Smoking Cessation Medicine
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What is a smoking cessation drug? A drug that supports the will to quit smoking
What are smoking cessation drugs?
Smoking cessation drugs are drugs that are expected to have the effect of suppressing nicotine withdrawal symptoms such as the satisfaction gained from smoking, the frustration caused by smoking cessation, and the urge to smoke. ” will be.
Recently, in addition to health effects such as nicotine addiction, lifestyle illness, and increased risk of lung cancer due to smoking, smoking cessation treatment is increasing due to the promotion of smoking cessation by the government and companies and the rise in tobacco prices. Is increasing in demand because it is possible to quit smoking medically and pharmaceutically .
Currently, various products are sold as ethical drugs, over-the-counter drugs (over-the-counter drugs), and overseas drugs.
Let’s explain in detail from the effects of smoking cessation drugs to how to purchase them.
Three medicines to help you quit smoking
There are two types of anti-smoking drugs: “nicotine preparations” that replace the nicotine that was ingested by smoking with drugs, and “nicotine-free preparations” in which the pharmaceutical ingredients have nicotine-like and inhibitory effects.
As nicotine preparations, patches, nicotine gum, and nicotine-free preparations (oral medications) are broadly divided into these three types of products used to assist smoking cessation.
Each type of smoking cessation treatment has a different mechanism of action, usage, advantages and disadvantages, and there are various classifications of medicines, so the purchase method is also different.
In this part, I will explain each feature in detail and introduce the products that are sold.
Non-Nicotine Medications
Nicotine-free smoking cessation medications are medicines that contain active ingredients that have nicotine-like effects (nicotine-like effects) and nicotine-inhibiting effects, and support smoking cessation.
Currently, the only therapeutic drug on the market is Champix , which is an internal medicine , and is designated as a prescription drug in USA that requires a doctor’s prescription.
The nicotine-like action can be expected to reduce the symptoms of nicotine withdrawal due to smoking cessation and the craving for smoking, and the nicotine inhibitory action can also be expected to have the effect of suppressing the satisfaction obtained by smoking and making cigarettes less delicious.
Due to these effects, the success rate of smoking cessation (Champix 64%, patch 42%) is high compared to other therapeutic agents , especially those who have smoked for many years and heavy smoking with a large number of cigarettes per day. It is the first-line drug for smoking cessation treatment for people.
It has the advantages of high efficacy, high success rate of smoking cessation, and no side effects of patch rash and itch.
On the other hand, there are disadvantages such as not being sold at drug stores, limited use due to concomitant drugs and chronic diseases, risk of side effects such as drowsiness, nausea and headache, and high price compared to other therapeutic drugs.
nicotine patch
Nicotine patch is a patch containing nicotine, which can be applied to the arms and abdomen to replenish nicotine through the skin and support smoking cessation .
Currently, nicotine TTS for ethical drugs, nicotine patch, Ciganon CQ for over-the-counter drugs (over-the-counter drugs), and nicotine patches made overseas are also popular.
The nicotine alternative therapy that uses nicotine preparations is called nicotine alternative therapy. For the irritability that appears when quitting smoking and the stress of enduring smoking, nicotine is supplemented as a drug and the amount of supplementation is gradually reduced to acclimatize the smoking cessation state.
It is a treatment that alleviates those nicotine withdrawal symptoms and gets out of psychological dependence, physical dependence, and smoking habits.
Use once a day and continue according to the prescribed dose and period.
While it has the advantages of being able to be purchased just by pasting it and over-the-counter drugs, it also has the disadvantages of risking side effects such as rashes and itchiness, and restrictions on its use due to concomitant medications and chronic illnesses.
In addition, smoking during use is prohibited in principle because it causes excessive nicotine supplementation and side effects such as nausea, dizziness, and abdominal pain are more likely to occur.
nicotine gum
Nicotine gum is a gum that contains nicotine. By chewing instead of tobacco, nicotine is replenished from the mucous membrane of the mouth and supports quitting smoking.
Products currently on sale include Nicotinel Gum, Nicorette Gum , and Nicotex .
Smoking cessation treatment using nicotine preparations is called nicotine replacement therapy .
By gradually reducing the amount of supplementation and acclimatizing to a nicotine-free state, it becomes a treatment method that relieves symptoms and breaks away from psychological dependence, physical dependence, and smoking habits.
The amount of use is adjusted individually at the timing when you want to smoke.
- Can be used according to smoking desires and is easy to adjust
- Has immediate effect compared to patches
- Can be purchased with over-the-counter drugs
There are advantages such as On the other hand
- low success rate
- Side effects such as stomatitis and oral irritation
There are also disadvantages such as.
In addition, smoking during use is prohibited in principle, as side effects are more likely to occur due to oversupply of nicotine.
How to quit smoking with nicotine-free drug Champix
The advent of the smoking cessation drug Champix has simply expanded the options for smoking cessation treatments, where the use of nicotine preparations was common until then.
Not only that, but the increased efficacy for heavy smokers such as those who have failed to quit smoking repeatedly, long-term smokers, and nicotine addicts has expanded the therapeutic range and helped them quit smoking. It has also contributed to a significant increase in treatment success rates.
However, due to its high efficacy and mechanism of action, it is also a drug with many restrictions and side effects.
In order to provide effective smoking cessation treatment, we will explain in detail the correct effects, usage, and precautions of Champix.
What is Champix
Champix is an oral smoking cessation drug developed and marketed by Pfizer, Inc. , a major American pharmaceutical manufacturer .
The drug was launched in the United States under the brand name “Chantics” in August 2006, in Europe in December 2006, and in USA in May 2008.
In USA, it is designated as a “prescription drug (medical drug) and powerful drug” in the “Act on Securing Quality, Effectiveness, and Safety of Pharmaceuticals and Medical Devices”.
The active ingredient name is varenicline tartrate, which is classified as an α4β2 nicotine receptor agonist. It has the major feature of having two functions, one is to partially stimulate the nicotine receptors of nerve cells in the brain and the other is to antagonize them.
In addition to the epoch-making effects, around the time when Champix was launched in USA, smoking cessation treatment insurance coverage (2006), tobacco price surge (2010), health consciousness and smoke separation orientation expanded, etc. It is said that the number of people who want to quit smoking has increased and the demand has increased.
Today, it is said that the annual number of users is more than 400,000, and it is a product that can be said to be synonymous with smoking cessation treatment.
Effects / features
When a person smokes a cigarette, the nicotine contained in the cigarette enters the blood from the lungs, then reaches the brain and binds to and stimulates the α4β2 nicotine receptor of nerve cells in the brain, thereby releasing a neurotransmitter called dopamine.
This dopamine creates the satisfaction of smoking.
If you smoke for a long time and your brain feels this satisfaction, you will start to have nicotine withdrawal symptoms such as frustration and wanting to smoke when nicotine is no longer working.
By repeating smoking and nicotine withdrawal, the number of cigarettes will increase, and it will become difficult to quit smoking.
Champix works by the active ingredient varenicline tartrate binding to the α4β2 nicotine receptor instead of nicotine .
Varenicline tartrate works to release dopamine in the same way as nicotine, but since the amount released is about half that of nicotine, it is possible to obtain a certain degree of satisfaction without smoking, so withdrawal symptoms due to smoking cessation can be caused. It can be reduced .
In addition, even if you smoke while taking it, the receptor is covered with varenicline tartrate, which has the effect of suppressing satisfaction and making cigarettes less delicious.
Usage / dose
Champix should be taken one week before the start of smoking cessation and the dose should be gradually increased.
On days 1 to 3, take 0.5 mg once a day after meals (anytime in the morning, lunch or dinner). On days 4 to 7, take 0.5 mg twice a day after breakfast and dinner. After that, take 1mg twice a day after breakfast and dinner.
When prescribed by a medical institution, use the Champix Starter Pack, which is easy to understand for the first 2 weeks and comes in one sheet, so you don’t have to worry about getting the dosage wrong.
If side effects occur when the dose is increased to 1 mg at a time, twice a day, the dose may be decreased to 0.5 mg twice a day, and in severe cases, administration may be discontinued.
For patients with severe renal impairment (estimated creatinine clearance less than 30 ml/min), start with 0.5 mg once a day, up to a maximum of 0.5 mg twice a day. You can take it.
If you miss a dose, take it as soon as you notice.
However, if it is almost time for the next regular dose, do not take it and start taking it from the next dose. Do not take 2 doses at a time.
Smoking cessation treatment period
The basic dosing period for Champix is 12 weeks .
When visiting a medical institution, undergo a total of 5 consultations (first consultation, 2nd week, 4th week, 8th week, 12th week) and treat while checking the quitting status and the presence of nicotine withdrawal symptoms and side effects. I will do it.
In addition, after completing the 12-week smoking cessation treatment, it is possible to continue taking it if necessary, considering the patient’s wishes and the need for continued treatment.In that case, the dosage is 1 mg once. After breakfast and dinner twice a day, the maximum possible period is 12 weeks (total of 24 weeks).
Basic / prolongation even if the dose is adjusted due to side effects, if there is a residual drug due to forgetting to take it, or if the person who did not succeed in quitting smoking during or after 12 weeks of administration treatment takes Champix again. The administration period does not change.
However, if smoking cessation treatment using Champix is performed at a medical institution, insurance will be applied only for the normal administration period of 12 weeks.
Subsequent administrations, and administrations within one year from the date of the first medical examination for treatments previously covered by health insurance, will not be covered by insurance, including examination fees, prescription fees, and drug fees.
side effects
In clinical trials in USA, the side effects that are often reported as cases are
- nausea
- insomnia
- Unusual dream
- headache
will be In particular, nausea has a high incidence of 28%, and is a side effect that is frequently seen at the start of administration or when the drug dose is increased.
In addition, hypertension, palpitations, arrhythmia, angina pectoris, anxiety, depression, dysgeusia, eye pain, conjunctivitis, tinnitus, gastric ulcer, diarrhea, constipation, stomatitis, hyperhidrosis, arthralgia, sexual dysfunction, irregular menstruation , weight gain, etc. may appear.
Also, as a serious side effect
- Skin and mucosal disorders (rash, blisters, heat sensation, itching, sore lips and oral cavity, sore throat)
- Angioedema (swelling of the face, throat, limbs)
- Disturbed consciousness (dizziness, decreased consciousness, sudden loss of consciousness)
- Liver dysfunction (malaise, anorexia, brown urine)
Has also been reported.
Due to various side effects, it is said that administration should be performed carefully during dialysis for those who fall under the following categories.
- mental illness
- schizophrenia
- Severe renal dysfunction
- bipolar disorder
- patients with depression
- senior citizen
Since its safety has not been established for use by pregnant and lactating people, it can be administered only when the therapeutic benefit outweighs the risk.
Drugs to suppress nicotine withdrawal symptoms taken instead of cigarettes
Nicotine preparations are drugs developed and marketed for the purpose of assisting smoking cessation by supplementing nicotine from the oral mucosa and skin as a drug instead of tobacco and suppressing the nicotine withdrawal symptoms that appear when smoking cessation.
As the treatment progresses, the amount of replenishment is gradually reduced, and smoking cessation is used as a treatment method.
Since nicotine supplementation only changes from cigarettes to drugs, there are few side effects due to drug components and it can be used safely.
With the advent of Champix, it is true that the amount used as a prescription drug has decreased, but many people still use it because it is a non-smoking drug that can be purchased at pharmacies and drug stores as an over-the-counter drug. increase.
Let’s explain the outline, types, dosage forms, and classification of medicines for sale.
Nicotinel
Nicotinel is a nicotine preparation manufactured and sold by Novartis Co. , Ltd. , a Swiss pharmaceutical manufacturer .
The product name is derived from “Nicotine” and “Nell”, and the products include patches and gum.
It was marketed as nicotinel TTS, a patch for ethical drugs, and after its use and safety were recognized, nicotinel patch and nicotine gum for over-the-counter drugs were launched.
However, Nicotinel patch is a first-class drug that requires a pharmacist to sell.
Nicotinel TTS has standards of TTS30, TTS20, and TTS10, and the administration period is 8 weeks in principle. Apply TTS30 for the first 4 weeks, TTS20 for the next 2 weeks, and TTS10 for the last 2 weeks.
Nicotinel patch has the standards of Nicotinel patch 20 and Nicotinel patch 10, and the administration period is 8 weeks in principle. Patch 20 is applied for the first 6 weeks and patch 10 is applied for the last 2 weeks.
There are three types of nicotine gum, peppermint flavor, spearmint flavor, and mango flavor, and there are 10 pieces, 20 pieces, 50 pieces, and 90 pieces, so you can choose according to your taste.
When you want to smoke, chew one piece for 30 to 60 minutes.
Start with 4 to 12 pieces per day, and gradually increase or decrease the number of pieces to be used for a period of 3 months to get used to smoking cessation. (The number of cigarettes used depends on the number of cigarettes smoked per day before smoking cessation.)
Nicolette
Nicorette is a nicotine drug manufactured and sold by Johnson & Johnson, a major American pharmaceutical and medical device manufacturer. In USA, it is sold by Takeda Consumer Healthcare Co., Ltd., which has received business consignment.
There are four types of Nicorette with different tastes, including 12 pieces, 24 pieces, 48 pieces, and 96 pieces, so you can choose according to your taste.
Both products are over-the-counter drugs and are second-class drugs that can be sold without a pharmacist, so they can be purchased at any drug store.
When you want to smoke, chew one piece for 30 to 60 minutes. Start using 4 to 12 pieces per day, and increase or decrease the number of pieces used for about 3 months to get used to smoking cessation.
In addition, Nicorette gum , which can be easily used as a smoking cessation treatment , has been commercialized in many countries overseas, and it is a popular product that is easy to continue because it comes with flavors such as mint and fruit flavors.
Ciganon CQ
Ciganon CQ is a nicotine preparation manufactured and sold by GlaxoSmithKline Ltd., a major British pharmaceutical manufacturer. In USA, it is sold by Taisho Pharmaceutical Co., Ltd., which has received business consignment.
The product is only a patch agent. It is an over-the-counter drug and can be purchased at pharmacies and drug stores, but it is designated as a class 1 drug, so it cannot be purchased without a pharmacist.
It is sold overseas under product names such as Nikoderm CQ and Nikuitin CQ, and holds a 40% share of the global market for over-the-counter smoking cessation drugs (patches).
The biggest feature is the nicotine content, which is overwhelmingly higher than other nicotineel patches, and has the same content as the prescription drug nicotinel TTS.
Therefore, although it has the advantage of being effective for a long time, there are many reports of skin problems such as itching and redness.
There are two types of Ciganon CQ, Ciganon CQ1 and Ciganon CQ2, and the administration period is 8 weeks in principle. CQ1 is applied for the first 6 weeks and CQ2 is applied for the last 2 weeks once a day when waking up. To do.
How to start smoking cessation treatment
Smoking cessation treatment has different effects (success rate of smoking cessation), ease of use, and cost depending on each treatment method.
In addition, there are various smoking cessation drugs, and many people may be at a loss as to which one to start with.
Depending on the patient’s smoking status, such as the number of cigarettes and years of smoking, health condition, medications being taken, and the need to quit smoking (risks associated with continued smoking), there are effective treatment options and medications that are suitable for oneself. It is important to choose a treatment method that is , and can be continued.
We will introduce how to start smoking cessation treatment, how to purchase smoking cessation treatment drugs, and explain the outline, advantages and disadvantages, so please refer to it.
Go to a non-smoking outpatient department
It is a method to receive treatment at a hospital or clinic that specializes in smoking cessation treatment .
If you are examined by a doctor and determined that you need continuous treatment and medication, we will prescribe medication.
The drug used is either the prescription drug Champix or Nicotinel TTS, but while it is highly effective, it also has a high risk of side effects, and it may be a drug that requires caution depending on the illness being treated, medical history, or the drug being taken. ..
There are great merits of getting the support of doctors and pharmacists, such as follow-up of smoking cessation status and health condition, management of drugs according to the presence or absence of effects and side effects, and adjustment of dosage in continuous treatment.
Currently, smoking cessation treatment outpatients are covered by insurance if certain conditions such as the number of cigarettes smoked per day, the number of years of smoking, and the nicotine addiction judgment test are met, so they can be received at a relatively low cost.
If you are a heavy smoker, it may be your preferred treatment.
however,
- A total of 5 visits are required in 12 weeks
- Treatment after 12 weeks is not covered by insurance and is fully paid by the patient.
- May not be prescribed depending on mild smoker, patient health, and medications taken
Please note that there are also disadvantages.
Online purchase of smoking cessation aids
You can buy smoking cessation drugs online or at pharmacies or drugstores and take them for treatment.
In general, only over-the-counter drugs such as “Nicotinel Patch”, “Nicotiner Gum”, “Nicorette”, and “Ciganon CQ” can be purchased over the counter in USA.
・Nicotine preparations are also available for purchase.
- Various types to try
- Easy to use as there is no need to go to the hospital
- Low cost because only drug fees are required
There are advantages such as
However, there are also disadvantages such as having to manage all the drugs and motivation for smoking cessation by yourself, and the success rate of smoking cessation is low compared to the treatment at the smoking cessation outpatient department.
Nicotine preparations for over-the-counter drugs have a lower nicotine content than prescription drugs and cannot be expected to be effective for severe smokers.
In addition, ethical pharmaceuticals such as Champix and nicotine preparations have many side effects, precautions for taking, and precautions for concomitant use, so be sure to check the precautions before purchasing.
Recommendation of utilization of smoking cessation treatment drug (summary)
In recent years, many people have become more aware of smoking cessation due to the insurance coverage of smoking cessation treatment, the impact on health, the promotion of separate smoking areas, and the rise in cigarette prices. is increasing.
Nowadays, the idea that smoking cessation is treated is becoming more common.
Since smoking cessation drugs are medicines, there is a risk of side effects and care must be taken when handling them, but if used properly with correct knowledge, they can be treated effectively and safely.
Not only those who have failed to quit smoking many times, but also those who are thinking about quitting smoking for the first time, why not try using a smoking cessation drug once.