How to Use Nicotine Lozenges
There are seven medicines approved by the Food and Drug Administration (FDA) to help you quit. They work in different ways. All have been shown to be safe and effective for adults who smoke cigarettes.
These quit-smoking medicines include nicotine replacement medicines (the nicotine patch, lozenge, gum, oral inhaler, and nasal spray) and pill medicines (varenicline and bupropion SR).
Some other strategies, with or without medicines, can help you quit as well.
Nicotine lozenges look like small hard candies. You put one in your mouth between your gums and your cheek. You may feel a warm or tingling sensation as it slowly dissolves. Do not chew or swallow the lozenge. The nicotine is absorbed mostly in your mouth.
Nicotine lozenges can be used every 1-2 hours, either one at a time to control withdrawal symptoms (up to 20 pieces per day), or in combination with nicotine patch as needed for stronger cravings.
- For best results, make sure you start on the right dose. The nicotine lozenge comes in two sizes (regular and mini) and each size comes in two strengths (2 mg and 4 mg). The right dose for you depends on when you usually have your first cigarette each day and how much you are currently smoking. If you have your first cigarette within 30 minutes of waking, you should consider starting with the 4 mg dose. If you are using the lozenge along with the nicotine patch, you may want to start with the 2 mg dose. Over time (typically after 8 to 12 weeks), you can lower the dose and how often you use it with the goal of eventually stopping use of the lozenge completely.
- Use 1 lozenge every 1-2 hours for the first six weeks of your quit attempt. Try to think ahead about when you might get a craving for a cigarette, and then use a lozenge before the craving happens. To ensure that your body gets enough nicotine to ease your withdrawal symptoms, it is best to use at least 9 lozenges per day for the first six weeks.
- If you are using the lozenge along with the nicotine patch, you may not need to use the lozenge as frequently because you will use it when you get or expect a craving. Do not use more than 5 lozenges in 6 hours, and do not use more than 20 lozenges per day. After 6 weeks of use, you can reduce use to 1 lozenge every 2-4 hours, and then 1 lozenge every 4-8 hours.
- If you use fewer than 10 cigarettes per day, or do not smoke every day, talk with your doctor or other healthcare provider about dosing. They may want you to start on a lower dose and use the lozenge less frequently.
- Do not use more than one lozenge at a time, and do not use one lozenge right after another. This could cause side effects like heartburn or nausea.
- Do not eat or drink for 15 minutes before using the lozenge or while the lozenge is in your mouth. Food and drinks that are acidic, such as soda and coffee, can stop the lozenge from working as well.
- Nicotine lozenges are not like regular lozenges. To use properly, put the lozenge in your mouth between your gums and your cheek. You may feel a warm or tingling sensation. Allow the lozenge to dissolve slowly over 20-30 minutes, moving it around every so often from one side of your mouth to the other. Do not chew, suck, or swallow it.
- Keep out of reach of children and pets. Nicotine lozenges may have enough nicotine to make children and pets sick. If you need to remove the lozenge, wrap it in paper and immediately throw it in the trash. In case of accidental use or ingestion, contact a Poison Control Center right away (1-800-222-1222).
- Quitting smoking may make some people depressed or anxious, whether quitting with medication or not. Get help if you have feelings of depression or anxiety that last for more than two weeks or that get worse.
- Learn more about nicotine lozenges, including side effects and precautions.
- Consider combining the lozenge with nicotine patches. You can do this when you first start using the medicine, or if you continue to have withdrawal symptoms. Patches can provide a steady level of nicotine in the body to help lessen withdrawal, while the lozenge can be used to more quickly relieve cravings as they happen.
- If you have strong cravings while using the nicotine lozenge, make sure you are using a strong enough dose and that you are using the lozenge often enough. If you smoke regularly, it’s best to use at least 9 lozenges a day for the first 6 weeks, and you can use up to 20 lozenges per day. You can also consider adding the nicotine patch, as described above.
- What if I slip up and smoke while using the lozenge? You do not need to stop using the lozenge if you slip up and smoke. Throw away your cigarettes and get back on track with your quit attempt. Keep using the lozenge as directed.
- What if I don’t like the taste of the lozenge? Remember that the nicotine lozenge is a medication, not a candy. Most people get used to the taste after a day or two. The good news is that the lozenge comes in different sizes (regular and mini) and flavors (cherry, mint, cinnamon). If you do not like what you start with, consider trying a different size or flavor.
- For best results, use nicotine lozenges as part of a program that includes coaching support. Talk with your healthcare provider and connect with your state tobacco quitline (1-800-QUIT-NOW) for help.
- Can be used regularly and when you feel withdrawal symptoms or urges coming on.
- Acts faster than nicotine patch or quit-smoking pills.
- Can be used with the patch to deal with breakthrough urges.
- You control how often you use it, so you won’t get more nicotine than you want.
- May help delay weight gain associated with quitting.
- Comes in two sizes, regular and mini. Each of these is available in two strengths.
- May help substitute for a cigarette because you put it in your mouth.
- May be easier to use than gum.
- Available without a prescription (over-the-counter).
- You have to remember to use it regularly and often.
- You should not eat or drink for 15 minutes before using or when it is in your mouth.
- Some people don’t like the taste of nicotine lozenges (the mini size may work better).
- Can cause stomach upset.
Possible Side Effects (and what you can do about them):
- Nausea, hiccups, or heartburn (do not chew, suck or swallow; try lower dose or wait longer between doses).
- Trouble sleeping (don’t use for several hours before bedtime).
- Headache or cough (try lower dose or wait longer between doses).
Nicotine Lozenge Precautions (If any of these apply to you, talk to your doctor or other healthcare provider before starting to use the lozenge.):
- A heart attack in the last two weeks.
- A serious heart rhythm problem.
- Pain in your heart (angina) that is serious or getting worse.
- Could be pregnant or are breastfeeding.
- Less than 18 years old.
More precautions and general information are available about nicotine lozenges.
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