Nicotine Gum

Description: 
See FDA package insert for more complete information

Nicotine gum is currently available as an over-the-counter medication in 2-mg and 4-mg dosages. If you smoke 25 or more cigarettes a day, it is recommended that you use the 4-mg gum. Use one piece every 1 to 2 hours for the first 6 weeks; use up to 12 weeks. Do not exceed 24 pieces per day. The gum should be used for up to 12 weeks.


How Well Does It Work?

Studies have shown that people who used nicotine gum for a regular course and long-term use had about 1.5 times the long-term quit rates compared to people who received a placebo (Fiore et al. 2000).

Warnings

Precautions

  • Cardiovascular disease: Nicotine replacement therapies (NRTs), such as nicotine gum, have not been proven to increase the risk of having a heart attack, but should be used with caution in people who have had a heart attack within 2 weeks. The gum also might not be right for you if you have a history of coronary heart disease, serious arrhythmias, or vasospastic diseases.

  • Pregnant or nursing women: You should not use nicotine gum if you are pregnant. If you are nursing, you should consult your doctor. Pregnant women are encouraged to quit without medication. It is most important that you quit smoking, so your doctor may way the risks vs. the benefits and recommend another medication. Nicotine gum has not been evaluated in breastfeeding patients. Seeking intensive counseling support in your quit attempt is a good idea.

  • The gum might not be right for you if you have active peptic ulcers.

  • The gum might not be right for you if you have malignant hypertension.

  • The gum might not be right for you if you have hyperthyroidism or insulin-dependent diabetes.

Side Effects

  • Jaw ache

  • Hiccups

  • Mouth soreness

  • Dyspepsia (indigestion)

  • (All of the above tend to be mild and can be lessened by proper chewing techniques.)

  • Nausea, vomiting, headache, dizziness, cold sweat, pallor, and weakness are all symptoms of an overdose.

How Do I Take This Medication?

  • Chewing technique: Chew the gum slowly until you get a peppery or flavored taste and then park the gum between your cheek and gum. This aids in nicotine absorption through the lining of your mouth. You should chew and park slowly and intermittently for approximately 30 minutes or until the taste dissipates. For maximum benefit, chew the gum on a fixed schedule; for example, your doctor might tell you to chew at least 1 piece every 1 to 2 hours for at least 1 to 3 months.

  • You should completely quit smoking before you start using the gum.

  • Gradual reduction in use is recommended over the last 7 to 12 weeks.

  • Coffee, juices, and soft drinks are all acidic beverages and should be avoided 15 minutes before and during chewing. These products interfere with the absorption of nicotine.

(Fiore et al. 2008; PDR 2001; Slotkin 1998)

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