Using Nicotine Nasal Spray to Quit Smoking

Woman using nasal spray for controlling rhinitis

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Nicotine nasal spray is a medicine that reduces cravings to smoke when a measured dose of nicotine solution is sprayed into the nose. The spray is absorbed into the bloodstream through the nasal mucous membrane.

You need a prescription for nicotine nasal spray. Nicotine nasal spray and the nicotine inhaler are the two forms of nicotine replacement therapy (NRT) that require a doctor's prescription and supervision. All other NRTs are available over-the-counter.

Before Starting

Be sure to tell your doctor if any of the following apply to you before starting an NRT.

  • You are pregnant, planning to get pregnant, or are breastfeeding.
  • You are allergic to nicotine or any other prescription medicine.
  • You've had a heart attack, have angina, irregular heartbeat or heart disease.
  • You have sinus problems and/or allergies.
  • You have thyroid problems.
  • You have problems with circulation such as Buerger's disease or Raynaud's phenomena.
  • You have high blood pressure, kidney or liver disease.
  • You take insulin for diabetes.
  • You have an ulcer.

Also, let your doctor know about any medications you take, including vitamins, herbal remedies, and over-the-counter drugs. Be sure to alert your doctor if you take any of the following medicines:

  • Acetaminophen (Tylenol)
  • Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax), and terazosin (Hytrin)
  • Beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
  • Caffeine-containing medications (Esgic, Esgic Plus, Fioricet, NoDoz, Norgesic, others)
  • Cough and cold medications; imipramine (Tofranil); insulin; isoproterenol (Isuprel); oxazepam (Serax); pentazocine (Talacen, Talwin NX); and theophylline (TheoDur).

Some medications are metabolized more quickly for smokers. So, when you stop, the dosage level might need to be adjusted.

How to Use

Each dose consists of two sprays—one spray per nostril. Your doctor will direct you on the specific amount and frequency of dosage that's right for you, but will likely suggest that you start with one or two doses per hour.

Never use more than five doses per hour or 40 doses in a 24-hour period.

Wash your hands and blow your nose to clear nasal passages. Before the first use, prime the pump on the bottle by pumping it into a paper towel until a fine mist appears. Discard the towel in the trash.

Tilt your head back slightly and insert the tip of the bottle into your nose, pointing it toward the back of the nose. Pump one spray into each nostril. Don't inhale, sniff or swallow while spraying.

If your nose runs, sniff to keep the medicine in. Don't blow your nose for a few minutes after administering the dose. Repeat the process in the second nostril.

If it has been more than a day since the last dose, prime the bottle as described above. Avoid priming too much though, as this might decrease the amount of medicine in the dose.

The solution should only be used in the nose. If it gets on your skin or in your eyes or ears, rinse well with water.

In general, nicotine nasal spray therapy begins with an eight-week course at the dosage level your doctor prescribed initially. After that, your doctor may suggest reducing the amount used daily over the next four to six weeks until you wean off of it completely.

Combining With Another Quit Aid

Occasionally, some ex-smokers have trouble stopping smoking by NRT alone. If you find that the nicotine nasal spray is not doing the trick for you, have a discussion with your doctor about whether it might be feasible to combine NRT with another non-nicotine quit aid like Zyban (bupropion hydrochloride).

Side Effects

These are the most common side effects associated with nicotine nasal spray:

  • Hot, spicy feeling at the back of the nose or throat
  • Runny nose
  • Sore throat
  • Coughing
  • Sneezing
  • Watering eyes

In rare instances, side effects can be serious. If you experience a rapid heart rate while using nicotine nasal spray, seek medical attention immediately. Additionally, nicotine nasal spray can cause symptoms other than those listed above. If you experience anything unusual while using this product, call your doctor.

Nasal Spray Addiction

Nicotine nasal spray can be habit-forming. So, it is important to follow your doctor's instructions for use carefully. In general, however, the amount of nicotine in NRTs is less than it would be in cigarettes and is administered more slowly.

The risk is reduced, but not zero. If you find that you are unable to stop using nicotine nasal spray at the end of the therapy period, inform your doctor and he/she will help you.

Nasal Spray and Smoking Don't Mix

Do not smoke while using nicotine nasal spray or you will run the risk of a nicotine overdose. Don't use any other nicotine-containing quit aid (nicotine patchgumlozenges or inhaler) while using nicotine nasal spray.

Signs of Nicotine Overdose

Signs of a nicotine overdose may include:

  • Dizziness
  • Upset stomach
  • Bad headaches
  • Vomiting
  • Cold sweats
  • Drooling
  • Confusion
  • Blurred vision
  • Hearing problems
  • Weakness or fainting

If you suspect you've had an overdose of nicotine, stop using the nicotine nasal spray and call your doctor immediately.

Store Safely

Store the nasal spray bottles in a location where young children and pets cannot access it. The nicotine solution could be dangerous or even fatal if accidentally ingested. Do not store in a hot/humid location (like the bathroom).

If there is leakage or a spray bottle breaks, use rubber gloves to clean up the nicotine solution right away. Wipe the area with a cloth or paper towel and discard in the trash. Wash the area several times to be sure all of the solution has been removed.

Discard empty spray bottles with the child-resistant cap on in the trash. If you have unused full bottles that you need to discard, don't flush them down the toilet or throw away in the trash. Contact your doctor or pharmacist about medicine take-back programs in your community.

Symptoms of Nicotine Withdrawal

Nicotine withdrawal can cause a wide variety of physical symptoms that may come as a surprise to new ex-smokers. From feelings of lethargy to suffering from an inability to sleepindigestion and developing a new cough, the effects of stopping smoking can bring out some unusual responses in our bodies.

Nicotine nasal spray will take the edge off of the discomforts, but it probably won't eliminate nicotine withdrawal entirely.

Be prepared by knowing what the symptoms are and also by what you can do to minimize them.

A Word From Verywell

Nicotine nasal spray can be an effective quit aid when used as directed and combined with support and education about what to expect when you quit smoking. Don't think of nicotine nasal spray or any other quit aid as a magic bullet that will make smoking cessation easy. They can and will help a great deal, but only when you are resolved to do the work it takes to quit smoking.

Take your quit program one simple day at a time and be patient with yourself. Healing from nicotine addiction takes as long as it takes. There's no rushing the process. Stick with it, and the day will come when tobacco no longer controls your life.

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