What is the role of combination drug treatment for nicotine addiction?

Updated: Jul 16, 2018
  • Author: R Gregory Lande, DO, FACN; Chief Editor: Glen L Xiong, MD  more...
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To improve smoking cessation, medications can be combined. For example, passive nicotine delivery (eg, via a transdermal patch) may be used in conjunction with another medication that permits acute dosing (eg, gum, nasal spray, or inhaler). Combining the nicotine patch (which may prevent the appearance of severe withdrawal) with acute-dosing formulations (which can provide relief in trigger-to-smoke contexts) may provide an excellent treatment alternative to the use of either therapy alone. [48, 49]

Bupropion in combination with a nicotine patch appears to be more efficacious than a nicotine patch alone, possibly because the 2 medications act via different pharmacologic mechanisms. [50] Despite the possibility of increased efficacy, the US Clinical Practice Guideline recommends that such combination therapy be prescribed under the direction of an experienced clinician or a specialty clinic.

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