Starting nicotine lozenges

Nicotine lozenges are a medium-acting formulation of nicotine replacement therapy (NRT); they take 20 minutes to reach peak effect. Lozenges are best used as part of combination NRT with a patch and possibly also a mist spray; for advice on how to tailor treatment, see Overview of nicotine replacement therapy and Choice of formulation of nicotine replacement therapy.

The 4 mg lozenge is preferred over lower doses because it is more likely to control cravings and increases the likelihood of success in managing tobacco smokingLindson, 2019.

If nicotine lozenges are chosen for NRT, use:

nicotine 4 mg lozenges, suck 1 lozenge 1- to 2-hourly as required to control cravings; for strong cravings, repeat after 30 minutes at the earliest (to allow time to reach peak effect). Usual maximum dosage is 16 lozenges in 24 hours. nicotine nicotine replacement therapy nicotine replacement therapy

If a patient has symptoms of withdrawal with lozenge use, ask about their technique; printable patient advice is available in Correct use of nicotine replacement therapy—patient information; see also patient education videos on the Quit website.