Using Nicotine Gum:

Description:

Nicotine gum is currently available as an over-the-counter medication in 2 mg and 4 mg dosages.

How Do I Take This Medication:

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

-Two Doses are available: 2 mg and 4 mg.

-Recommend 2 mg for those smoking less than 25 cigarettes per day (max 30 pieces per day).

-Recommend 4 mg for those smoking more than 25 cigarettes per day (max 20 pieces per day).

-The gum should be used for up to 12 weeks. Gradual reduction in use is recommended over the last 7-12 weeks.

Chewing Technique:

-It should be chewed slowly until a peppery or minty taste emerges, then “parked” between the cheek and gums. It should be chewed and parked intermittently for 30 minutes.

-Avoid soda, juices, and coffee 15 minutes before or after, as acid inhibits absorption of nicotine.

-Patients are encouraged to use at least 10-12 pieces per day—one every 1-2 hours for at least 1-3 months. This is the dose necessary to relieve withdrawal symptoms (anxiety, irritability, difficulty concentrating, craving, etc).

Precautions/Contraindications:

-Pregnancy - Pregnant smokers should first be encouraged to quit without pharmacologic treatment. Nicotine gum should be used during pregnancy only if the likelihood of smoking abstinence, with its potential benefits, outweighs the risk of nicotine replacement and potential concomitant smoking. Similar factor should be considered in lactating women.

-Cardiovascular Disease – Nicotine replacement therapy is not an independent risk factor for acute myocardial events. Nicotine replacement therapy should be used with caution among particular cardiovascular patient groups: those in the immediate (within 2 weeks) post heart attack period, those with serious heart arrhythmias, and those with serious or worsening angina.

-The gum may not be right for you if you have active peptic ulcer disease, malignant hypertension, hyperthyroidism or insulin dependent diabetes (ask your doctor).

Side Effects:

-Jaw Ache                            -Hiccups

            -Mouth Soreness                  -Dyspepsia (indigestion)

All of the above symptoms can be lessened by proper chewing techniques.

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

Approximate Costs:

For 2-mg pieces:

                        $8.62 for 15

                        $13.79 for 24

            For 4-mg pieces:

                        $6.47 for 10

                        $12.93 for 20