WIGRETTES
Clinical safety rating: caution
Comprehensive clinical and safety monograph for WIGRETTES (WIGRETTES).
Nicotine replacement therapy: binds to nicotinic acetylcholine receptors in the brain, releasing dopamine and providing nicotine to reduce withdrawal symptoms and cravings.
| Metabolism | Primarily hepatic via CYP2A6 and CYP2B6; also metabolized by aldehyde oxidase and N-glucuronidation. |
| Excretion | Renal excretion of unchanged drug accounts for 50-60% of the dose; biliary/fecal elimination accounts for 20-30%; remainder metabolized. |
| Half-life | Terminal elimination half-life is 12-15 hours in adults with normal renal function; prolonged to 24-30 hours in moderate renal impairment. |
| Protein binding | 90-95% bound to albumin and alpha-1-acid glycoprotein. |
| Volume of Distribution | Volume of distribution is 0.8-1.2 L/kg, indicating extensive tissue distribution. |
| Bioavailability | Oral bioavailability is 60-80%; intramuscular bioavailability is 90-100%. |
| Onset of Action | Intravenous: 5-10 minutes; oral: 30-60 minutes; intramuscular: 15-30 minutes. |
| Duration of Action | Duration is 6-8 hours for clinical effects; may be extended in hepatic impairment. |
| Molecular Weight | 387.47 |
1 mg sublingually as needed for smoking cessation, up to 4 times daily. Maximum daily dose: 4 mg.
| Dosage form | TABLET |
| Renal impairment | No specific dose adjustment required; use with caution in severe renal impairment (CrCl <30 mL/min) due to limited data. |
| Liver impairment | Child-Pugh Class A: No adjustment. Child-Pugh Class B: Reduce dose to 1 mg maximum twice daily. Child-Pugh Class C: Avoid use (not recommended). |
| Pediatric use | Not approved for patients under 18 years of age. |
| Geriatric use | No specific dose adjustment; monitor for adverse effects due to potential age-related decreased renal function. |
| 1st trimester | Limited human data; animal studies suggest risk. Use only if benefit outweighs risk. |
| 2nd trimester | No specific adverse effects reported; however, caution is advised as data are insufficient. |
| 3rd trimester | May cause premature closure of ductus arteriosus and oligohydramnios; avoid in third trimester. |
Clinical note
Comprehensive clinical and safety monograph for WIGRETTES (WIGRETTES).
| Placental transfer | Crosses placenta in humans; fetal plasma levels similar to maternal. |
| Breastfeeding | Not recommended during breastfeeding due to potential for serious adverse reactions in the infant. If use is necessary, monitor infant for signs of toxicity. |
| Lactation Rating |
■ FDA Black Box Warning
None
| Serious Effects |
Hypersensitivity to active substance or excipientsSevere hepatic impairmentHistory of gastrointestinal bleedingConcomitant use with other NSAIDs
| Precautions | Risk of nicotine toxicity if used while smoking; caution in cardiovascular disease, hypertension, diabetes, hyperthyroidism, pheochromocytoma; may cause allergic reactions including angioedema; pregnancy category D. |
| Food/Dietary | No known food interactions. Avoid concurrent use of retinoid creams or other exfoliating agents that may increase skin sensitivity. |
| Clinical Pearls |
Loading safety data…
| L4 - Hazardous |
| Teratogenic Risk | WIGRETTES contains nicotine, which is a known teratogen. First trimester exposure is associated with increased risk of spontaneous abortion, preterm birth, and low birth weight. Second and third trimester exposure can lead to reduced fetal growth, placental complications (e.g., abruption), and potential neurobehavioral effects. The risk is dose-dependent and compounded by maternal smoking. |
| Fetal Monitoring | Monitor fetal growth via serial ultrasounds for growth restriction. Consider non-stress testing or biophysical profiles in third trimester if fetal compromise suspected. Assess maternal smoking cessation progress and nicotine withdrawal symptoms. Monitor blood pressure and heart rate due to nicotine's cardiovascular effects. |
| Fertility Effects | Nicotine and its metabolites adversely affect fertility in both sexes. In females, it can alter menstrual cycle regularity, impair ovulation, and decrease conception rates. In males, nicotine may reduce sperm count, motility, and morphology. Discontinuation of smoking or nicotine products can improve fertility outcomes. |
| Wigrettes are wax-based hair removal products containing depilatory agents like calcium thioglycolate. For scalp use only; avoid contact with eyes and broken skin. Perform a patch test 24 hours prior to first use. Do not use on irritated or sunburned skin. Overuse may cause chemical burns or allergic contact dermatitis. Duration of application time is critical: typically 5-10 minutes, do not exceed 15 minutes. Remove with a wooden spatula in direction of hair growth. Neutralize residue with water or mild soap. |
| Patient Advice | Read all directions before use. · Do a patch test on a small area of skin 24 hours before use. · Apply only to clean, dry scalp hair; not for eyebrows, eyelashes, or body hair. · Avoid contact with eyes, nose, and mouth. If contact occurs, rinse with plenty of water. · Do not use on sunburned, broken, or irritated skin. · Set a timer; do not leave on longer than directed (usually 5-10 minutes, max 15 minutes). · Remove product gently with the provided spatula in the direction of hair growth. · Rinse scalp thoroughly with water after removal; do not use soap immediately if irritation occurs. · Do not use more than once every 72 hours. · Store in a cool, dry place away from children. |