivers approximately 50 microliters containing 0.5mg of nicotine. Each nostril gets one spray making up one dose which is equivalent to 1mg of nicotine. The dose may increase depending on the individual and according to the doctor's directions but should never exceed the recommended 40mg (80 sprays) per day. Initially, the physician may put you on a regular dosing schedule, so your body adjusts to the medication and does not experience too many side effects. They aim for one that reduces the urge to smoke with minimal side effects. The dose should decrease with time.

Therapy with Nicotrol should ideally take about three months, according to dosing recommendations. However, if one needs to go on, it should not exceed six months. As the patients continue the treatment, the doctor should gradually wean them off the spray for eventual discontinuation. They usually direct the patient to use half the dose at specific points in the duration of therapy. They encourage them to monitor how much they spray daily, over time and to reduce the frequency of use. They recommend trying to meet a steady use reduction target, skip some doses, plan when to stop and progressively work towards it. Their doctors and support systems should help them monitor and achieve their objectives. The aim of treatment is the complete cessation of smoking. Sometimes one may be unable to quit smoking after the recommended time of use and may need to stop using Nicotrol and look for other alternatives.

If you have a Nicotrol prescription and are using it on a regular dose schedule but skip a dose or forget to use the medicine as indicated, make sure you use it the moment you remember. If you remember when it's almost time for you to take the next dose, do not take the missed dose or double dose to make up for it. Go back to your usual dosing schedule and continue taking the medicine as instructed.

In case you overdose or suspect that an individual has suffered an overdose, get in touch with a medical practitioner or the local poison control center immediately. You can reach them at 1-800-222-1222. Narrate the full account of the things that happened. Some of the signs indicating an overdose include the heart beating faster than usual, shallow breathing, feeling dizzy, feeling weak, having hearing problems, seizures, drooling, confusion, and nausea, among others. Call 911 if the individual passes out or has difficulty breathing.

Major Drug Interactions

When using a drug together with another, the effects of one or both treatments in the body may be different due to the drugs' interactions with one another. The interaction may increase drug metabolism; absorption may also increase which may lead to toxicity, or it could reduce, leading to reduced effectiveness. Some new side effects may also come about as a result. When using Nicotrol NS, there are drugs which one needs to look out for because of the possible interaction. Some of these include:

  • Aleve (Naproxen)
  • Aspirin
  • Ergocaf-PB
  • Ergocomp-PB
  • Ergomar (Ergotamine)
  • Ergonovine
  • Aplenzin (Bupropion)
  • Sansert (Methysergide Maleate)
  • Spastrin
  • Gabapentin
  • Varenicline
  • Temazepam
  • Trazodone
  • Klonopin (Clonazepam)
  • Lisinopril
  • Loratadine
  • Ondansetron
  • Restoril (Temazepam)
  • Simvastatin
  • Spiriva (Tiotropium)
  • Ventolin HFA (Albuterol)
  • Vitamin D3 (Cholecalciferol)
  • Bel-Phen-Ergot
  • Bel-Tabs
  • Belcomp-PB
  • Bellamine
  • Bellamor
  • Bellaphen-S
  • Bellaspas
  • Bellergal-S
  • Bromocriptine
  • Budeprion
  • Buproban
  • Bupropion / Naltrexone
  • Baclofen
  • Cafatine
  • D.H.E. 45 (Dihydroergotamine)
  • Delalutin (Hydroxyprogesterone)
  • Delta-Lutin (Hydroxyprogesterone)
  • Dihydroergotamine
  • Duragal-S
  • Duralutin (Hydroxyprogesterone)
  • E-Caff P-B
  • Eperbel-S
  • Ercaf (Caffeine / Ergotamine)
  • Telotristat
  • Ergotamine
  • Ergotrate (Ergonovine)
  • Forfivo XL (Bupropion)
  • Makena (Hydroxyprogesterone)
  • Methergine (Methylergonovine)
  • Methylergonovine
  • Metformin
  • Multivitamin
  • Methysergide Maleate
  • Micomp-PB
  • Migergot (Caffeine / Ergotamine)
  • Migracet-PB
  • Migranal (Dihydroergotamine)
  • Parlodel (Bromocriptine)
  • Prodrox (Hydroxyprogesterone)
  • Xermelo (Telotristat)
  • Zyban (Bupropion)
  • Cafergot
  • Cafetrate
  • Citalopram
  • Clonazepam
  • Cymbalta (Duloxetine)
  • Caffeine
  • Champix (Varenicline)
  • Chantix (Varenicline)
  • Contrave (Bupropion / Naltrexone)
  • Cycloset (Bromocriptine)
  • Wellbutrin, Wellbutrin SR, Wellbutrin XL (Bupropion)
  • Wigraine (Caffeine / Ergotamine)
  • Hydroxyprogesterone
  • Hylutin (Hydroxyprogesterone)

It is essential to note that therapies which typically manage high levels of blood pressure are likely to interact with the Nicotine nasal spray. Examples of such medications include beta blockers like prozosin and labetalol. Decongestants, bronchodilators and other allergy or cold medications including phenylephrine and isoproterenol may also affect the working of the drug. If you are using other nasal sprays or taking nasal decongestant tablets and drugs like oxymetazoline and phenylephrine, they may also interact with Nicotrol. Let your doctor know if you are using other (non-nicotine) products to help you stop smoking as well.

Smoking affects the liver and if you were an ardent smoker and you engaged in the activity for a long time, it probably affected the proper functioning of the liver. One of the organ's primary roles is to eliminate drugs. Smoking may affect the elimination of medications such as:

  • Pentazocine
  • Acetaminophen
  • Theophylline
  • Caffeine
  • Tricyclic antidepressants such as amitriptyline and imipramine
  • Propranolol
  • Diuretics or waters pills for example furosemide
  • Insulin
  • Oxazepam
  • Propoxyphene

Warnings

The use of a drug comes with various warnings and precautions. Read the warnings given in the medicine guide and keenly follow those that your pharmacist gives you. Inform the doctor of the things you are allergic to including drugs, food, animals, manufactured products, dyes, and preservatives or any other allergies. Check the drug ingredients for possible allergens because the product may have inactive components that may cause hypersensitivity.

Keep a list of all the drugs that you take and give this information to your doctor in case of interaction or contraindications before you start the prescription. Let them know if there is another drug or nicotine replacement product you are using to help you quit as well.

Another crucial thing to do before commencing the treatment is to inform the physician of any diseases you suffer. A detailed medical history is vital because the drug has some disease interactions. Also, let them know when you are supposed to undergo a surgical procedure. Remember to tell the surgeon, dentist and other healthcare providers that you are using the nasal spray as well.

Mention to the health practitioner if you suffer the following conditions, and they will give you proper guidance:

Smoking presents risks in pregnancy, and so does nicotine. It is advisable to try and stop smoking as much as possible while you are pregnant to avoid harming the unborn baby. Using a nicotine replacement product to help you stop at this time is also not advised. The doctor should recommend other aids to help you quit and only when extremely necessary should one use Nicotrol NS and other nicotine products while pregnant. It is also not expedient for one to smoke or use the drug while breastfeeding because it is secreted into breast milk and could have negative effects on the nursing infant. One should also avoid smoking near a young baby.

There are no stringent dietary restrictions while using the drug. It is however imperative that one does not smoke because that may increase side effect severity. Using alcohol is also ill-advised.

Ensure that you follow all the dosing instructions and the spraying technique. Be careful that the drug does not touch your skin, mouth, lips, or get into the ears. Rinse the affected area off immediately with enough water only; do not use soap. If it gets into contact with your eyes, rinse them immediately with clear running water for about 20 minutes.

Storage

Store the drug at room temperature (15 to 30 degrees Celsius). Do not store it in the bathroom. Keep it away from moisture and direct light. Make sure you store it in a safe place where children and pets will not reach it. It is not advisable to flush drugs down the toilet or discard them down the drain unless directed to do so. Throw away the used container with the child restraint cap on as your local waste disposal or pharmacist advises.

Summary

The decision to quit smoking is very prudent because stopping will not only improve your health but your lifestyle as well. It will also help you avoid many other diseases and enable you to live longer. Patients should receive the necessary support in the journey to quitting. Nicotine replacement is a fundamental part of the behavioral, psychological and medical rehabilitation process. The goal of the Nicotrol spray is to help the patient completely quit smoking. However, do not rely only on the drug. Ensure you participate in formal programs designed to help you quit.

For proper efficiency, however, ensure that you follow the appropriate use and dosing recommendations to the letter. Heed all the warnings given, report the side effects and follow storage instructions and do not share your medicine. Share your smoking and medical history with the doctor along with a list of other drugs that you are on and substances you may be allergic to and tell your other physicians that you are also on Nicotrol for a safe prescription. Nicotrol may not help some completely quit smoking, and if abstinence isn't achieved within the recommended time, they may have to stop using it. The situation may call for different means of intervention or subsequent treatments after a period of time.