Nicorette, 10 mg/16 h, transdermal patch, translucent, 7 pcs.

Nicorette®

Treatment with the Nicorette® transdermal patch simulates the fluctuations in nicotine concentrations throughout the day in a smoker; Moreover, during sleep, nicotine does not enter the body. The use of a transdermal nicotine patch during the day does not cause the disturbances observed when nicotine enters the body during sleep.

Nicorette® transdermal patch can be used as monotherapy or in combination with Nicorette® chewing gum 2 mg, Nicorette® sublingual tablets 2 mg or Nicorette® topical spray 1 mg/dose. If symptoms of overdose appear (see section “Overdose”), use of the drug must be stopped immediately.

Children and teenagers

There is no experience with the use of the Nicorette® patch by adolescents under the age of 18, so the drug should be used by persons under 18 years of age strictly as prescribed by a doctor.

Adults

Nicorette® transdermal patch can be used for abrupt smoking cessation, as well as for increasing the time intervals between smoking in order to reduce smoking as much as possible until smoking cessation is complete.

The patient should do everything possible to permanently quit smoking while being treated with the Nicorette® patch.

Patients with a high degree of dependence (more than 20 cigarettes per day) are recommended to start with stage 1 of therapy, using 1 patch of 25 mg/16 hours, daily, for 8 weeks. Then begin a gradual reduction in the dose of the drug: 1 patch of 15 mg/16 hours, daily, for 2 weeks, and then 1 patch of 10 mg/16 hours, daily, for the next 2 weeks.

Patients with a low degree of dependence (10-20 cigarettes per day) are recommended to begin therapy with stage 2, using 1 patch of 15 mg/16 hours, daily, for 8 weeks. Then begin a gradual reduction in the dose of the drug to stage 3: 1 patch 10 mg/16 hours, daily, over the next 4 weeks.

In most cases, the use of a transdermal patch for more than 6 months is not recommended. However, some patients may require longer therapy to avoid relapse into smoking.

How to apply a transdermal patch

The patch is applied to an intact area of ​​skin immediately after waking up in the morning and removed before going to bed. The patch should be applied to dry, clean, intact, hair-free skin, such as the thighs, upper limbs or chest. It is necessary to change the application site every day: do not use the same area for two consecutive days. After applying the patch, wash your hands thoroughly to avoid eye irritation from possible nicotine contact.

1. Wash your hands thoroughly before applying the patch.

2. Use scissors to cut the patch package along the edge as indicated on the package. Select a clean, dry, hair-free area of ​​skin (such as the thigh, upper limb, or chest).

3. Remove one half of the silver aluminized protective film without touching the adhesive surface of the patch.

4. Fasten the part of the patch freed from the protective film to the skin and remove the remaining half of the silver aluminized protective film.

5. Press the patch firmly against the skin with your palm or fingertips.

6. Run your finger along the edge of the patch, making sure it is firmly attached.

7. If the patch comes off, apply a new one. Using skin care oil or talcum powder may prevent the patch from adhering properly.

In combination with chewing gum, tablets and sublingual, topical spray

For smokers with a severe nicotine addiction (more than 20 cigarettes per day) or experiencing an irresistible craving for smoking, or smokers who have not been able to quit smoking using only one type of nicotine replacement therapy, the Nicorette patch can be used to quickly relieve the craving for smoking ® in combination with Nicorette® chewing gum at a dosage of 2 mg/Nicorette® sublingual tablets at a dosage of 2 mg/Nicorette® topical spray at a dosage of 1 mg/dose.

The patch is applied to an intact area of ​​skin immediately after waking up in the morning and removed before going to bed. The patch should be applied to dry, clean, intact, hair-free skin, such as the thighs, upper limbs or chest. It is necessary to change the application site every day: do not use the same area for two consecutive days. After applying the patch, wash your hands thoroughly to avoid eye irritation from possible nicotine contact.

Initial therapy:

Treatment should begin with a 25 mg patch/16 hours (stage 1) in combination with 2 mg chewing gum/2 mg sublingual tablets/1 mg/dose topical spray. Usually 5-6 chewing gum/sublingual tablets per day or 13 doses of topical spray per day are sufficient. The maximum daily dose for chewing gum is 15 pieces, for sublingual tablets - 24 pieces, for topical spray - 32 doses.

Patients should completely stop smoking during therapy. Usually the general course of treatment lasts for 8 weeks. After this, the dose of nicotine should be gradually reduced.

Cancellation of combination therapy:

Combination therapy can be discontinued in two ways.

Method 1: Over the next 2 weeks, switch from the 25 mg/16 hour patch (Stage 1) to the 15 mg/16 hour patch (Stage 2), and then, over the next 2 weeks, to the 10 mg/16 hour patch ( Stage 3), while maintaining, if necessary, the number of chewing gums/sublingual tablets/topical spray doses used, as in Initial Therapy. Next, gradually reduce the number of chewing gums/sublingual tablets/topical spray doses until complete discontinuation for the time required by the patient depending on his needs, but no later than 12 months after the start of combination therapy.

Method 2: involves completely removing the patch immediately after completing the Initial Therapy

. Next, gradually reduce the number of chewing gums/sublingual tablets/topical spray doses until complete discontinuation for the time required by the patient depending on his needs, but no later than 12 months after the start of combination therapy.

Recommended dose:

Please note that only a new patch should be applied the next day!

Nicorette patch 1 stage 25 mg N7 (Johnson)

Treatment with the Nicorette® transdermal patch simulates the fluctuations in nicotine concentrations throughout the day in a smoker; Moreover, during sleep, nicotine does not enter the body. The use of a transdermal nicotine patch during the day does not cause the disturbances observed when nicotine enters the body during sleep. Nicorette® transdermal patch can be used as monotherapy or in combination with Nicorette® chewing gum 2 mg, Nicorette® sublingual tablets 2 mg or Nicorette® topical spray 1 mg/dose. If symptoms of overdose appear (see section “Overdose”), use of the drug must be stopped immediately. Children and adolescents There is no experience with the use of the Nicorette® patch by adolescents under the age of 18 years, therefore the drug should be used by persons under 18 years of age strictly as prescribed by a doctor. Adults Nicorette® transdermal patch can be used for abrupt smoking cessation, as well as for increasing the time intervals between smoking in order to reduce smoking as much as possible until smoking cessation is complete. The patient should do everything possible to permanently quit smoking while being treated with the Nicorette® patch. Patients with a high degree of dependence (more than 20 cigarettes per day) are recommended to start with stage 1 of therapy, using 1 patch of 25 mg/16 hours, daily, for 8 weeks. Then begin a gradual reduction in the dose of the drug: 1 patch of 15 mg/16 hours, daily, for 2 weeks, and then 1 patch of 10 mg/16 hours, daily, for the next 2 weeks. Patients with a low degree of dependence (10–20 cigarettes per day) are recommended to begin therapy with stage 2, using 1 patch of 15 mg/16 hours, daily, for 8 weeks. Then begin a gradual reduction in the dose of the drug to stage 3: 1 patch 10 mg/16 hours, daily, over the next 4 weeks. Highly dependent patients (more than 20 cigarettes per day) Low dependent patients (10–20 cigarettes per day) Dosage regimen Duration Dosage regimen Duration Step 1: Nicorette® patch 25 mg/16 hours First 8 weeks Step 2: Nicorette® 15 mg patch/16 hours Next 2 weeks Step 2: Nicorette® patch 15 mg/16 hours First 8 weeks Step 3: Nicorette® patch 10 mg/16 hours Next 2 weeks Step 3: Nicorette® patch 10 mg/16 hours Next 4 weeks In most cases, the use of a transdermal patch for more than 6 months is not recommended. However, some patients may require longer therapy to avoid relapse into smoking. How to apply a transdermal patch The patch is applied to an intact area of ​​skin immediately after waking up in the morning and removed before going to bed. The patch should be applied to dry, clean, intact, hair-free skin, such as the thighs, upper limbs or chest. It is necessary to change the application site every day: do not use the same area for two consecutive days. After applying the patch, wash your hands thoroughly to avoid eye irritation from possible nicotine contact. 1. Wash your hands thoroughly before applying the patch. 2. Use scissors to cut the patch package along the edge as indicated on the package. Select a clean, dry, hair-free area of ​​skin (such as the thigh, upper limb, or chest). 3. Remove one half of the silver aluminized protective film without touching the adhesive surface of the patch. 4. Fasten the part of the patch freed from the protective film to the skin and remove the remaining half of the silver aluminized protective film. 5. Press the patch firmly against the skin with your palm or fingertips. 6. Run your finger along the edge of the patch, making sure it is firmly attached. 7. If the patch comes off, apply a new one. Using skin care oil or talcum powder may prevent the patch from adhering properly. In combination with chewing gum, sublingual tablets, topical spray For smokers with a severe nicotine addiction (more than 20 cigarettes per day) or experiencing an irresistible craving for smoking, or smokers who have not been able to quit smoking using only one type of nicotine - replacement therapy, to quickly relieve cravings for smoking, it is possible to use the Nicorette® patch in combination with Nicorette® chewing gum at a dosage of 2 mg/Nicorette® sublingual tablets at a dosage of 2 mg/spray for topical use of Nicorette® at a dosage of 1 mg/dose. The patch is applied to an intact area of ​​skin immediately after waking up in the morning and removed before going to bed. The patch should be applied to dry, clean, intact, hair-free skin, such as the thighs, upper limbs or chest. It is necessary to change the application site every day: do not use the same area for two consecutive days. After applying the patch, wash your hands thoroughly to avoid eye irritation from possible nicotine contact. Initial therapy: Treatment should begin with a 25 mg/16 hour patch (stage 1) in combination with 2 mg chewable gum/2 mg sublingual tablets/1 mg/dose topical spray. Typically, 5-6 chewable gum/sublingual tablets per day or 13 doses of topical spray per day are sufficient. The maximum daily dose for chewing gum is 15 pieces, for sublingual tablets - 24 pieces, for topical spray - 32 doses. Patients should completely stop smoking during therapy. Usually the general course of treatment lasts for 8 weeks. After this, the dose of nicotine should be gradually reduced. Withdrawal of combination therapy: There are two ways to discontinue combination therapy. Method 1: Over the next 2 weeks, switch from the 25 mg/16 hour patch (Stage 1) to the 15 mg/16 hour patch (Stage 2), and then, over the next 2 weeks, to the 10 mg/16 hour patch ( Stage 3), while maintaining, if necessary, the number of chewing gums/sublingual tablets/topical spray doses used, as in Initial Therapy. Next, gradually reduce the number of chewing gums/sublingual tablets/topical spray doses until complete discontinuation for the time required by the patient depending on his needs, but no later than 12 months after the start of combination therapy. Method 2: involves completely removing the patch immediately after completing the Initial Therapy phase. Next, gradually reduce the number of chewing gums/sublingual tablets/topical spray doses until complete discontinuation for the time required by the patient depending on his needs, but no later than 12 months after the start of combination therapy. Recommended dose: Initial therapy Time period Transdermal patch Chewable gum 2 mg/Sublingual tablets 2 mg/Topical spray 1 mg/dose First 8 weeks 1 patch 25 mg/16 hours (1 stage) daily As needed. Recommended: 5-6 chewable gums/sublingual tablets/13 doses of topical spray per day Withdrawal - Method 1 Next 2 weeks 1 15 mg patch/16 hours (step 2) daily Continue use of chewable gums/sublingual tablets/topical spray as per as needed Next 2 weeks 1 10 mg patch/16 hours (step 3) daily Continue gummies/sublingual tablets/topical spray as needed Up to 12 months after starting combination therapy ————— Gradually discontinue chewing gums/sublingual tablets / topical spray Withdrawal - method 2 Up to 12 months after starting combination therapy ————— Gradual withdrawal of chewing gum/sublingual tablets/topical spray Please note that only a new patch should be applied the next day!

Nicorette transdermal patch 25 mg/16 h 7 pcs. translucent in St. Petersburg

Nicotine is slowly released from the Nicorette® patch and is continuously absorbed through the skin. The Nicorette® patch is intended for use during waking hours, i.e. for approximately 16 hours, which coincides with the period of nicotine intake during smoking. This allows you to avoid sleep disturbances caused by nicotine intake during sleep. Absolute bioavailability exceeds 90%, regardless of where the patch is applied.

In the therapeutic range (10–25 mg/16 hours), the relationship between the concentration of nicotine in the blood plasma and its dose is linear. Below are the maximum nicotine concentrations (Cmax) when using different doses.

Nicotine dose (mg/16 hours) Cmax (ng/ml)

10 10

15 15,5

25 26,5

The maximum concentrations of nicotine in blood plasma calculated by the model correspond to those measured: 11 ng/ml – when using a 10 mg transdermal patch and 25 ng/ml – for 25 mg. The maximum plasma concentration obtained by interpolation when using a 15 mg transdermal patch was 16 ng/ml.

The time to reach maximum plasma concentration (tmax) is approximately 9 hours and occurs in the afternoon or evening, when the risk of relapse is greatest.

The volume of distribution after intravenous administration of nicotine is approximately 2–3 L/kg, and its half-life is approximately 2–3 hours. Nicotine is primarily excreted by the liver, with an average plasma clearance of about 70 l/hour. Nicotine is also metabolized in the kidneys and lungs.

More than 20 nicotine metabolites have been identified, the activity of which is inferior to that of the parent substance.

The binding of nicotine to plasma proteins is less than 5%. In this regard, disturbances in nicotine binding during the simultaneous use of other drugs or changes in plasma protein levels in various diseases should not have a significant effect on the kinetics of nicotine.

The main metabolite of nicotine, cotinine, has a half-life of 15–20 hours and is found in the blood plasma at a concentration 10 times higher than that of nicotine.

The main nicotine metabolites excreted in the urine are cotinine (12% of the administered dose) and trans-3-hydroxy-cotinine (37% of the administered dose). Approximately 10% of nicotine is excreted unchanged in urine. At high filtration rates and urine pH below 5, the amount of nicotine excreted unchanged in urine can reach 30%.

Progression of renal failure may be accompanied by a decrease in overall nicotine clearance. In smokers with concomitant chronic renal failure treated with hemodialysis, an increase in plasma nicotine concentrations was observed.

The pharmacokinetics of nicotine in mild liver failure (5 points on the Child-Pugh scale) does not change; in moderate liver failure (7 points on the Child-Pugh scale), nicotine clearance decreases.

A slight decrease in the total clearance of nicotine was observed in healthy elderly patients, which, however, does not require dose adjustment.

The concentration of nicotine in the blood plasma increases with the use of three types of transdermal patches in proportion to the dose.

There were no differences in the pharmacokinetics of nicotine between men and women.

Nicorette spray for local use 1 mg/dose 150 doses (Johnson)

For application to the oral mucosa. The patient should do everything possible to permanently quit smoking while being treated with Nicorette® spray. Adults over 18 years of age Nicorette® Spray should be used at the moment when an irresistible urge to smoke occurs. After preparing the spray for use (see below for Instructions for Use when using the spray for the first time), place the tip of the spray as close to your open mouth as possible. Press the dispenser from above, thus releasing one dose of the drug into the oral cavity; Avoid getting the spray on your lips. To prevent the substance from entering the respiratory tract, do not inhale when pressing the dispenser. For best results, do not swallow saliva for several seconds after injection. While using the spray, eating and drinking is not recommended. If symptoms of overdose appear (see section “Overdose”), use of the drug must be stopped immediately. Complete smoking cessation Nicorette® Spray should be used in all cases of craving for smoking or to prevent cravings in situations that may provoke it. Smokers who want or are able to quit smoking immediately should immediately replace smoking cigarettes with Nicorette® spray and, as soon as possible, reduce the number of injections until they stop completely. If you completely quit smoking, take 1 or 2 injections during the period of time when you usually smoked a cigarette, as well as if you have a craving for smoking. If after a single injection the craving for smoking does not decrease within a few minutes, a second injection should be made. If two doses are required, subsequent application of the spray may consist of 2 consecutive injections. Every hour you are allowed to take no more than 4 dosed injections of the spray. Do not inject more than 2 doses of spray at a time or use more than 64 doses per day (or 4 doses per hour for 16 hours). Each bottle contains at least 150 doses. The average course of use of the spray at the indicated dose is 6 weeks. Then you should begin to reduce the number of injections so that by the end of the 9th week the number of doses is half the average number of doses per day received in the first 6 weeks, and during the 12th week - no more than 4 doses per day. When the daily dose drops to 2-4 injections, use of the spray should be discontinued. After completion of therapy, to prevent a return to smoking, patients can use Nicorette® spray if they have an irresistible urge to smoke. In such situations, you can make 1 injection, and if after a single injection the craving for smoking does not decrease within a few minutes, you should make a second injection. In this case, you should not exceed 4 dosed injections per day. Regular use of the spray for more than 6 months is usually not recommended, but some patients may require longer therapy to avoid relapse into smoking. Reducing the number of cigarettes smoked Smokers who want to reduce the number of cigarettes they smoke should use the spray as needed between smoking episodes to increase the amount of time between smoking and to reduce smoking as much as possible. Once readiness is felt, smokers should aim to quit completely. After quitting smoking, you should follow the recommendations for therapy and gradual dose reduction indicated above for complete smoking cessation. Behavioral therapy and psychological support usually increase treatment success. Those who have managed to quit smoking but find it difficult to give up the spray are advised to consult a doctor for medical help. Temporary smoking cessation The spray can be used during periods when it is necessary to abstain from smoking, for example, when in places where smoking is prohibited, or in other situations when it is necessary to abstain from smoking. The maximum daily dose for temporary smoking cessation is 64 doses. In combination with a transdermal patch For smokers with a severe nicotine addiction (more than 20 cigarettes per day) or experiencing an irresistible craving for smoking, or smokers who have not been able to quit smoking using only one type of nicotine replacement therapy, it is possible to use a spray for the mucous membrane Nicorette® oral membranes in combination with Nicorette® transdermal patch for rapid relief of smoking cravings. The patch is applied to an intact area of ​​skin immediately after waking up in the morning and removed before going to bed. The patch should be applied to dry, clean, intact, hair-free skin, such as the thighs, upper limbs or chest. It is necessary to change the application site every day: do not use the same area for two consecutive days. After applying the patch, wash your hands thoroughly to avoid eye irritation from possible nicotine contact. Initial therapy: Treatment should begin with a 25 mg/16 hour patch (stage 1) in combination with a 1 mg/dose spray. Usually 13 doses of spray per day are sufficient. The maximum daily dose of the spray is 32 doses. Patients should completely stop smoking during therapy. Usually the general course of treatment lasts for 8 weeks. After this, the dose of nicotine should be gradually reduced. Withdrawal of combination therapy: There are two ways to discontinue combination therapy. Method 1: Over the next 2 weeks, switch from the 25 mg/16 hour patch (Stage 1) to the 15 mg/16 hour patch (Stage 2), and then, over the next 2 weeks, to the 10 mg/16 hour patch ( stage 3), while maintaining, if necessary, the number of doses of Nicorette® spray used, as with Initial therapy. Next, the number of doses of the spray is gradually reduced until complete withdrawal for the time that the patient needs depending on his needs, but no later than 12 months after the start of combination therapy. Method 2: involves completely removing the patch immediately after completing the Initial Therapy phase. Next, gradually reduce the number of doses of Nicorette® spray until complete withdrawal during the time that the patient needs depending on his needs, but no later than 12 months after the start of combination therapy. Children and adolescents under 18 years of age The drug is not recommended for use by persons under 18 years of age. There is no experience in treating adolescents under 18 years of age with the spray.

Nicorette chewing gum 2 mg No. 15x2

Name

Nicorette.

Release forms

Chewing gum.

INN

Nicotine.

FTG

A treatment for nicotine addiction.

Compound

Active ingredient: nicotine-polymer complex 20% - 10 mg (corresponds to 2 mg of nicotine) Excipients: chewing gum base*, sorbitol (E420), liquid sorbitol (crystallizing), anhydrous sodium carbonate, sodium bicarbonate, flavor additive for smokers 84.6422, flavor additive Haverstroo ZD 49284, glycerin 85%. * Chewing gum base is a mixture of different types of wax, resin and other hydrocarbons (about 60%) and calcium carbonate (up to 40%).

Description

Square beige pads with a characteristic odor and size approximately 14 × 14 × 5 mm.

Pharmacotherapeutic group

Medicines used for nicotine addiction. ATX code: N07BA01.

Pharmacological properties

Pharmacodynamics After abrupt cessation of smoking in patients who have annually used tobacco-containing products for a long time, withdrawal syndrome may develop, which includes: dysphoria, insomnia, increased irritability, anxiety, impaired concentration, decreased heart rate, increased appetite or in weight. An important symptom of withdrawal syndrome is the desire to smoke. In the treatment of tobacco addiction, nicotine replacement therapy reduces the need for the number of cigarettes smoked, reduces the severity of withdrawal symptoms that occur with complete cessation of smoking in those who decide to quit smoking, facilitates temporary abstinence from smoking, and also helps reduce the number of cigarettes smoked in those who cannot or does not want to completely quit smoking. Pharmacokinetics Nicotine coming from chewing gum is quickly absorbed through the mucous membrane of the cheek and is detected in the blood after 5-7 minutes. The maximum concentration of nicotine is reached 30 minutes after the start of chewing. The volume of distribution of nicotine when administered intravenously is 2-3 l/kg, and the half-life is approximately 2 hours. Nicotine is primarily eliminated by the liver, with an average plasma clearance of about 70 L/hour. Nicotine is also metabolized in the kidneys and lungs. More than 20 nicotine metabolites have been identified that are inferior to it in activity. The binding of nicotine to plasma proteins is less than 5%. In this regard, disturbances in nicotine binding during concomitant use of other drugs or changes in plasma protein levels in various diseases should not have a significant effect on nicotine kinetics. The main metabolite of nicotine in plasma, cotinine, has a half-life of 15-20 hours, and its concentration is 10 times higher than that of nicotine. Mainly cotinine (15% of the dose) and trans-3-hydroxy-cotinine (45% of the dose) are excreted in the urine. From 10% to 30% of the nicotine dose is excreted unchanged in the urine. The progressive deterioration of renal function is accompanied by a decrease in the overall clearance of nicotine. Its pharmacokinetics does not change in patients with liver cirrhosis with mild liver dysfunction (Child-Pugh index 5) and decreases in patients with liver cirrhosis with moderate liver dysfunction (Child-Pugh index 7). In smokers treated with hemodialysis, an increase in plasma nicotine concentrations was noted. In elderly patients, there is a slight decrease in the total clearance of nicotine, which does not require dose adjustment.

Indications for use

Treatment of tobacco addiction by reducing the need for nicotine in the following cases: - reducing withdrawal symptoms that occur with complete cessation of smoking in patients who decide to quit smoking; - with temporary cessation of smoking; - reducing the number of cigarettes smoked by those who cannot or do not want to completely quit smoking.

Contraindications

Hypersensitivity to nicotine or other components of chewing gum. Age up to 12 years. Use in non-smokers.

Pregnancy and lactation

Nicotine crosses the placenta and is excreted in breast milk, and therefore its use may pose a danger to the fetus or child. Patients should be informed of the need to attempt to quit smoking without nicotine replacement therapy. If such attempts are unsuccessful, the decision to carry out therapy is made after comparing the possible positive effect and potential harm. Nicotine passes into breast milk in small quantities even when taken in therapeutic doses, which can negatively affect the baby’s health when the drug is taken by a nursing mother. In order to reduce the negative effects of nicotine on a child, Nicorette® chewing gum should be used immediately after feeding. The use of Nicorette® chewing gum during pregnancy and breastfeeding is possible only after consultation with a doctor, after assessing the ratio of the expected benefit and risk to the fetus or child.

Directions for use and doses

Adults and elderly people The dosage is selected individually depending on the intensity of smoking. As a rule: - Nicorette® chewing gum at a dosage of 2 mg should be used when smoking less than 20 cigarettes a day or when smoking the first cigarette 30 minutes after waking up; How to use Nicorette® chewing gum Nicorette® chewing gum should be used in all cases when an irresistible urge to smoke occurs, in accordance with the following scheme: Chew the gum slowly, for approximately 30 minutes, until a strong taste or mild feeling appears. burning sensation, stop chewing and leave the gum between the inside of the cheek and the gum; after the taste and/or burning sensation disappears, slow chewing should be resumed. Complete smoking cessation You should chew only one pad at a time when you stop smoking. When completely quitting smoking, the dose of chewing gum per day is determined by the degree of dependence on nicotine, but is usually 8-12 pieces per day and should not exceed 15 pieces per day. Chewing gum should be used at the indicated dose for at least 3 months, after which the number of gums used daily should be gradually reduced until completely discontinued. The gum is discontinued when the daily dose is 1 - 2 pieces per day. Regular use of chewing gum for more than 12 months is usually not recommended, but some people require longer therapy to avoid relapse into smoking. Reducing the number of cigarettes smoked Chewing gum should be used between smoking episodes to lengthen the intervals between smoking cigarettes in order to minimize cigarette consumption. If within 6 weeks it is not possible to reduce your daily cigarette consumption, you should seek help from a specialist. An attempt to quit smoking should be made as soon as you feel ready, but no later than 6 months after starting therapy. If you have not been able to make a serious attempt to quit smoking within 9 months of starting therapy, you should consult a specialist. Regular use of chewing gum for more than 12 months is usually not recommended, however, some people require longer therapy to avoid relapse or return to their previous level of tobacco use. The simultaneous provision of medical counseling and psychological support usually increases the effectiveness of therapy. Temporary Smoking Quit Chewing gum can be used during periods when you need to abstain from smoking, such as when you are in a smoke-free area or in other situations when you need to abstain from smoking. Under the age of 18, chewing gum can only be used on the recommendation of a doctor! Do not exceed the indicated dose! It is recommended to carry Nicorette® chewing gum with you so that you can use it when the urge to smoke arises.

Side effect

With a sharp cessation of smoking, emotional and cognitive effects may occur (dysphoria and depression, insomnia, irritability, frustration or anger, anxiety, difficulty concentrating, agitation or impatience, sleep disturbance, attacks of euphoria or depressed mood, irritability, decreased concentration) and physical effects (dizziness, headache, fainting symptoms, decreased heart rate, increased appetite and weight gain, cough, constipation, bleeding gums or canker sores, nasopharyngitis). At the beginning of treatment, the nicotine contained in chewing gum can sometimes cause mild irritation of the mucous membrane of the mouth and pharynx and increased salivation. If excessive amounts of dissolved nicotine are ingested at the beginning of treatment, hiccups may occur. Excessive use of Nicorette® Chewable Gum by individuals who do not smoke smoke may result in nausea, weakness, or headaches (similar to symptoms experienced by smoke smokers). Most adverse effects are dose-related and occur within the first 3-4 weeks. Some side effects are usually associated with the wrong way of using chewing gum. This problem usually resolves by chewing gum more slowly or using gum containing 2 mg nicotine (at shorter intervals if necessary). Frequency of occurrence of undesirable side reactions: very often (≥ 1/10), often (≥ 1/100 - frequency unknown - pain in the masticatory muscles. Gastrointestinal tract disorders: - very often - nausea - often - vomiting, abdominal pain , flatulence, dyspepsia, dry mouth, stomatitis, increased salivation, diarrhea - uncommon - belching, glossitis, aphthous ulcers or dryness of the oral mucosa, paresthesia of the oral mucosa, blistering of the oral mucosa and detachment of the mucous membrane - rare - dysphagia , oral hypoesthesia, retching - frequency unknown - dryness of the laryngeal mucosa, discomfort in the gastrointestinal tract, pain on the lips General disorders and disorders at the injection site: - often - burning, feeling of fatigue - infrequently - asthenia, discomfort and chest pain, malaise If any of the listed symptoms or other reactions not listed in these instructions appear, you should consult a doctor.

Overdose

Excessive intake of nicotine from replacement therapy and/or smoking may cause overdose symptoms. Symptoms of overdose are similar to those of acute nicotine poisoning and include nausea, vomiting, increased salivation, abdominal pain, diarrhea, sweating, headache, dizziness, hearing loss and severe weakness. When using high doses of nicotine, the following may occur: arterial hypotension, weak and irregular pulse, difficulty breathing, prostration, vascular insufficiency, circulatory collapse and generalized convulsions. Nicotine in doses tolerated by adult smokers can cause severe symptoms of intoxication, including death, in young children. Suspected nicotine poisoning in a child should be considered an emergency and treatment should be provided immediately. Treatment of overdose: nicotine use should be stopped immediately and symptomatic treatment should be prescribed. Activated carbon reduces the absorption of nicotine in the gastrointestinal tract. If necessary, artificial respiration and oxygen are prescribed.

Interaction with other drugs

Smoking (but not nicotine) causes an increase in the activity of the CYP1A2 enzyme. After smoking cessation, a decrease in the clearance of substrates of this enzyme may be observed. This may result in increased plasma levels of some drugs that are metabolized by this enzyme, which has potential clinical implications when using drugs with a low therapeutic breadth such as theophylline, tacrine, clozapine and ropinirole. Plasma levels of other drugs metabolized by CYP1A2, such as imipramine, olanzapine, clomipramine and fluvoxamine, may also increase after smoking cessation. However, there is no data to support this fact and the clinical effects of these drugs are unknown. Limited data suggest that smoking may induce the metabolism of flecainide and pentazocine. Clinically significant interactions with other drugs have not been established. However, there is an assumption that nicotine may increase the hemodynamic effect of adenosine, which can manifest itself in increased blood pressure, tachycardia and chest pain.

Precautionary measures

The benefits of quitting smoking outweigh any risks associated with the proper use of nicotine-containing medications. Nicorette® chewing gum should be used only after consulting a doctor. The risks and benefits should be assessed for patients suffering from the following diseases: - Cardiovascular disease: patients with a recent myocardial infarction or stroke, unstable or progressive angina, including Prinzmetal angina, severe arrhythmia, uncontrolled hypertension, cerebrovascular disorders, severe disorders heart rate, recent acute cerebrovascular accident, or after bypass surgery or angioplasty, patients with uncontrolled arterial hypertension should first of all be advised to quit smoking. If this fails, treatment with Nicorette® should be carried out under strict medical supervision. — Diabetes mellitus: Nicotine entering the human body during replacement therapy or smoking causes the release of catecholamines from the adrenal medulla. In this regard, Nicorette® chewing gum should be used with caution in patients with diabetes mellitus. - Renal and hepatic insufficiency: should be prescribed with caution to patients with moderate or severe liver dysfunction, severe renal failure. In these patients, the clearance of nicotine and its metabolites may be reduced, which in turn may lead to an increased risk of side effects. — Pheochromocytoma and uncontrolled hyperthyroidism: nicotine entering the human body through replacement therapy or smoking causes the release of catecholamines from the adrenal medulla. In this regard, Nicorette® chewing gum should be used with caution in patients with pheochromocytoma and uncontrolled hyperthyroidism. — Diseases of the gastrointestinal tract: it is necessary to prescribe with caution to patients suffering from esophagitis, gastric and duodenal ulcers, as when using Nicorette® chewing gum, an exacerbation of these diseases is possible. — The use of Nicorette® chewing gum in patients wearing dentures can be complicated by the fact that the chewing gum can stick to the denture and, in rare cases, even damage it. — Danger for children: doses of nicotine tolerated by adult patients can cause acute poisoning in children, including death. Therefore, nicotine-containing medications should be stored out of the reach of children. — Smoking cessation: polycyclic aromatic hydrocarbons found in tobacco smoke increase the activity of the CYP 1A2 enzyme (possibly also CYP 1A1), which can lead to an increase in the plasma concentration of a number of drugs that are metabolized by these enzymes (see section “Interactions”) with other drugs"). The use of Nicorette® chewing gum is associated with less risk than smoking.

Impact on the ability to drive vehicles and potentially dangerous mechanisms

No negative effect on the ability to drive a car or operate machinery has been established.

Package

15 chewing gums in a blister made of PVC/PVDC/aluminium. 1 or 2 blisters along with instructions for use in a cardboard box.

Storage conditions

Store at a temperature not exceeding 25°C. Keep out of the reach of children.

Best before date

2.5 years. Note The expiration date marking (the period from the date of manufacture to the date specified in the “Best before” paragraph) may be less than 2.5 years by 1 month. Do not use the drug after the expiration date indicated on the package.

Conditions for dispensing from pharmacies

Dispensed from pharmacies without a prescription.

Buy Nicorette chewing gum. 2 mg in blister pack No. 15x2 in the pharmacy

Price for Nicorette chewing gum. 2 mg in blister pack No. 15x2

Instructions for use for Nicorette chewing gum. 2 mg in blister pack No. 15x2

Nicorette Tablets, 30 pcs., 2 mg, for resorption

Directions for use and doses

Depending on the severity of smoking addiction, Nicorette chewing gums with different concentrations of the active substance are used. If the patient smokes 20 or less cigarettes per day or smokes the first cigarette 30 minutes after waking up, then chewing gum with a nicotine content of 2 mg should be used. If the patient smokes more than 20 cigarettes per day or has failed to quit smoking while using chewing gum with a nicotine content of 2 mg, then it is recommended to use chewing gum with a nicotine content of 4 mg. Nicorette should be used in all cases when an irresistible urge to smoke arises. The gum should be chewed slowly until a strong taste appears, then the chewing should be stopped and the gum should be placed between the gum and the inside of the cheek. After the taste disappears, chewing should be resumed. You should use only 1 chewing gum at a time. If you completely quit smoking, the average daily dose is 8-12 gum, the maximum is 15 gum. It is necessary to continuously use the drug in the first 3 months after quitting smoking. Then you should gradually reduce the amount of gum consumed. When the daily consumption of the drug decreases to 1-2 gum, its use should be discontinued. When reducing the number of cigarettes smoked, chewing gum should be used between smoking episodes to lengthen the intervals between smoking cigarettes in order to reduce cigarette consumption as much as possible. The patient should be warned that if after 6 weeks of using the drug it has not been possible to reduce daily cigarette consumption, he should consult a specialist. The patient should try to quit smoking when he is ready, but no later than 6 months after starting treatment. If you have not been able to quit smoking within 9 months after starting therapy, you should consult a specialist. It is not recommended to use Nicorette chewing gum for more than 12 months. However, some patients may require longer treatment to prevent a return to smoking or previous levels of tobacco use. Chewing gum can be used during periods when you need to temporarily quit smoking, such as when you are in a smoke-free area or in other situations when you need to abstain from smoking. Specialist consultations and psychological support help improve the effectiveness of therapy. Use in combination with TTC (patch) Nicorette: If it is not possible to quit smoking using chewing gum alone, or if it is necessary to reduce the daily consumption of chewing gum due to local adverse reactions, you can use Nicorette in the form of a patch (TTC) together with gum chewable 2 mg. Initial therapy. Treatment should begin with one 15 mg/16 hour patch, which is placed on an intact area of ​​skin every day upon waking in the morning and removed before bed, in combination with 2 mg chewing gum. Use at least 4 chewing gums of 2 mg per day; Usually 5-6 chewing gums are enough. You should not use more than 15 chewing gums per day. The full dose should be used for 6-12 weeks, after which the drug should be gradually weaned off. Weaning from a combination of drugs is carried out in two ways. The first method: by using a patch of lower dosage, i.e. application of the 10 mg/16 hour patch for 3-6 weeks and subsequent use of the 5 mg/16 hour patch for 3-6 weeks with the same number of 2 mg chewing gums as in initial therapy, and then gradually reducing the number of chewing gums 2 mg for 12 months. The second method is to stop using the patch and gradually reduce the amount of 2 mg chewing gum over 12 months.