1st line drug options:

  • nicotine replacement therapy
  • Nicotine patch(Habitrol, Nicoderm)–expensive, skin sensitivity, nightmares, N&V, insomnia
  • Nicotine gum(polacrilex, Nicorette)–temporary relief only
  • Nicotine inhaler—cough, throat irritation, nightmares, N&V, insomnia
  • bupropion 150mg QD x 3days, then 150mg BID x 7-12 weeks
  • can cause seizure, liver dysfunction
  • least expensive oral medication for smoking cessation, around CAN$100 per month

2nd line drugs:

  • nortriptyline: has a lot of interactions with other drugs, herbs.
  • Clonidine: causes low BP, dizziness, lightheadedness which may causing falling/faint, can`t be stopped abruptly since that will cause clonidine withdrawal syndrom—hypertension crisis, sometimes even missing a    dose can make you end up in ER.
  • Varenicline: Nausea and vomiting is a very common SE.