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nicotine lozenge (Commit)
Tradename: Commit.
Indications:
- Smoking cessation:
Contraindications:
- ok for patients with dental disease
Dosage:
1) based on 'time to 1st cigarette'
2) 4 mg for patients who normally start smoking within 30 minutes of awakening
3) 2 mg for patients who normally start smoking > 30 minutes after awakening
4) 1 lozenge every 1-2 hours for 6 weeks, then every 2-4 hours for 3 weeks, then 4-8 hours for 3 weeks
5) do NOT chew lozenges; this causes nicotine to release too rapidly
6) may be used with nicotine patch
* 2-mg or 4-mg QD) efficacy, 35% at 4 weeks, 30% at 12 weeks, 25% at 26 weeks, & 20% at 52 weeks, & similar frequency of adverse effects [2]
Pharmacokinetics:
-> acidic drinks reduce absorption
-> avoid orange juice, coffee, soft drinks before & during use of Commit
Adverse effects:
1) dyspepsia
2) see nicotine
General
pharmacologic combination
References
- Prescriber's Letter 9(12):69 2002
- Baker TB, Piper ME, Stein JH et al
Effects of Nicotine Patch vs Varenicline vs Combination
Nicotine Replacement Therapy on Smoking Cessation at 26 Weeks.
A Randomized Clinical Trial.
JAMA. 2016;315(4):371-379
PMID: 26813210
http://jama.jamanetwork.com/article.aspx?articleid=2484340
Components
nicotine