Nicotine Lozenge

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The nicotine lozenge (Commit) is a nicotine replacement medicine. It gives you nicotine in a lozenge that dissolves in your mouth. Like other nicotine replacement medicines, it has been found to double quit rates! One nice thing about the lozenge is that it can be used any time you have tough cravings. Some people prefer the taste of the lozenge to the gum.

 

How to Use Nicotine Lozenges

The nicotine lozenge should be used when you are having strong cravings or by following the recommended use:

  • Weeks 1- 6: 1 lozenge every 1- 2 hours
  • Weeks 7- 9: 1 lozenge every 2 - 4 hours
  • Weeks 10-12: 1 lozenge every 4 - 8 hours

On average, people use nine or more lozenges per day for the first six weeks.

There are two dose strengths of lozenge: the 2mg and 4mg. Many users start with the 2mg lozenges. If you smoke 20 or more cigarettes per day or smoke within 30 minutes of waking, you can start with the 4-mg lozenge.

Use lozenges exactly as directed. Place the lozenge in your mouth and let it slowly dissolve. Move the lozenge from one side of your mouth to the other. It is normal to feel a warm or tingling sensation. Do not eat or drink 15 minutes before using or while the lozenge is in your mouth; this may make them less effective. Do not chew or swallow lozenges.

 

Warnings

Tell your doctor if you have or have ever had:

  • Heart attack
  • Irregular heart rate
  • Angina or uncontrolled high blood pressure
  • Ulcers
  • Pheochromocytoma
  • Overactive thyroid
  • Diabetes
  • Kidney or liver disease
  • Dental condition or disorder

IMPORTANT NOTE: Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using nicotine replacement, stop using it and call your doctor immediately. Nicotine may cause harm to the fetus or baby.

 

Ask a doctor or pharmacist before use if you are:

  • Using a non-nicotine stop smoking drug
  • Taking prescription medicine for depression or asthma; your prescription dose may need to be adjusted
  • Using prescription and/or nonprescription medication(s), especially acetaminophen (Tylenol), caffeine, diuretics ('water pills'), imipramine (Tofranil), insulin, medications for high blood pressure, oxazepam (Serax), pentazocine (Talwin, Talwin NX, Talacen), propoxyphene (Darvon, E-Lor), propranolol (Inderal), theophylline (Theo-Dur, Slo-bid), and vitamins

IMPORTANT NOTE: Do not use more than one lozenge at a time or continuously use one lozenge after another since this may give you hiccups, heartburn, nausea or other side effects. Stop using the nicotine lozenge at the end of 12 weeks. If you still feel the need to use nicotine lozenges, talk to your doctor.

Nicotine lozenges may cause side effects.

 

Stop use and ask a doctor if you develop:

  • Mouth problems (ulcers, bleeding, pain)
  • Severe indigestion or severe sore throat
  • Irregular heartbeat or palpitations

IMPORTANT NOTE: It is optimal to begin using the NRT products on the day you stop using tobacco. However, it is not essential to stop using tobacco products when you begin NRT products, if you are not able to stop using tobacco at that time. If you are using an OTC NRT while trying to quit smoking but slip up and have a cigarette, you should not stop using the NRT. You should keep using the OTC NRT and keep trying to quit. Call your doctor if you get too much nicotine (an overdose). Signs of an overdose may include dizziness, upset stomach, bad headaches, vomiting, cold sweats, confusion, blurred vision, hearing problems, weakness or fainting.

 

Effectiveness

Nicotine lozenges have been found to be safe and effective as a stop smoking aid. Using the lozenges as directed can prevent side effects or nicotine overdose symptoms.

 

References

Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence:  2008 Update.  Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

US Department of Health and Human Services. (2000). Reducing Tobacco Use: A report of the surgeon general. Atlanta, Georgia: USDHHS, Center for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health, Office on Smoking and Health.

 

Please note, National Jewish Health does not endorse specific products. The names of NRT products are included to familiarize the consumer with the various products that are available. 

 

This information has been approved by Thomas Ylioja, MSW, PhD (December 2018).

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