Nicotine replacement therapy (NRT)
Nicotine
Brand names: NicoRette, Niquitin, Nicabate, Nicotinell
Adult dose
Dose: Patch: 21mg/24h or 25mg/16h, step down. Gum 2mg/4mg PRN. Lozenge 2mg/4mg PRN. Inhalator/nasal spray PRN. Combination patch + short-acting often most effective
Route: Transdermal/Buccal/Inhaled/Nasal
Frequency: PRN
Clinical pearls
- First-line aid to smoking cessation (NICE NG209)
- Combination NRT (patch + short-acting) most effective; can be used in pregnancy if behavioural support insufficient
Contraindications
- Recent MI / unstable angina (caution)
- Severe arrhythmia
- Recent CVA (caution)
- Hypersensitivity
Side effects
- Nausea
- Headache
- Sleep disturbance
- Local irritation
- Palpitations
Interactions
- Smoking cessation alters CYP1A2 — clozapine/theophylline/olanzapine levels rise after stopping
Reference: BNF; NICE NG209; https://bnf.nice.org.uk/drugs/nicotine/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- DAPT Score for Dual Antiplatelet Therapy Duration · Antiplatelet Therapy
- ACC/AHA Pooled Cohort Equations (ASCVD Risk) · Cardiovascular Risk
- DAPT Decision Tool (Ticagrelor vs Clopidogrel) · Antiplatelet Therapy
- Weight-Based Levothyroxine Dose Calculator · Thyroid
- Travis Criteria for Severe Ulcerative Colitis · Inflammatory Bowel Disease
- Milan Criteria vs UCSF Criteria for Liver Transplantation in HCC · Liver Transplantation
Pathways
- Sepsis Screening and Sepsis Six · UK Sepsis Trust; NICE NG51; Surviving Sepsis Campaign 2021
- Unintentional Weight Loss Workup · NICE NG12; BSG
- Chronic Fatigue Workup · NICE NG206; BMJ Best Practice
- Lymphadenopathy Workup · NICE NG12; BMJ Best Practice
- Pre-op Medical Clearance · NICE NG45; ESC 2022
- Secondary Hypertension Workup · NICE NG136; ESH 2023