Nicotine
Standing risks
| Risk | Recorded values | Confidence | Article section |
|---|---|---|---|
| Compulsive use risk, monitor frequency |
| high | View in article: Compulsive use risk, monitor frequency |
| High dependence, taper carefully |
| high | View in article: High dependence, taper carefully |
| Chronic toxicity, limit exposure |
| high | View in article: Chronic toxicity, limit exposure |
Lethal interactions
| Combination | Type | Severity | Mechanisms | Confidence |
|---|---|---|---|---|
| MAOIs | Drug class | lethal | 6 | high |
Dangerous interactions
26 dangerous interactions recorded for this substance.
See the full interactions tableContraindications
| Condition | Severity | Note |
|---|---|---|
| Cardiovascular | ||
| coronary artery disease | relative | Relative contraindication. Nicotine increases heart rate, blood pressure, and myocardial oxygen consumption while reducing coronary perfusion. Particularly dangerous in patients with existing coronary stenosis. |
| recent myocardial infarction | relative | Relative contraindication in the acute post-MI period. Nicotine's hemodynamic and prothrombotic effects may increase risk of recurrent cardiac events. |
| severe uncontrolled hypertension | relative | Relative contraindication. Nicotine consistently raises blood pressure and may reduce the efficacy of antihypertensive medications. |
| serious cardiac arrhythmias | relative | Relative contraindication in patients with serious or unstable cardiac arrhythmias. Arrhythmia risk documented particularly during exercise. |
| Metabolic | ||
| pheochromocytoma | absolute | Absolute contraindication. Risk of hypertensive crisis due to nicotine-induced catecholamine surge on top of autonomous catecholamine secretion from the tumor. |
| Pregnancy & Breastfeeding | ||
| pregnancy | absolute | Nicotine is teratogenic. NRT is not demonstrably safe in pregnancy — nicotine itself, independent of tobacco combustion products, causes developmental harm. Absolute contraindication for non-therapeutic nicotine use during pregnancy. |
| breastfeeding | relative | Nicotine is excreted in breast milk. Relative contraindication; risk-benefit assessment required (smoking cessation with NRT may be preferable to continued smoking during lactation). |
| Age | ||
| adolescence | relative | Relative contraindication. Adolescent-onset nicotine exposure carries elevated addiction risk and produces lasting neurobiological changes not observed with adult-onset use. |
| Other | ||
| active peptic ulcer disease | relative | Relative contraindication. Nicotine increases gastric acid output and may exacerbate or delay healing of peptic ulcers. |