Medications to Help you Quit - Tobacco Treatment Medications , doses, uses, and side effects

Medications to help quit

Bupropion SR 150 - Prescription Only: Zyban, Wellbutrin SR, Generic SR
CAUTIONS: Not for use if you
*Currently use a monoamine oxidase (MAO) inhibitor
*Use bupropion in any other form (Zyban/Wellbutrin)
*Have a history of seizures
*Have a history of eating disorders
SIDE EFFECTS:
* Insomnia
*Dry mouth
DOSAGE:
*Days 1-3:150 mg each morning
*Days 4-end: 150 mg twice daily
USE:
* Start 1-2 weeks before your quit date; use 2 to 6 months

Nicotine Gum (2 mg or 4 mg) -Over the Counter only as Nicorette and Generic
CAUTIONS:
* Don't drink acidic beverages during use!
* Caution with dentures
SIDE EFFECTS:
* Mouth Soreness
* Stomach ache
DOSAGE:
* 1 piece every 1 to 2 hours, as cravings dictate.
* 2 mg: if smoking 24 cigarettes or less per day
* 4 mg: if smoking 25 or more cigarettes a day or use chewing tobacco
USE:
* Use up to 12 weeks or as needed

Nicotine Inhaler, Kind of a misnomer as it is not inhaled but is absorbed through the lining of the mouth. - Available through prescription only
CAUTIONS:
* May irritate mouth/throat at first but improves with use.
* DON'T drink acidic beverages during use. coffee, cola drinks or caffiene drinks
SIDE EFFECTS:
* Local irritation of the mouth and throat
DOSAGE:
* 6-16 Cartridges/day
* Inhale 80 times per cartridge , may save partially-used cartridge for next day
USE: Up to 6 months, taper at the end

Nicotine Lozenge, 2mg or 4 mg -OTC only as Commit, or Generic (Nicabate)
CAUTIONS:
* Do not eat or drink 15 minutes before or during use
* One lozenge at a time , no more than 20 in a 24 hr period.
SIDE EFFECTS:
* Hiccups
* Cough
* Heartburn
DOSAGE:
* 2 mg: if smoking after first 30 minutes you're awake
* 4 mg if smoking within first 30 minutes you're awake
* Weeks 1-6: every 1-2 hours
* Weeks 7-9: 1 every 2-4 hours
* Weeks 10-12: 1 every 4-8 hours
USE: up to 12 weeks

Nicotine Nasal Spray, -Prescription Only as Nicotrol NS
CAUTIONS:
* Not for patients with asthma
* May irritate nose (Improves over time)
* May cause dependence
SIDE EFFECTS:
* Nasal irritations
DOSAGE:
* 1 dose = 1 squirt per nostril
* 8 - 40 doses per day
* Do NOT Inhale
* 3-6 months, taper at the end

Nicotine Patch, Over the counter as Nicoderm CQ, Nicotrol or through Badger Care and some other insurance coverage, Prescription: Generic Legend.
CAUTIONS:
* Do not use if you have severe eczema or psoriasis
SIDE EFFECTS:
* Local skin reaction
* Insomnia and or weird dreams
DOSAGE:
* One patch per day , if have bad dreams take off at night
* If more than 10 cigs/day: 21 mg for 4 wks, then 14 mg for 2 wks, then 7 mg for 2 wks.
* If less than 10 cigs/day: 14 mg for 4 wks, then 7 mg for 4 wks
USE:
* 6-8 weeks
Varenicline - Prescription Only, 1st pick a quit date!
CAUTIONS:
* Not encouraged if you suffer from depression
* Use with caution and consider dose reduction in patients: with significant renal impairment, or undergoing dialiysis
SIDE EFFECTS:
* Nausea
* Insomnia
* Abnormal dreams
* Headache
DOSAGE:
*Days 1-3: 0.5 mg every morning
* Days 4-7: 0.5 mg twice daily
* QUIT CIGS, Days 8-end 1 mg twice daily
USE:
* Start 1 week before QUIT date; use 3-6 months.

Read the information, think about what fits your situation and speak to your health care advisor, then decide on a medication to use. Many people find that using more than one medication is helpful, for example the patch and during a bad craving also using the Nicotine Nasal Spray, or the Nicotine Inhaler. Research shows that medication can increase your likelyhood of success with Quitting.

Medications, try try again

Looking further into Medications to Quit

I have said a lot about medications in the past, but on this blog I would like to focus on what you have learned in past quit attempts about different medications. What have you learned that can help you now as you choose medications that can help.
I often hear people say " I have tried that and it didn't work for me" and it makes me wonder what happened that made it not work. Sometimes it is because it is the wrong medication for that person, like if a person has really sensitive skin maybe the Nicotine Replacement Therapy, The Nicotine Patch, isn't going to work. But with some reflection you might find that a medication that you tried at another time will work now.
For this reason I would like to encourage you to look a bit more deeply at what medications you have tried and what worked about it and what didn't. If you can understand what did work it will lead you to several possible next steps. It is possible to change the way you use the medications to make it work, supplement it by adding other medications to the main one, or perhaps getting better support will make the difference in success. Sometimes a change in behavior is what will make things work for you.
On further reflection has a medication worked most of the time but during extreme cravings didn't cut it? Maybe it will work better if you sometimes supplement it with another medication. An example is using the Nicotine Patch or Nicotine gum and when cravings hit hard also use a dose of nicotine inhaler or a nicotine nasal spray. Both of these medications send nicotine to the brain quickly. I have found that sometimes people who have tried Chantix didn't make a firm quit date and haven't spent any time thinking about how to address the social and emotional needs that tobacco meets. If you never really quit while taking Chantix, but continued to use the tobacco for emotional reasons then a firm quit date and using other methods of handling stress will bring success within your reach. Did you relapse when you were at a bar at your last quit attempt? Maybe changes in behavior is what is necessary and the medication can be tried again. Staying away from bars and alcohol is what helped my son quit. He found it difficult to be in bars without smoking because physically his brain made associations between drinking and alcohol so when he was at a bar his brain made the connection and craved a smoke. He also was used to smoking there and so even his personal habits and rituals made him reach into his pocket for a cigarette. He kept away from bars for a few months before he felt ready to go back to drinking without smoking.
Sometimes people will have reactions to a medication that when managed differently will work for them. An example of this is the NRT, The Nicotine Patch which sometimes gives people intense dreams, even nightmares. If the patch is taken off during the night and another applied the next day it might allow them to continue to use The Patch and they can sleep uninterrupted.
I am going to suggest journaling again as a way to sort out what medication to try. Don't automatically disregard something that you have tried in the past, which didn't work, but instead look a bit deeper to see why it didn't work and if it might possibly work with some adjustments on your part. Talk to your health care provider, they will also have insights to what might work best for you. I send you my best wishes and thoughts on all of your efforts to quit, I know that you can be a Successful Quitter.

Triggers, What to do?

You have studied what your triggers are and now the serious work of what to do during these difficult times. The first bit of advice is to eliminate them when possible. If drinking alcohol is a trigger for you, or going to a bar then for the first month or so after quitting it is helpful to stay away from bars. There are some reasons that alcohol and nicotine go together or at least that your brain perceives that they do so my best advice is to stay away from alcohol as much as possible for awhile.
Now there are probably some other places or activities that you almost always smoke at. This might be when you go out on a break at work, do you usually head for an outside location with your other smoking buddies to smoke. If this is the case then take a break at another location. Maybe ask a co worker that you usually smoke with if they also want to quit and you can take a walk or pursue another short activity with them. Some folks smoke every time they are in the car or when they are on the phone. Before your quit date you are going to clean the inside of your car maybe even have it detailed. This will remove everything about smoking that might strengthen this trigger. Have some cinnamon or any kind of tooth pick to play with in the car or maybe just a straw to chew on. Something oral seems to help with the hand to mouth habit that often can be reassuring to a smoker. Cinnamon has been found to be a flavor that is often helpful to quitters. Some people that smoke when on the phone have resorted to texting more or might just try to be on the phone in a different location than usual and also have some things like the tooth picks or straws to play with while on the phone. Remember that when and where you smoke is associated by the brain with smoking and when you are in the places or times it will remind you with cravings to smoke. The more you can change these the easier you will find it to quit. The more you can change up these times and places will also help with walks or physical activity being a very helpful change up.
The early morning, first thing upon waking up cigarette is a very important one for most people. This is when it is most important to change up your morning routine. A change of beverage, a change of where you drink the beverage and then a change in the routine of it. If you always have a cigarette when drinking your coffee during a relaxing time around the kitchen table then have tea or chai or even hot chocolate in a different mug sitting outside, although not where you usually smoke. What seems to help most of us is to go for a walk and have your relaxing moment smelling the roses while you drink your tea. Look at your other cigarettes that seem most important to you and change each routine so that you are relaxing or giving yourself a down moment in a way you haven't in the past. Sometimes the last cigarette in the day is really an important one or the after supper one. Make these moments so unlike the past that there will be fewer reminders that you aren't having a cigarette.
My next blog will be about the stress busters we all need more of in our hurried life style

Things to Think About Before you Quit

You have decided to quit, Great Decision, you've decided on a date, great way to begin, so now what. This is a good week to do some studying on tobacco and You, Take some time over the next few days to think about some things. Each time you smoke a cigarette, think about whether you are smoking out of habit, or because you really feel you need that cigarette; for example are you smoking because you always smoke when you are with Darcy or Jane or whoever; or are you smoking because you really "want, need" the nicotine? What are your feelings, or emotions when you light up, down or bored or excited, what is your state of mind? Some people make a mental note of these two things each cigarette but others like to write this information down so that they can look over the smoking diary and see if there are some patterns to learn from. Which ever you choose to do, make a mental note or physically write it down, the important part of this is to see if you see some patterns. Another part of becoming more aware of when, why and how come you smoke is noting where you are. It might be in the car, out on the porch, whatever. This will alert you to some problematic locations that you will have to plan around when you quit.
Some things people have noted in smoking journals I have seen are, stressed notations, or _____ called and I had a cigarette while we talked. Soon it was apparent that often when she was on the phone she also smoked, or when the kids argued she went out for a cigarette. Most people recognize that they smoke in response to certain triggers, now it is important to use this awareness and to plan some different responses to these triggers than smoking. When stressed I will do a breathing exercise, or I will have tea and drink it in the kitchen instead of coffee on the porch first thing in the morning.
In my next blog I will talk about some different options people have taken when confronted with a trigger during their first few smokeless days. Actually I think quitting and the self awareness and changes it brings to a persons life often means there are new healthful habits that become a part of the persons life so be mindful of yourself in the next week or so and think about your triggers.
Think about the When, Why and Where of your smoking life and ways these can change when you are ready to change your life and quit smoking.
Build an awareness of when you are smoking just because, or if there are certain times when smoking seems very important to you. Obviously each situations needs to be planned for but thinking about this helps you recognize the cigarettes which will be the hardest to give up. A plan, a new routine can be really helpful.
Think and write about the emotions or feelings that often lead to a cigarette, I hope to encourage some healthier alternatives to these than smoking.
I know you can quit and what you will do in the next few weeks will help you do it.