nicotine at a glance
Medicine class
Nicotine replacement therapy
Selected forms
Medicated gum, nasal spray, mouth spray and sublingual tablet
Important safety point
Keep every nicotine product away from children and pets
What is nicotine used for?
Selected products are licensed for nicotine dependence from tobacco or electronic-cigarette use.
Relieving cravings and nicotine-withdrawal symptoms during quitting.
Supporting reduction before stopping completely.
Temporarily replacing smoking or vaping when stopping immediately is not possible.
How does nicotine work?
Nicotine activates nicotinic receptors in the brain and peripheral nervous system. Replacement products lessen cravings and withdrawal without tobacco combustion products. Absorption speed varies by formulation.
nicotine preparations and strengths
Medicated chewing gum
Route: Oromucosal
Strengths: 2 mg, 4 mg
Oromucosal preparation
Route: Oromucosal
Strengths: 1 mg
Sublingual tablet
Route: Sublingual
Strengths: 2 mg
How to take nicotine
Follow the leaflet for the exact product, as administration differs substantially between formulations.
Gum: chew slowly until the taste becomes strong, then rest it between the cheek and gum; repeat.
Nasal spray: prime as directed, spray into the nostril pointing towards the back of the nose, and avoid the eyes.
Mouth spray: spray into the open mouth, avoiding the lips; do not inhale during spraying or swallow immediately afterwards.
Sublingual tablet: allow it to dissolve under the tongue; do not chew or swallow it whole.
Do not combine the selected nasal spray with another nicotine-replacement product unless advised by a healthcare professional.
nicotine side effects
Common or expected effects
- Headache, dizziness or nausea
- Hiccups, cough, throat irritation or unusual taste
- Mouth discomfort, indigestion or increased saliva with oral products
- Sneezing, runny nose, watery eyes or nasal irritation with nasal spray
- Palpitations
- Irritability, poor concentration, sleep disturbance and increased appetite may reflect nicotine withdrawal
Get urgent medical advice
- Severe allergic reaction, including swelling, wheezing or collapse
- Seizure
- Severe breathing difficulty, chest pain or marked irregular heartbeat
- Persistent vomiting, sweating, severe weakness or faintness from excessive nicotine exposure
nicotine in pregnancy
Stopping smoking is strongly beneficial during pregnancy. Nicotine replacement may be used when it helps someone stop and they cannot manage without it; a midwife, pharmacist, GP or stop-smoking adviser should help select the product. Avoid liquorice-flavoured nicotine products during pregnancy.
nicotine interactions
Few direct interactions with nicotine replacement are established. Stopping tobacco smoking can alter medicine concentrations because tobacco smoke, not nicotine, induces drug-metabolising enzymes.
Clozapine and olanzapine
Stopping smoking may raise concentrations and adverse-effect risk; review and monitoring may be needed.
Theophylline
Clearance may fall after smoking stops, increasing toxicity risk.
Common questions about nicotine
Answers are fully visible for fast scanning and source review.
Is nicotine replacement the same as smoking?
No. It supplies nicotine to reduce withdrawal but does not expose the user to tobacco smoke, tar or carbon monoxide.
Can nicotine help someone stop vaping?
Yes. Selected products include licensed indications for cravings and withdrawal associated with electronic-cigarette dependence, although age restrictions differ.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.