Evaluation of a novel nicotine inhaler device: Part 1-arterial and venous pharmacokinetics

© The Author 2014. Introduction: In the United Kingdom, licensed nicotine-containing products can be recommended to reduce the harm associated with smoking. Many smokers find currently available nicotine replacement products unsatisfactory. The arterial and venous pharmacokinetics (PK) of nicotine delivered via a novel inhaler device were determined. Methods: Results are reported for Parts A (N = 18) and C (N = 18) of a 4-part (A-D) Phase I study. Participants (18-55 years, ≥10 cigarettes/day, smoking within 1hr of waking, expired carbon monoxide >10 ppm on screening) orally inhaled 2 single doses of nicotine (2 of 3 dose levels [0.22, 0.45, and 0.67 mg]) (Part A) and repeated hourly doses of 0.67mg nicotine for 12hr (Part C), via the novel device. Arterial and venous PK and tolerability were assessed. Results: In Part A, mean arterial plasma nicotine concentrations at 2min after the start of inhalation were 1.10, 2.06, and 2.59ng/mL for the 0.22, 0.45, and 0.67mg doses, respectively. Mean maximum arterial plasma nicotine concentrations (Cmax) were 2.11, 3.73, and 4.38ng/mL and mean times to Cmax were 10.2, 7.3, and 6.5min after the start of inhalation for the 0.22, 0.45, and 0.67mg doses, respectively. In Part C, the mean pre- and postdose venous plasma nicotine concentration increased steadily and fluctuated in the range 8-10mg/mL after 9hr. The novel device was well tolerated; most adverse events were mild. Conclusion: The novel inhaler device delivers nicotine rapidly into the systemic circulation and offers a viable alternative to cigarettes for those finding it difficult to quit the behavioral and sensorial aspects of smoking.