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What Are the Side Effects of Nicotine Lozenges?

author image Karla Casco
Karla Casco began writing in 2010, focusing her work on diseases and treatments and their side effects. She has also created patient handouts, PowerPoint presentations and journal clubs. Karla has a doctorate in pharmacy from St. John's University and holds a pharmacy license for the state of New York.
What Are the Side Effects of Nicotine Lozenges?
Using the nicotine lozenges is one way to quit smoking. Photo Credit arcady_31/iStock/Getty Images


Nicotine lozenges are an over-the-counter medication used as a nicotine replacement therapy. These lozenges are a smoking cessation aid in either 2mg or 4mg strengths that relieve nicotine withdrawal symptoms. People who have their first cigarette within 30 minutes of waking may prefer the 4mg strength lozenges. Many common side effects are typical with the use of the nicotine lozenges.

Nausea and Vomiting

Nausea and vomiting are common side effects that may occur with nicotine lozenges. If these are severe or bothersome, you may be using a 4mg lozenge, then may need to switch to the 2mg lozenge. If the nausea and vomiting are still persistent, speak with a physician about possibly switching to another nicotine replacement therapy.


Insomnia or trouble sleeping may occur while using the nicotine lozenges. Less than 5 percent of people experience insomnia. Nicotine usually causes this side effect, so you may want to avoid sucking on the lozenges before going to sleep.

Changes in Behavior

Nicotine lozenges may cause changes in behavior that may be nicotine withdrawal symptoms. These symptoms occur because of the low dose of nicotine and include irritability, anxiety, restlessness, inability to concentrate, and mood changes. If you are on 2mg dose, ask your doctor if you should switch to the 4mg dose.

Headache and Lightheadedness

You may experience a headache while using nicotine lozenges. This may also be due to nicotine withdrawal but should subside as the body adjusts to lower levels of nicotine. Lightheadedness is a side effect that may occur if the dose is too high. You may need to switch from the 4mg dose to the 2mg dose if you experience lightheadedness.

Heart Palpitations

Heart palpitations, or a fast heart rate, may occur with nicotine lozenges. People with an irregular heart beat or severe chest pain should not use any form of nicotine replacement. Precaution should be taken in people with a history of high blood pressure, coronary artery disease and those who had a heart attack. Seek advice from a health care professional before starting any over-the-counter medication to ensure that it is safe for you.

Other Side Effects

Hiccups, coughs and flatulence are also common side effects, and may be persistent and bothersome. Report any side effects to a physician and decide whether to switch to another medication. Heartburn is also typical with nicotine lozenges and must be reported to a physician. People with a history of peptic ulcer or esophagitis must use the nicotine lozenges with caution.

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