Combination Nicotine Replacement Therapy
Some quitters need extra support
What is combination NRT?
Combination NRT (nicotine replacement therapy) 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.
![NICODERM + Inhaler OR Gum OR Lozenge OR QUICKMIST](/fr-ca/sites/academyplus_ca/files/combo_therapy_march2023.png)
Who is a good candidate for combination NRT?
![icon of a broken cigarette with a “Fail” sign over top](/fr-ca/sites/academyplus_ca/files/brokencigarettewithfailsign.png)
Patients who have used NRT in a previous quit attempt but relapsed
![icon of multiple X’s](/fr-ca/sites/academyplus_ca/files/multiplexicon.png)
Patients who have had multiple failed quit attempts
![icon of a nicotine patch with a “+” beside it](/fr-ca/sites/academyplus_ca/files/nicotinepatchicon.png)
Patients who feel they need something more than a patch or single NRT format
![icon of person looking anguished](/fr-ca/sites/academyplus_ca/files/anguishedperson_icon.png)
Patients who are experiencing breakthrough cravings or who have a high level of dependence
REDUCE TO QUIT® using combination therapy
How effective is combination therapy?
Why do some patients need 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.3
Monotherapy may not be able to provide both high daily baseline nicotine levels as well as the nicotine levels needed during the craving phase.3
Combination therapy was 30% more effective at 12 months than monotherapy alone1
In a meta-analysis of first-line smoking cessation pharmacotherapies 6 months after quitting4:
- Combination therapy was similarly effective to varenicline
- Patch (>14 weeks) plus ad lib NRT (gum or spray): OR 3.6 (2.6, 5.2 - 95% CI)
- Varenicline: OR 3.1 (2.5, 3.8 - 95% CI)
![Graph showing results of a subject study](/fr-ca/sites/academyplus_ca/files/nicotinelevelsthroughtheday-graph.png)
Combination NRT using patch + an oral form of NRT enables coverage of both peak and trough levels of nicotine.