Single-Dose Pharmacokinetics of Nicotine When Given With a Novel Mouth Spray for Nicotine Replacement Therapy

INTRODUCTION: As the efficacy of nicotine replacement therapy might be improved by faster systemic nicotine uptake, a new nicotine mouth spray has been developed. The current study was performed to evaluate the single-dose pharmacokinetics of nicotine at 3 doses of the mouth spray and to compare the speed of nicotine uptake from the spray versus nicotine lozenge and gum. METHODS: In a randomized crossover study, 45 healthy adult smokers received single doses of nicotine mouth spray 1, 2, and 4 mg, nicotine lozenge 4 mg, and nicotine gum 4 mg on separate occasions. Blood samples were collected for 12 hr to determine pharmacokinetic variables. RESULTS: Mean plasma nicotine concentrations during the first 10 min, measured using area under the curve (AUC(10 min)), were 3 times as high with spray 4 mg as with lozenge or gum. The AUC(10 min) with 2 and 1 mg doses of spray, respectively, was twice and 1.5 times as high as the AUC(10 min) with lozenge or gum. The maximum baseline-corrected plasma nicotine concentration (cC(max)) with 4 mg spray exceeded that for lozenge and gum by 34% and 20%; the median time to reach C(max) was 10-12.5 min for the 3 doses of spray, 45 min for lozenge, and 30 min for gum. The mean baseline-corrected area under the plasma nicotine concentration-versus-time curve (cAUC(∞)) with 4 mg spray was 15% higher than that with gum but did not differ significantly from that with lozenge. CONCLUSION: Nicotine delivered via the mouth spray is absorbed considerably faster than nicotine given via gum or lozenge.