Nicotine Nasal Spray

See FDA package insert for more complete information

The nasal spray is available by prescription only. Each spray delivers 0.5 mg of nicotine. One dose consists of 2 sprays, one in each nostril, for a total of 1.0 mg of nicotine. A minimum of 8 doses is recommended per day, with the initial dose being 1 to 2 doses per hour, increasing dose as needed. Eight (16 sprays) to 40 (80 sprays) doses per day is the recommended range. Therapy duration is 3 to 6 months.

How Well Does It Work?

Studies have shown that people who used the nicotine spray had more than double the likelihood of long-term quitting than those on placebo (Fiore et al. 2008).



  • Cardiovascular disease: Nicotine replacement therapies (NRTs), such as nicotine gum, have not been proven to increase the risk of having a heart attack, but should be used with caution in people who have had a heart attack within 2 weeks. The gum also might not be right for you if you have a history of coronary heart disease, serious arrhythmias, or vasospastic diseases.
  • Pregnant women: Pregnant women are encouraged to quit without medication. Nicotine nasal spray has not been shown to be effective for tobacco dependence in pregnant women and it has not been evaluated in breastfeeding women. The risks of such drugs to unborn children are not fully known. It is most important that you quit smoking, so consult your doctor. Seeking intensive counseling support in your quit attempt is a good idea.
  • Nicotine nasal spray might not be right for you if you have bronchospastic disease. It is not recommended if you have severe reactive airway disease. Users often report moderate to severe nasal irritation at first and persistant mild to moderate irritation.
  • Nicotine nasal spray might not be right for you if you have hyperthyroidism or insulin-dependent diabetes.
  • Nicotine nasal spray might not be right for you if you have active peptic ulcers.
  • Nicotine nasal spray might not be right for you if you have malignant hypertension.
  • Dependency may arise from use, causing you to increase your dose or use the spray longer than is recommended.

Side Effects

  • Nasal irritation that decreases in severity with use
  • Runny nose
  • Throat irritation
  • Watering eyes
  • Sneezing
  • Coughing
  • Nausea, vomiting, headache, dizziness, cold sweat, pallor, and weakness are all symptoms of an overdose.

How Do I Take This Medication?

  • You should completely quit smoking before you use the nasal spray.
  • To reduce irritating effects, do not sniff, swallow, or inhale through the nose when administering doses.
  • Your head should be tilted back slightly when administering.

(Fiore et al., 2008; PDR, 2001; Slotkin, 1998)

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