Combination Nicotine Replacement Therapy (NRT)
What is Combination NRT?
Combination NRT is the use of NICODERM® patch PLUS an additional form of short-acting NICORETTE® oral NRT (gum, lozenge, inhaler, QUICKMIST®) on an as needed basis.
Now, you can power up your patient's quit journey by combining NICODERM® and NICORETTE® products.
58% more effective vs NRT monotherapy (patch) to get patients to a successful quit. 133
NICODERM® and NICORETTE®: Now Approved to be Used in Combination
Combination NRT therapy should be encouraged when quitting with monotherapy has not been successful or if breakthrough cravings occur.113,114
Total abstinence is the ultimate goal. Combination NRT (nicotine patch + an oral form of NRT) yields among the highest abstinence rates* compared to other pharmacological interventions.109
The first and only NRT in Canada permitted for use in combination as supported by the Health Canada Product License.18,50,60,92,93
Why Combination NRT?
Smokers’ nicotine levels vary throughout the day resulting in a gradual build-up of trough nicotine levels and regular nicotine peaks each time they smoke.111
Monotherapy may not be able to provide both high daily baseline nicotine levels as well as the nicotine levels needed during the craving phase.113
Combination NRT using patch + an oral form of NRT enables coverage of both peak and trough levels of nicotine:
Evidence shows Combination NRT is an effective approach to achieving abstinence:
Versus Monotherapy (patch)
Over 2x more effective vs NRT patch monotherapy (aggregated relative risk of abstinence of combination therapy vs. monotherapy: 1.58 [1.25-1.99] at 12 months)133
Versus Cold Turkey
Nearly 3x more effective vs cold turkey
Compared to cold turkey, smokers using Combination NRT were nearly 3x more likely to quit for good (OR 2.73; 95% CI 2.07-3.65)110
Versus Cold Turkey
Nearly 5x more effective vs cold turkey alone:
Pharmacotherapy combined with HCP support can increase a smoker’s success of quitting by fivefold47
"There is little evidence for concern that either high-dose NRT or combination NRT will result in significant health harm."114
- Carpenter MJ et al, Drugs, 2013.
"Combining a long-acting from of NRT (e.g. nicotine path) with a faster-acting formulation (e.g. nicotine gum) is a highly efficacious and safe smoking cessation treatment."115
- Fucito et al, Nicotine & Tobacco Research, July 2014.
Putting Combination NRT into practice
Who is a good candidate for Combination NRT?
have used NRT in a previous quit attempt but relapsed while using it
Feel they need something more than a patch or other single form of NRT to keep from smoking.
Meet Four Smokers Who Could Benefit from Combination NRT: