Treatment

Pharmacotherapy

Medication improves smoking cessation success and reduces withdrawal symptoms. The chart below describes the current FDA approved pharmacotherapies, with information on dosing, side effects, cost, and Medicaid/Medicare coverage.

TREATMENT (Rx)	DOSAGE	DURATION	PRECAUTIONS	SIDE EFFECTS	AVERAGE COST	COVERAGE
Bupropion SR Zyban® generic SR Wellbutrin SR®	Begin treatment 1-2 weeks before quit date: • 150mg every morning for 3 days, then 150mg twice daily	7-12 weeks, maintenance up to 6 months	• History of seizure • History of eating disorder	• Insomnia • Dry mouth	150mg - 1 box of 60 tablets: • Zyban®: $185.99 • Wellbutrin SR®: $167.99 • generic SR: $101.99	Medicaid Medicare Part D* Zyban® requires a prior authorization; Bupropion SR does not; Wellbutrin SR® is not covered
Varenicline Chantix®	Begin treatment 1 week before quit date: • Days 1-3: 0.5mg tablet every morning • Days 4-7: 0.5mg tablet twice daily • Days 8-end of treatment: 1mg tablet twice daily	3-6 months	• Observe for serious neuropsychiatric symptoms: changes in behavior, agitation, depressed mood, suicidal ideation and suicidal behavior • Significant renal impairment • Patient undergoing dialysis	• Nausea • Insomnia • Abnormal dreams • Dry mouth	Cost varies: Approximately $115/month	Medicaid Medicare Part D*
Nicotine Inhaler Nicotrol Inhaler®	6-16 cartridges/day	Up to 6 months		• Local irritation of mouth and throat	1 box of 168 cartridges: $166.99	Medicaid Medicare Part D*
Nicotine Nasal Spray Nicotrol NS®	8-40 doses/day	3-6 months		• Nasal irritation	40mls - 1 metered dose dispenser: $190.99	Medicaid Medicare Part D*
Nicotine Gum Nicorette® generic	1-24 cigs/day: 2mg gum (up to 24 pieces/day) 25+ cigs/day: 4mg gum (up to 24 pieces/day)	Up to 12 weeks		• Mouth soreness • Dyspepsia	2mg - 1 box of 50 pieces: • Nicorette®: $29.99 • generic: $22.99 4mg-1 box of 50 pieces: • Nicorette®: $32.99	Medicaid Requires a fiscal order
Nicotine Lozenge Commit® generic	Patient smokes 1st cigarette more than 30 min. after waking: 2mg (up to 20 per day) Patient smokes 2nd cigarette less than 30 min. after waking: 4mg (up to 20 per day)	Up to 12 weeks		• Nausea • Insomnia	2mg - 48 lozenges: • Commit®: $29.99 4mg - 48 lozenges: • Commit®: $29.99 • generic: $24.99	Not covered by Medicaid or Medicare
Nicotine Patch Nicoderm CQ® generic Prescription-only: generic (legend)	• 21mg/24 hours • 14mg/24 hours • 7mg/24 hours	• 4 weeks • then 2 weeks • then 2 weeks		• Local skin reaction • Insomnia	21mg - box of 7: • Nicoderm®: $29.00 • generic: $21.99 14mg - box of 7: • Nicoderm®: $29.00 • generic: $21.99 7mg - box of 7 • Nicoderm®: $29.00 • generic: $21.99	OTC: Medicaid Requires a fiscal order Prescription-only: Medicare Part D*
Medicare Counseling Coverage is Available: 4-10 minutes: Medicare Part B 10+ minutes: Medicare Part B Eligible tobacco users include: • People with a disease caused or exacerbated by smoking; and/or • People "taking a therapeutic agent whose metabolism or dosing is affected by tobacco use"

Click here to download chart in PDF format

*Information on this page is drawn directly from the U.S DHHS Public Health Guideline for Treating Tobacco Use and Dependence, June 2000.

*Medicare coverage varies depending on the individual’s drug plan.