Nicotine Adverse Reactions
- abdominal pain
- appetite stimulation
- constipation
- diarrhea
- dizziness
- dysmenorrhea
- erythema
- flushing
- headache
- hypertension
- hypotension
- insomnia
- irritability
- nausea/vomiting
- pruritus
- syncope
- urticaria
- weakness
Nicotine Adverse Reactions
Concern has been expressed regarding the potential cardiovascular toxicity of nicotine patches in subjects with cardiovascular disease. To assess this, Joseph et al. evaluated VA subjects, 45 years or older, with documented cardiac disease and found that, while study end points including both serious and minor events were slightly more frequent in the group receiving and using nicotine patches compared to the placebo group, this difference was not statistically significant. Since nicotine patches generally produce lower nicotine blood concentrations than tobacco smoking and since the nicotine dose-response curve from patches is much flatter than for smoking, it should not be expected that use of nicotine patches would pose a greater cardiovascular risk than smoking itself. Pharmacologically, the effects of nicotine on the cardiovascular system mimick those of sympathetic stimulation; agonism of nicotinic receptors on adrenal medullary cells causes the release of epinephrine and norepinephrine. Nicotine raises systolic and diastolic blood pressure and can increase the inotropic and chronotropic actions of the heart. The degree to which these reactions occur is a function of the nicotine blood concentration. Hypertension has been reported with nicotine patches. New onset or worsening of existing hypertension occurs in a higher percentage of patients (i.e., 6.1%) taking bupropion concurrently with nicotine trandermal systems (NTS) for smoking cessation. However, the product literature for nicotine patches does not describe other cardiovascular reactions such as atrial fibrillation, ventricular tachycardia, premature ventricular contractions (PVCs), myocardial ischemia, or myocardial infarction as adverse reactions. The absence of these findings is consistent with the kinetics of nicotine patches and the Joseph study. Since nicotine blood levels from patches can be additive to nicotine from tobacco smoking, patients should be warned against smoking while wearing the patches. The use of patches in a subject with preexisting cardiovascular disease does not appear to pose a greater risk than smoking itself, as long as the subject refrains from smoking while wearing the patch.
Nicotine patches may cause localized erythema, pruritus, rash, or urticaria.
Symptoms of nicotine overdose include nausea/vomiting, severe abdominal pain, diarrhea, severe headache, and/or severe weakness. More severe symptoms of overdose include fainting or syncope, hypotension, weak pulse, and seizures.
Minor side effects that occur during use of nicotine products include mild headache, appetite stimulation, constipation, diarrhea, dizziness, dysmenorrhea, flushing, insomnia, and irritability. Other reported side effects include hiccups, jaw ache, and sore throat.
Nicotine chewing gum is stickier and heavier than regular gum and can affect artificial teeth or other dental work.
[ Last revised: 4/16/2004 10:24:00 PM ]
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