Using Multiple Medications to Help Quit

Using more than one medication at a time may help you manage cravings and other withdrawal symptoms better than using only one medication.

Using a combination of medications can be more effective than only using one type. This is especially true for people who are very dependent on nicotine. This is also true for people who have not had success trying to quit using only one type of medication.

How does using multiple medications to help quit work?

Different combinations of medications work differently.

For example, patch + gum. The nicotine patch can be used to provide a steady level of nicotine to control most withdrawal symptoms, and the gum can be used when nicotine from the patch does not control cravings or other symptoms.

Or, varenicline + lozenge. Varenicline blocks the pleasant effects of nicotine from smoking on the brain, and the lozenge can be used for breakthrough cravings.

Long-acting medications

Long-acting medications make withdrawal symptoms easier to manage over a longer period of time. They include:

• Nicotine patch
• Varenicline
• Bupropion

Short-acting medications

Short-acting medications can help you cope with cravings that are not controlled by a long-acting medication (sometimes called “breakthrough cravings”). Short-acting medications include:

• Nicotine gum
• Nicotine lozenge
• Nicotine nasal spray
• Nicotine inhaler (no longer available in the United States)

How can I get medications to help quit?

If you are 18 years or older, some medications are available over the counter and others require a prescription. If you are under 18, talk to your healthcare provider about medication to help you quit.

Prescription medications

• A prescription is required for varenicline, bupropion, and nicotine nasal spray.
• If you have insurance, most health plans offer quitting medication at no or very low cost to members. Call the number on the back of your insurance card to check on your benefits. Some insurance plans require a prescription from your health care provider to cover the cost of the medications.

Over the counter medications

• Many states make quitting medications available through a state quitline. Call 1-800-QUIT-NOW to find out what is available in your state.
• Nicotine patches, gum, and lozenges are available for sale without a prescription at pharmacies and other stores.

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How to use multiple medications to help quit

• Read the package instructions before using any medication.
• Talk with your doctor or pharmacist about whether this combination of medications is right for you. They can determine an appropriate starting dose and a plan for using it and tapering off.