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What should I discuss with my healthcare provider before using nicotine nasal or inhalation (Nicotrol Inhaler, Nicotrol NS)?

Ask a doctor or pharmacist if it is safe for you to use this medicine if you have:

• coronary heart disease, chest pain (angina), or heart rhythm disorder;
• circulation problems, Raynaud's syndrome
• history of stroke, blood clot, or heart attack;
• untreated or uncontrolled high blood pressure;
• nasal or sinus problems, including nasal polyps or hay fever;
• liver or kidney disease;
• type 1 diabetes;
• a thyroid disorder;
• a stomach ulcer;
• asthma, bronchitis, or COPD (chronic obstructive pulmonary disease); or
• pheochromocytoma (tumor of the adrenal gland).

Nicotine can pass into breast milk and may harm a nursing baby. Do not use this medication if you are breast-feeding unless your doctor has told you to.

Smoking cigarettes during pregnancy can cause low birth weight, miscarriage, or stillbirth. Using a nicotine replacement product during pregnancy or while breast-feeding may be safer than smoking. However, you should try to stop smoking without using a nicotine replacement product if you are pregnant or breast-feeding. Talk with your doctor about the best way for you to stop smoking.

How should I use nicotine nasal or inhalation (Nicotrol Inhaler, Nicotrol NS)?

Nicotine nasal or inhalation is only part of a complete program of treatment that may also include counseling, group support, and behavior changes. Your success will depend on your participation in all aspects of your smoking cessation program.

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

This medication comes with patient instructions for safe and effective use. Follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

To use the nasal spray:

• Blow your nose if needed. Tilt your head back slightly and insert the tip of bottle into your nostril. Breathe through your mouth while spraying gently into your nostril. Do not inhale or sniff while spraying. If your nose runs, gently sniff to keep the nasal spray from leaking out.
• Do not use the nasal spray more than 5 times per hour or 40 times in 24 hours.
• Avoid getting the spray in your eyes or mouth, or on your skin. If this does happen, rinse with water.
• Do not blow your nose for at least 2 minutes after using the nasal spray. Recap the bottle after each use.
• If the nasal spray has not been used for longer than 24 hours, prime it by spraying 1 or 2 times into a tissue.

To use nicotine inhalation:

• Insert an inhaler cartridge into the mouthpiece as directed in the patient instructions.
• Inhale deeply or puff in short breaths for 5 minutes at a time. One inhaler cartridge may be used for about 20 minutes of active puffing time.
• Nicotine inhalation is given in two treatment phases: initial treatment (up to 12 weeks) and gradual reduction (up to 12 weeks).
• During the first 3 to 6 weeks of initial treatment, use at least 6 inhaler cartridges per day. You may use up to 16 cartridges per day, depending on how much nicotine you feel you need.
• After your initial treatment, start your gradual reduction by using fewer cartridges per day or using them less often for up to 12 more weeks.
• Use the inhaler at temperatures above 60 degrees Fahrenheit. Use in the cold will reduce the amount of nicotine you inhale.
• Remove an empty inhaler cartridge from the mouthpiece and throw it away in a safe place.
• Clean the inhaler mouthpiece regularly with soap and water. Store the mouthpiece in the locked position in its storage case when not in use.

Store at room temperature away from moisture, heat, and light. Keep the nasal spray bottle tightly closed when not in use. Store inhaler cartridges away from open flame or high heat, such as in a car on a hot day.

Keep this medicine out of the reach of children or pets.

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