How does this medication work? What will it do for me?

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 that 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.

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. If you want to quit smoking completely, this medication works best when used with a comprehensive program to quit smoking.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those 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.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

2 mg
Each piece of gum contains 2 mg of nicotine as nicotine polacrilex. Nonmedicinal ingredients: acesulfame potassium, calcium carbonate, carnauba wax, flavours, gelatin, glycerol, gum base, mannitol, sodium bicarbonate, sodium carbonate, sorbitol, sucralose, talc, titanium dioxide, xylitol.

4 mg
Each piece of gum contains 4 mg of nicotine as nicotine polacrilex. Nonmedicinal ingredients: acesulfame potassium, calcium carbonate, carnauba wax, flavours, gelatin, glycerol, gum base, mannitol, sodium bicarbonate, sodium carbonate, sorbitol, sucralose, talc, titanium dioxide, xylitol.

How should I use this medication?

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. Initial treatment should be based on your level of nicotine dependence.

When you start to experience a cigarette craving, start chewing one piece of gum. Proper use of the gum is important to receiving the greatest 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 the 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 per day) 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. Most people need a 3 month treatment, although some may need 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 taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children and pets.

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.

Who should NOT take this medication?

Do not use nicotine gum if you:

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

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

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 doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • bleeding gums
  • burping
  • cough
  • gingivitis (inflamed gums)
  • hiccups
  • headache
  • increased salivation
  • irritated or inflamed tongue
  • lightheadedness
  • jaw ache
  • mouth or throat soreness
  • nausea
  • upset stomach
  • unusual taste in your mouth

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

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

  • chest pain
  • fast or irregular heartbeat
  • feelings of dependence on the medication or difficulty stopping the medication after your treatment is done
  • fever with or without chills
  • runny nose
  • shortness of breath, tightness in chest, difficulty breathing, or wheezing
  • skin rash, itching, or hives
  • stomach upset that does not go away
  • vomiting

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • symptoms of a serious allergic reaction (such as hives, difficulty breathing, or swelling of the face and throat)

Symptoms of overdose

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

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.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Medical conditions: If you have thyroid conditions, diabetes, stomach ulcers, heart disease, blood vessel disease, kidney disease, mouth or throat inflammation, or dental problems that might be made worse by chewing gum, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are using nicotine gum, it may affect your baby. Do not breast-feed while you are 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.

What other drugs could interact with this medication?

There may be an interaction between nicotine chewing gum and any of the following:

  • acetaminophen
  • adenosine
  • benzodiazepines (e.g., oxazepam)
  • caffeine
  • cimetidine
  • furosemide
  • imipramine
  • insulin
  • labetalol
  • phenylephrine
  • prazosin
  • propranolol
  • theophylline
  • varenicline

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. 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 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.

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