Use: Smoking cessation aid
Contraindications: Nontobacco users; recent MI (less than or equal to 3 mnths); unstable, progressive angina pectoris; Prinzmetal variant angina; severe cardiac arrhythmias; acute phase stroke; pregnancy, lactation, children Precautions: Dentures; oropharyngeal inflammation; active peptic ulcer; cardiovascular, cerebrovascular disease; uncontrolled hypertension; hyperthyroidism; phaeochromocytoma; mod/ severe hepatic impairment; severe renal impairment; effects of smoking cessation:
Adverse Reactions: Headache; GI upset; sore mouth or throat; denture damage; dependence;
Dose: 2mg; 4mg; Individualise dosage; commence with 2 mg gum; highly dependent smokers (> 20 cigarettes/day), failure on 2 mg: commence with 4 mg gum. Chew 1 gum piece slowly and intermittently when urge to smoke is felt. Usually: 16-24 mg daily; max 40 mg daily. Use for greater than or equal to 3 mnths then reduce dose.
Flavour: Classic, Mint, Freshmint, Citrus

So what is Nicorette gum?
Nicorette gum is a gum base that contains nicotine polacrilex 20%. Nicorette Chewing Gum is a treatment aid in smoking cessation.

How fast is nicotine released?
Nicotine is readily absorbed in the mouth and nicotine can be detected in the blood within 5-7 minutes after you start chewing and reaches a maximum in about 5-10 minutes after stopping chewing. The actual amount of nicotine is dependent on how enthusiastically and for how long the gum is chewed. The problem is that the nicotine concentration from swallowing is lower because the blood that carries the nicotine from the mouth has to pass through the liver which metabolizes some of the nicotine. Normally 1.4 (from 2mg gum) and 3.4mg (from 4mg gum) are extracted.


Who shouldn’t use this?
Check with your doctor before commencing Nicorette gums. It is contraindicated in pregnant women, in children and in people who are non-smokers. Please with hypersensitivity to nicotine or any component of the gum. It should not be used by patients with heart attacks, chest pain, severe cardiac arrhythmias or suffer from strokes. Smokers who wear dentures may experience difficulty in chewing Nicorette Chewing Gum. The chewing gum may stick to and may, in rare cases, damage dentures.

What are the common side effects?
Most side effects occur within the first 3-4 weeks of starting the gum. The chewing gum may stick to and, in rare cases, may damage dentures. The more common adverse event include headaches, stomach upset, hiccups, nausea, vomiting, sore throat and jaw muscle ache. Less common side effects include erythema, palpitations, and rarely causes reversible atrial fibrillation. Allergic reactions can also happen.

What is the recommended use?
The use should be individualized, but often smokers need about 8 to 12 pieces of the 2 mg gum or 4 to 6 pieces of the 4 mg gum. Smokers should not use more than an equivalent to a daily dose of 40 mg. The gum should be used for at least 3 months and then gradually weaned off. Generally Nicorette stop smoking gum is ceased around 12 months. Use of this gum should be coupled with professional support to improve success. Remember that the nicotine effects are only felt after 5 minutes, so expect a slight delay after chewing. Smokers should also chew at a recommended rate of a chew per 2 seconds. Rapid chewing may irritate the throat or cause hiccups. Acidic drinks like coffee or soft drinks interfere with the absorption of nicotine, so should not be drunk 15 minutes before chewing.

Conclusions
Nicorette gum is another good nicotine replacement product but can cause jaw pain when used excessively. Soft drinks and coffee used before chewing can also affect the rapid relief that you will get so if you need the immediate relief from nicotine, and inhaler might be more effective.