Smoking Cessation Drugs: What Smoking Cessation Medications Exist?
Quitting smoking can be one of the most difficult challenges a person can face. Many smokers have tried to quit “cold-turkey”, but only about 5 out of every 100 people are successful. Fortunately there are options for the other 95% of smokers who want to quit. A wide variety of smoking cessation drugs exist and they can be acquired by over-the-counter purchase or by prescription. The most common smoking cessation medications are:
- Nicotine (e.g. NicodermCQ, Nicorette, Nicotrol)
- Bupropion (e.g. Zyban, Wellbutrin, and Aplenzin)
- Varenicline (e.g. Chantix)
- Clonidine (e.g. Catapres)
- Nortriptyline (e.g. Pamelor)
Each of these smoking cessation drugs are most effective when used in conjunction with support groups, counseling, and therapy. They all have possible side effects, but keep in mind that the doctor who has prescribed a drug has judged the benefit of the drug to outweigh the risk of the side effects. Furthermore, the negative side effects are not guaranteed.
Nicotine Replacement Therapy
Medications that contain nicotine and are known as Nicotine Replacement Therapies (NRT). These products supply the body with nicotine via skin patches, chewing gum, nasal spray, inhalers, or lozenges. Such products are intended to help wean smokers off of tobacco. Nicotine replacement therapies help relieve withdrawal symptoms while removing exposure to other harmful chemicals produced by smoking.
The over-the-counter options for nicotine replacement therapy are among the most commonly known smoking cessation medications, these include NicodermCQ patches and Nicorette gum. Nasal sprays and inhalers can be prescribed by a doctor. The differences among NRT smoking cessation drugs are preferential, for example some people don’t like to use the gum because it is more public than the patch.
Some people might suggest replacing cigarettes with e-cigarettes. There are some pros and cons to vaping, but the bottom line is that there is no clear data on the health effects of using e-cigarettes, nor is it not clear whether vaping helps you quit smoking.
What to tell your doctor before using Nicotine Replacement Therapy
Over-the-counter medications might not be appropriate for certain individuals. In particular people with asthma, heart problems, diabetes, or who are pregnant should seek medical consultation before proceeding with nicotine replacements.
Side effects of Nicotine Replacement Therapies
These therapies are relatively mild. The most common side effect is irritation in the area where the nicotine is consumed.
- Skin patches can cause a rash underneath the patch.
- Chewing gum can cause sore jaws or upset stomach. Hiccups may occur.
- Nasal sprays can cause nasal irritation, diarrhea, and possibly an increased heart rate.
- Inhalers may cause irritation along the throat and mouth or cause coughing.
- Lozenges might cause mouth sores, sore throat, nausea, or heartburn.
- If any additional side effects are experienced you should contact a doctor.
Antidepressants (Bupropion, Zyban, and Wellbutrin for quitting smoking)
Bupropion is a common prescription drug that alters moods and can help a smoker quit. It is approved for people who smoke over 10 cigarettes a day and who are over the age of 18. Brand names of bupropion include Zyban and Wellbutrin. Using Zyban to quit smoking and using Wellbutrin for smoking cessation are equivalent, however there may be differences between inactive ingredients that could trigger allergies. Furthermore the Wellbutrin for smoking cessation dosage may be different than if taking Zyban to quit smoking.
Bupropion smoking cessation helps reduce nicotine withdrawal symptoms related to mood (e.g. irritability, depression, anxiety, and the urge to smoke), however it doesn’t treat physical withdrawal symptoms such as increased appetite, insomnia, or headache. For this reason, bupropion is often used in conjunction with support group therapy, counseling, or nicotine replacement therapy.
Tablets are taken orally as prescribed by a doctor. Using bupropion begins approximately a week in advance of your smoking cessation date. The dosage that is prescribed should be followed strictly. Abrupt cessation of taking the drug could lead to bupropion-withdrawal symptoms.
What to tell your doctor before using Zyban or Wellbutrin
If you have a seizure disorder or an eating disorder, tell your doctor. If you have recently (and abruptly) stopped using alcohol, seizure medication, or sedative medication such as Xanax or Valium; then other smoking cessation drugs should be considered. Some preexisting conditions are risk factors in bupropion causing seizures including: past seizures, injuries to the head or brain or spinal cord, heart disease, high blood pressure, heart attack, diabetes, kidney disease, liver disease, bipolar disorder, or if you drink alcohol.
Dangerous drug interactions can occur. Do not take Zyban to quit smoking or wellbutrin to quit smoking if you have used MAO inhibitors in the past 14 days. Bupropion and MAO inhibitors can cause severe or fatal drug interactions.
Wellbutrin and Zyban are both bupropion and taking dosages from both can result in bupropion overdose, which could be fatal. Tell your doctor if you are already taking Wellbutrin to treat depression. Also notify your doctor of any other over-the-counter and prescription drugs, vitamins, or herbal supplements that you are taking.
Notify your doctor before taking Wellbutrin or Zyban to quit smoking if you are pregnant, are planning to get pregnant, or are breast feeding. Drowsiness or dizziness can occur while taking Wellbutrin or Zyban to quit smoking and operating machinery or driving while using Wellbutrin or Zyban is not recommended. Alcohol and marijuana use in conjunction with taking Wellbutrin or Zyban is also not recommended.
Side effects of using bupropion smoking cessation
The percent of patients who quit using bupropion due to adverse reactions is only 8%, however the percent of patients who quit from adverse reactions who are taking a placebo is 5% (rxlist.com).
- Common side effects — As a body gets used bupropion it may experience trouble sleeping, dry mouth, or a stuffy nose. Some other common symptoms include nausea, dizziness, joint pain, stomach pain, increased sweating, diarrhea or constipation, blurred vision, drowsiness, or a strange taste in the mouth.
- When to contact a doctor — There are some rare, but serious side effects that warrant notifying a doctor. Contact a doctor if you experience any chest pain, fast or irregular heartbeat, unusual mood changes or swings, muscle aches or pains, or unusual weight gain or loss.
- When to seek immediate medical attention — Seek medical attention right away if you experience eye pain or changes in vision. Seizures can be caused by bupropion, though rarely. If you have a seizure while using bupropion for smoking cessation then stop taking the drug and seek medical attention immediately.
It is possible to have a serious allergic reaction to bupropion that produces symptoms such as rash, swelling, dizziness, or trouble breathing. Such reactions are unlikely, but require immediate medical attention.
Chantix works by blocking nicotine’s effect on the brain and thus blocking the desire to smoke. Chantix is a pill that is taken orally. Medication begins 1 week prior to your quit date with one 0.5 mg pill per day. The dosage gradually increases to help minimize possible side effects. Chantix treatments last 12 weeks.
What to tell your doctor before using Chantix
Make sure your doctor or pharmacist is aware of any allergies you may have, they could be triggered by inactive ingredients. Your doctor should be aware of your medical history before prescribing Chantix, particularly kidney disease, mental disorders or mood swings, heart disease or blood vessel disease, strokes or seizures.
- Common side effects include nausea or vomiting, insomnia, drowsiness, unusual dreams, constipation and gas, or headache.
- When to contact a doctor — Rare side effects can occur such as a burning sensation in your toes or feet, or unusual pain in the legs while walking. If you experience any of these side effects, contact your doctor.
- When to seek immediate medical attention — Stop taking Chantix and seek immediate care if you have an allergic reaction (very rare, but serious). Signs of an allergic reaction include hives, swelling of the throat / mouth / lips / tongue / face, or difficulty breathing. Other rare but serious side effects that warrant immediate medical care include signs of stroke, heart attack, seizure, development or worsening of mental health issues (e.g. suicide, depression, or harmful behavior).
Other Smoking Cessation Drugs
Clonidine treats high blood pressure by reducing the levels of certain chemicals in the blood. It has been found by a number of studies to improve the chances of a successful quit. When used as a smoking cessation drug it is taken orally as a pill twice a day, or worn as a patch. Unlike bupropion and varenicline, clonidine treatment can begin on the day you quit.
- Common side effects include constipation, dizziness, dry mouth or eyes, tiredness or weariness, irritability, insomnia or nightmares.
- Contact a doctor immediately if you experience rare side effects such as severe chest pain or headache, nosebleeds, irregular heartbeat, or a very slow heartbeat.
Nortriptyline is another anti-depressant that can be effective in treating smoking cessation. It improves mood and well-being by balancing neurotransmitters in the brain. It is taken orally in pill form, 1 to 4 times a day.
- Common side effects include dizziness or blurred vision, drowsiness, trouble urinating, dry mouth, constipation, and weight gain. Drinking plenty of water, keeping a high fiber diet, and exercising can help mitigate the possibility of constipation, dry mouth, and weight gain.
- Contact a doctor immediately if you experience rare side effects such as severe dizziness/nausea/vomiting/diarrhea, hallucinations, fast heartbeat, enlarged and painful breasts, muscle spasms, or other side effects.
When to Contact a Doctor
If you are a smoker, anytime is a good time to talk to a doctor about quitting. Talking to a doctor about quitting can improve your chance for a successful quit by more than double. A doctor can help construct a quit-plan that is right for you including recommendations for over-the-counter or prescription medications. If you are ready to quit, call or book online with PlushCare to set up a phone appointment with a top U.S. doctor today.