Nicorette Gum

Brand Names: Nicorette Gum

Common Name: nicotine chewing gum

What is this drug used for?

This medication belongs to the family of medications known as nicotine replacement therapies. It is used to help people over 18 years of age quit smoking. When a person stops smoking, they go through withdrawal from nicotine which can cause symptoms such as irritability, mood swings, restlessness, trouble concentrating, and increased appetite. This medication helps reduce the symptoms of nicotine withdrawal by replacing some of the nicotine that the person no longer receives through cigarettes. Gradually, the dose is reduced until the person no longer craves nicotine, and they can stop using the medication.

The nicotine gum can also be used during smoke-free periods where smoking is not permitted or desired. You should not smoke and chew nicotine gum at the same time. When total cessation is desired, this medication works best when used with a comprehensive program to quit smoking.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Is there any reason not to take this drug?

This medication should not be used by people who:

• are allergic to nicotine, or any ingredients of the transdermal system
• are non-smokers or occasional smokers
• are under 18 years of age
• are pregnant or breast-feeding
• have just had a heart attack
• have life-threatening arrhythmias (abnormal heart rhythm)
• have severe or worsening angina (chest pain)
• have recently had a stroke
• have a condition affecting the jaw, such as temporomandibular joint (TMJ) disease

What about possible side effects?

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your health professional. They may be able to help you to deal with some of the effects.

The following side effects may go away as your body becomes used to the medication; check with your doctor if they continue or become bothersome.

More common
• hiccups
• headache
• indigestion
• jaw ache
• mouth and throat irritation
• nausea
• stomach discomfort

Less common
anxiety back pain change in taste sensation chest pain depression diarrhea difficulty sleeping dizziness excessive salivation feeling of burning, numbness, tightness, tingling, warmth, or heat feelings of drug dependence	flu-like symptoms general pain inflammation inside the mouth pain in jaw and neck pain in muscles passing of gas problems with teeth small sores in the mouth thirst unusual tiredness or weakness vomiting

Check with your doctor as soon as possible if any of the following side effects occur:

Less common
• fast or irregular heartbeat
• chest pain
• fever with or without chills
• runny nose
• shortness of breath, tightness in chest, difficulty breathing, or wheezing
• skin rash, itching, or hives
• tearing of eyes

Symptoms of overdose
• abdominal or stomach pain
• cold sweat
• confusion
• convulsions (seizures)
• disturbed hearing and vision
• drooling
• extreme exhaustion
• pale skin
• rapid heartbeat
• tremors

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

What if I am taking other drugs?

The following may affect how this nicotine chewing gum works, be affected by nicotine chewing gum, or increase the risk of side effects:

• acetaminophen
• caffeine
• furosemide
• imipramine
• insulin
• labetalol
• phenylephrine
• prazosin
• propranolol
• theophylline

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Other information:

Medical conditions: If using this medication, people with thyroid conditions, diabetes, stomach ulcers, heart disease, or blood vessel disease should be closely monitored by their doctors. This medication should be used with caution by people with any mouth or throat inflammation and those with dental problems that might be made worse by chewing gum.

Pregnancy: This medication is not recommended for pregnant women. If you are or may be pregnant, talk to your doctor.

Breast-feeding: This medication freely passes into breast milk and may cause adverse reactions in a nursing infant. If you are breast-feeding, speak to your doctor about the benefits and risks of using this medication.

Children and adolescents: The safety and effectiveness of this medication have not been established for people under 18 years of age.

It is very important to keep this medication out of the reach of children as their sensitivity to nicotine is much higher than that of adults.

Special Instructions:

Ask your doctor or pharmacist to determine your level of nicotine dependence. They can teach you how to use the nicotine gum effectively and give you tips on quitting smoking. Nicotine dependence is measured using the Fagerstrom Nicotine Tolerance Scale. Initial treatment should be based on your level of nicotine dependence.

When you start to experience a cigarette craving, start chewing on one piece of gum. Proper use of the gum is important to receiving the most benefit from it. Do not chew the gum as you would ordinary chewing gum. Bite on the gum once or twice and then leave it between your cheek and gum. Repeat after 1 minute. Continue this for 30 minutes, then discard then gum. Repeat this process for every cigarette craving. It is recommended that you do not drink fluids while chewing the gum since this may affect the ability of the medication to deliver nicotine. The dosage is individualized and depends on how much nicotine is needed to relieve nicotine withdrawal symptoms.

For the first 2 to 4 weeks of treatment, a higher dose (10 to 12 pieces of gum) is used, and then the dose is gradually reduced over the next 4 to 12 weeks. When you reach only 1 or 2 pieces per day, then the gum can be stopped. The maximum dose is 20 pieces per day. A 3-month treatment is what most people require, although some may require treatment for up to 6 months. You should not use the nicotine gum for more than 6 months without consulting with your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

© MediResource Inc. Terms and conditions of use: The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.