nicotine (gum, lozenge)

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Pronunciation: NIK oh teen

Brand: Leader Nicotine Polacrilex, Nicorelief, Nicorette, Thrive

What is the most important information I should know about nicotine gum or lozenges?

Do not smoke or use other nicotine products (including snuff, chewing tobacco, nicotine patches, inhaler, or nasal spray) while you are using nicotine gum or lozenges.

What is nicotine?

Nicotine is the primary ingredient in tobacco products.

Nicotine gum and lozenges are medical products used to aid in smoking cessation in adults. Using a controlled amount of nicotine helps reduce nicotine withdrawal symptoms when you quit smoking.

Nicotine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using nicotine gum or lozenges?

Ask a doctor or pharmacist if it is safe for you to use this medicine if you have:

  • heart disease, heart rhythm disorder;
  • untreated or uncontrolled high blood pressure;
  • diabetes;
  • stomach ulcer;
  • a history of seizures;
  • a food allergy;
  • if you have recently had a heart attack;
  • if you are on a low salt diet; or
  • if you are using any other smoking cessation medicine (bupropion, Zyban, or others).

Do not use this medication if you are pregnant unless your doctor has told you to. Use effective birth control, and tell your doctor if you become pregnant during treatment.

Nicotine can pass into breast milk and may harm a nursing baby. Do not use this medication if you are breast-feeding unless your doctor has told you to.

Smoking cigarettes during pregnancy can cause low birth weight, miscarriage, or stillbirth. Using a nicotine replacement product during pregnancy or while breast-feeding may be safer than smoking. However, you should try to stop smoking without using a nicotine replacement product if you are pregnant or breast-feeding. Talk with your doctor about the best way for you to stop smoking.

Nicotine lozenges may contain phenylalanine. Tell your doctor if you have phenylketonuria (PKU).

Do not give this medication to anyone under 18 years old without medical advice.

How should I take nicotine gum or lozenges?

This medicine is only part of a complete program of treatment that may also include counseling, group support, and behavior changes. Your success will depend on your participation in all aspects of your smoking cessation program.

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. This medicine comes with patient instructions for safe and effective use. Your dose will depend on how many cigarettes you smoked daily before quitting. Follow the guide in the patient instructions. Ask your doctor or pharmacist if you have any questions.

Do not smoke or use other nicotine products (including snuff, chewing tobacco, nicotine patches, inhaler, or nasal spray). Using many forms of nicotine together can be dangerous.

To use nicotine gum:

  • Chew the gum slowly and stop chewing when your mouth starts to tingle. "Park" the gum between your cheek and gum and leave it there until the tingly feeling is gone. Then slowly chew a few more times until the tingling returns. Park the gum again in a different place in your mouth.
  • Remove a piece of gum after 30 minutes, or when chewing no longer causes the tingly feeling.
  • If you have very strong or frequent cravings, you may chew a new piece of gum within 60 minutes.
  • Avoid chewing one piece of gum right after the other, or you may have side effects such as hiccups, heartburn, or nausea.
  • For best results, use at least 9 pieces of gum per day for the first 6 weeks of treatment. Do not use more than 24 pieces of gum per day.

To use nicotine lozenges:

  • Place the lozenge in your mouth and allow it to dissolve slowly over 20 to 30 minutes, without chewing or swallowing.
  • Move the lozenge from one side of your mouth to the other until it has completely dissolved.
  • You may notice a warm or tingly feeling in your mouth.
  • For best results, use at least 9 lozenges per day for the first 6 weeks of treatment. Do not use more than 5 lozenges in 6 hours (20 lozenges per day).

After removing the gum or lozenge, wrap it in paper and throw it away in a place where children and pets cannot reach it.

Do not use this medicine for longer than 12 weeks without the advice of your doctor.

Do not use more than one lozenge or piece of gum at a time. Do not use the gum and lozenges together at the same time.

Store at room temperature away from moisture, heat, and light.

Keep both used and unused gum and lozenges out of the reach of children or pets.

What happens if I miss a dose?

Since nicotine is used as needed, you are not likely to miss a dose. Do not use more than 20 lozenges or 24 pieces of gum per day.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. The amount of nicotine in a used or unused lozenge or piece of gum can be fatal to a child who accidentally sucks or chews on it. Seek emergency medical attention if this happens.

Overdose symptoms may include severe dizziness, nausea, vomiting, diarrhea, weakness, and fast heart rate.

What should I avoid while using nicotine gum or lozenges?

Do not eat or drink anything within 15 minutes before using the gum or lozenge or while the medicine is in your mouth.

What are the possible side effects of nicotine gum or lozenges?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if you have:

  • fast or pounding heartbeats, fluttering in your chest;
  • blisters inside your mouth;
  • problems with your teeth or jaw; or
  • wheezing, tightness in your chest, trouble breathing.

Common side effects may include:

  • mild dizziness;
  • dry mouth, upset stomach, burping, or hiccups;
  • mouth or throat soreness;
  • changes in taste; or
  • headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect nicotine gum or lozenges?

Other drugs may interact with nicotine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

Your pharmacist can provide more information about nicotine gum or lozenges.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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