How To Use Nicotine Lozenges, Plus 7 Other FAQs Answered

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Nicotine lozenges (Nicorette) are part of a group of medications called nicotine replacement therapy (NRT). These medications are a proven and safe method to help you quit smoking. Chances are, you've used a nonmedicated lozenge (or two) for a sore throat at some point. How different can nicotine lozenges be?

Well … they're actually quite different. Nicotine, even as part of an over-the-counter (OTC) lozenge, is a powerful substance. Correctly using nicotine lozenges lowers your risk for side effects and increases your chance of successfully quitting.

With that in mind, let's run through eight frequently asked questions about this product, including how to use nicotine lozenges.

1. How do you use nicotine lozenges?

To use a nicotine lozenge, place it in your mouth between your gums and cheek. From time to time, switch it to the other side of your mouth until it fully dissolves. This can take 20 to 30 minutes. Don't eat or drink for 15 minutes before using or while the lozenge is in your mouth.

While the nicotine lozenge is dissolving, you may experience a warm or tingling sensation. This means it's working. Your body absorbs the nicotine from the lozenge through your gums.

Don't chew, suck, or swallow the nicotine lozenge. This will prevent the nicotine lozenge from having its full effects.

2. What is the typical nicotine lozenge dosing?

Nicotine lozenges come in two strengths: 2 mg and 4 mg. The recommended dose depends on how quickly you smoke after waking up. If you have your first cigarette within 30 minutes of waking, you'll typically start with a 4 mg lozenge. If you have your first cigarette after 30 minutes have passed, you'll typically start with a 2 mg lozenge dose.

It's best to use a nicotine lozenge before a craving hits. So try to think ahead and predict when you'll have cravings for cigarettes. This will help reduce your risk of giving in to cravings.

The manufacturer of nicotine lozenges recommends treatment for a total of 12 weeks. Over time, you'll slowly reduce the number of lozenges you use. Below is a typical dosing schedule:

• Weeks 1-6: One lozenge every 1-2 hours, up to a maximum of 20 lozenges per day (or 5 lozenges in 6 hours).

• Weeks 7-9: One lozenge every 2-4 hours

• Weeks 10-12: One lozenge every 4-8 hours

You should aim to use at least 9 lozenges per day in the first 6 weeks. Using lozenges frequently during this period will help keep your nicotine cravings at bay.

Some people benefit from continuing nicotine lozenges for longer than 12 weeks. If you think you still need nicotine lozenges to keep away from cigarettes, or you haven't quit smoking after 12 weeks of using lozenges, talk to your healthcare professional (HCP). They can help you determine if it's safe to continue using nicotine lozenges.

3. How do nicotine lozenges work?

Nicotine lozenges and other NRT medications work by providing your body with a clean form of nicotine. This nicotine, which you typically get from smoking cigarettes, helps your body adapt to quitting smoking. And it doesn't have the thousands of harmful chemicals that are in cigarettes.

If you still experience cravings while using nicotine lozenges, you may be using too low of a dose, or not be using them frequently enough. As mentioned, make sure you're using at least 9 lozenges per day in the first six weeks.

If you still feel that nicotine lozenges aren't working for you, let your HCP know, or consider joining a smoking cessation program. A trained professional can help you troubleshoot your nicotine lozenge dosage and consider other medications that may help. Working with an HCP or smoking cessation program can also increase your chances of quitting.

4. Do nicotine lozenges have side effects?

Nicotine lozenges are safe when used correctly. But they can cause side effects for some people. However, side effects are usually mild and preventable by using lozenges correctly. Examples of side effects include:

• Nausea

• Hiccups

• Heartburn

• Difficulty sleeping

• Headache

• Cough

• Throat irritation

Some of these side effects (such as headache and nausea) can also be a sign of nicotine withdrawal, especially when you initially quit smoking cigarettes. Or to complicate things further, they can be a sign your lozenge dose is too high and you're getting too much nicotine.

Since the cause of these symptoms can be difficult to pinpoint, it's a good idea to reach out to your HCP if you experience ongoing side effects after starting the nicotine lozenge. They can help you adjust your dose if necessary.

Are nicotine lozenges addictive?

It's possible to become dependent on nicotine lozenges, because nicotine is an addictive substance. But NRT is considered much less addictive than cigarettes.

This is because NRT doesn't provide your body with as much nicotine as cigarettes do. And nicotine from lozenges doesn't reach your brain as quickly as nicotine from cigarettes does.

Although using nicotine lozenges long term has been found to be safe, it's not typically recommended to use them indefinitely.

Can nicotine lozenges cause cancer?

No. Nicotine lozenges and other NRT products aren't known to cause cancer, though we don't have enough long-term studies looking at this. However, we do know that smoking is a major risk factor for certain cancers due to chemicals in cigarettes known as carcinogens. It's not the nicotine itself that causes cancer.

Can you overdose on nicotine lozenges?

Though rare, it's possible to get too much nicotine and experience a nicotine overdose. Symptoms can include rapid heartbeat, weakness, and vomiting. More seriously, slowed breathing can also occur. Be sure to store NRT lozenges out of reach of younger family members. They can make children and pets sick.

A nicotine overdose with nicotine lozenges alone is unlikely. But if you're using more than one NRT product, or you're still smoking cigarettes while using the lozenges, getting too much nicotine is possible.

If you're experiencing symptoms of a nicotine overdose, stop using nicotine lozenges and contact your HCP. If your symptoms feel severe or life-threatening, call 911 or go to the closest emergency room.

5. Who shouldn't use nicotine lozenges?

Nicotine can increase your heart rate and blood pressure. If you have certain health conditions, using nicotine lozenges may be more risky than expected. That's why it's best to talk to your HCP before using nicotine lozenges, especially if you have one of the following conditions:

• Recent heart attack

• Irregular heartbeat (arrhythmia), such as atrial fibrillation

• Serious or worsening angina (chest pain)

• High blood pressure (hypertension)

• Stomach ulcers

• Diabetes

• Sodium-restricted diet

• History of seizures

If you're pregnant or breastfeeding, you should also talk to your HCP before using any NRT product. Though NRT is safer than continuing to smoke, your HCP may recommend trying to quit smoking cold turkey before trying NRT.

6. What happens if you accidentally swallow a nicotine lozenge?

Swallowing a single nicotine lozenge usually doesn't cause serious health problems. But it can increase your risk of side effects. This is because swallowing the lozenge sends nicotine to your stomach. When you use the nicotine lozenges correctly, the nicotine is absorbed through your mouth.

7. How are nicotine lozenges different from patches or gum?

Besides nicotine lozenges, other forms of NRT include:

• Patches (Nicoderm CQ, Habitrol)

• Gum (Nicorette)

• Nasal spray (Nicotrol NS)

So, how do nicotine lozenges compare to other forms of NRT? We'll cover some major similarities and differences below:

• Availability: The nicotine lozenges, gum, and patches are available OTC. The nicotine nasal spray is available by prescription only.

• Short- vs. long-acting forms of NRT: Nicotine lozenges, gum, and nasal spray are short-acting forms of NRT. They work fast, but their effects wear off quickly, too. That's why you need to use them multiple times throughout the day. But nicotine patches are a long-acting NRT form. You only apply the patch once per day, and it provides a steady supply of nicotine throughout the day.

• Side effects: Nicotine gum and lozenges have some similar side effects, including hiccups and throat irritation. The nicotine patch is unlikely to cause these side effects. Unlike nicotine gum or lozenges, the patch can cause skin irritation where the patch is applied. It can also cause vivid dreams. And the nicotine nasal spray can cause nose irritation.

Can you combine nicotine lozenges with other smoking cessation treatments?

Yes. In fact, it's recommended. Combining a short-acting NRT product with the nicotine patch can help increase your chance of quitting smoking.

While nicotine patches provide a steady supply of nicotine to your body throughout the day, nicotine lozenges, gum, or nasal spray can be used throughout the day on an as-needed basis.

If you're combining NRT products, it's a good idea to work with your HCP or engage with a smoking cessation program. They can help determine the optimal dosages for your NRT products.

Block quotes: It's possible that nicotine lozenges or other NRT products can be combined with bupropion sustained-release (Wellbutrin SR) to help you quit smoking. However, research hasn't shown that the combination is more effective than using NRT or Wellbutrin alone. NRT products may also be combined with varenicline (Chantix), although the manufacturer of varenicline doesn't recommend this. However, research has shown that the combination is effective (and possibly more effective than NRT alone). If you're interested in exploring these options, talk with your HCP.

How to save on nicotine lozenges

If you have insurance, nicotine lozenges may be partially or fully covered by your insurance plan. And if you have a health savings account (HSA) or flexible spending account (FSA), you can use these funds to cover the cost.

Additionally, you can use a GoodRx discount if you ask your HCP for a nicotine lozenge prescription. With a prescription, a pack of 144 lozenges may be as low as $15.10with a free GoodRx coupon.

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