Nicotine

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Toxicological Effects
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Induces
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Nicopass, Nicopatch, Nicorette, Nicotinell, Nicotrol, Nikaloz, Niquitin; Belgium: Nicopatch, Nicorette, Nicotinell, Niquitin; Bulgaria: Nicorette, Nicotinell, Niquitin; Cyprus: Nicopass, Nicorette, Nicotinell; Czech Republic: Nicopass, Nicopatch, Nicorette, Nicotinell, Niquitin; Denmark: Nicorette, Nicotinell; Estonia: Nicopass, Nicorette, Nicotinell, Niquitin; Finland: Nicopass, Nicopatch, Nicorette, Nicotinell; France: Nicopass, Nicopatch, Nicorette, Nicotinell, Niquitin; Germany: Nicopass, Nicopatch, Nicorette, Nicotinell, Nikofrenon, Niquitin; Greece: Nicopass, Nicorette, Nicotinell, Niquitin; Hungary: Nicopatch, Nicorette, Nicotinell, Niquitin; Ireland: Boots Nicotine, Nicorette, Nicotinell, Niquitin; Italy: Nicodose, Nicorette, Nicotinell, Niquitin; Latvia: Nicopass, Nicorette, Nicotinell; Lithuania: Nicopass, Nicorette, Nicotinell, Niquitin; Luxembourg: Nicorette, Nicotinell; Malta: Nicorette, Niquitin; Netherlands: Nicopass, Nicopatch, Nicorette, Nicorol, Nicotinell, Niquitin; Poland: Nico-Loz, Nicopass, Nicopatch, Nicorette, Nicotinell, Niquitin; Portugal: Nicopass, Nicopatch, Nicorette, Nicotinell, Niquitin; Romania: Nicorette, Nicotinell, Niquitin; Slovakia: Nicopatch, Nicorette, Nicotinell, Niquitin; Spain: Nicorette, Nicotinell, Niquitin; Sweden: Exmint, Habitrol, Newnic, Nicolan, Nicopass, Nicopatch, Nicorette, Nicorol, Nicotab, Nicotinell, Nikotin, Nikotugg, Niquitin, Ymint, Zetamint; UK: Boots NicAssist, Nicorette, Nicotinell, Niquitin.

North America

Canada: Nicorette, Nicotina, Nicotinum, Prostep TRD; USA: NicoDerm, Nicorette, Nicotrol.

Latin America

Argentina: Nicorette, Nicotinell, Niquitin; Brazil: Nicorette, Nicotinell, Niquitin; Mexico: Nicorette, Niquitin.

Asia

Japan: Nicotinell.

Drug combinations

Chemistry

Nicotine: C~10~H~14~N~2~. Mw: 162.23. (1) 3-(1-Methyl-2-pyrrolidinyl)pyridine; (2) β-Pyridyl-α-N-methyl pyrrolidine. CAS-54-11-5.

Pharmacologic Category

Autonomic Drugs, Miscellaneous. Smoking Cessation Aid. CNS Stimulant. (ATC-Code: N07BA01).

Mechanism of action

Nicotine is a potent ganglionic and CNS stimulant; its actions are mediated via nicotine-specific receptors. Main effect of nicotine in small doses is stimulation of all autonomic ganglia; with larger doses, initial stimulation is followed by blockade of transmission. Biphasic effects also evident in adrenal medulla, discharge of catecholamines occurs with small doses, whereas prevention of catecholamine release is seen with higher doses as response to splanchnic nerve stimulation.

Therapeutic use

Treatment to aid smoking cessation for relief of nicotine withdrawal symptoms (including nicotine craving).

Pregnancy and lactiation implications

Teratogenic in animal studies. Increased aortic blood flow, increased heart rate, decreased uterine blood flow, and decreased breathing reported in fetus. Smoking during pregnancy associated with sudden infant death syndrome, increased risk of asthma, infantile colic, and childhood obesity. Use of nicotine replacement products to aid in smoking cessation not adequately studied in pregnant women (amount of nicotine exposure is varied). Excretion in breast milk unknown (use with caution in nursing women).

Unlabeled use

Management of ulcerative colitis (transdermal).

Contraindications

Hypersensitivity to nicotine or any component of the formulation. Patients smoking during postmyocardial infarction period, or with life-threatening arrhythmias or severe or worsening angina pectoris. Active temporomandibular joint disease (gum). Pregnancy. Not for use in nonsmokers.

Warnings and precautions

Risk vs benefits should be weighed in cardiovascular disease, serious cardiac arrhythmias, or vasospastic disease (use caution in angina or hypertension). Use with caution in insulin-dependent diabetes, oropharyngeal inflammation, history of esophagitis, or peptic ulcer disease (healing may be delayed), severe hepatic impairment (effects on metabolism unknown), hyperthyroidism, pheochromocytoma, severe renal impairment (effects on elimination unknown), and in bronchospastic disease (due to potential airway irritation). Use of nasal product not recommended with chronic nasal disorders (e.g. allergy, rhinitis, nasal polyps, and sinusitis). Cautious use of topical nicotine in certain skin diseases. Hypersensitivity to topical products can occur. Transdermal patch may contain conducting metal (e.g. aluminum).

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