Brand name : Nicorette Gum , Nicorette inhaler ,Nicorette Nasal spray
Nicorette: Adult Dosing
Dosage forms: 2,4 gum
smoking cessation

<25 cigarette/day habit
Start: 2 mg PO q1-2h x6wk, then q2-4h x3wk, then q4-8h x3wk; Max: 30 pieces/day; Info: chew until tingle felt, then hold between buccal mucosa and gingiva until tingle gone; repeat process w/ same piece x30min; use >8 pieces/day during initial 3-6wk; avoid food, drink 15min prior and during use

>25 cigarette/day habit
Start: 4 mg PO q1-2h x6wk, then q2-4h x3wk, then q4-8h x3wk; Max: 20 pieces/day; Info: chew until tingle felt, then hold between buccal mucosa and gingiva until tingle gone; repeat process w/ same piece x30min; use >8 pieces/day during initial 3-6wk; avoid food, drink 15min prior and during use

Nicorette: Peds Dosing

This information is currently unavailable or not applicable for this drug.
Nicorette: Contraindications/Cautions

* hypersens. to drug/class/compon.
* TMJ disorder * caution if dental dz * arrhythmias, severe * MI, acute w/in 2wk * angina, worsening or severe * caution in pregnancy * caution if cigarette use continues * caution if asthma or reactive airway dz
* caution if cardiovascular dz * caution if peripheral vascular dz * caution if impaired liver fxn * caution if impaired renal fxn, severe * caution if hyperthyroidism
* caution if pheochromocytoma * caution if diabetes, insulin-dependent * caution if PUD, active
* caution if HTN Common Reactions

* jaw pain * tooth disorders * mouth/throat soreness * salivation * belching * headache * nausea * withdrawal symptoms * hiccups * rash * diarrhea * constipation * flatulence * HTN * palpitations * arthralgia * paresthesias

Nicotine is the primary compound found in tobacco products.

Nicotine in medical products is used as an aid to smoking cessation, to reduce nicotine withdrawal symptoms when you quit smoking.

Nicotine may also be used for purposes other than those listed in this medication guide.
What should I discuss with my healthcare provider before using nicotine?

Before taking this medication, tell your doctor if you have

* heart disease, an irregular heartbeat, high blood pressure or chest pain;
* temporomandibular joint (TMJ) disease; * hyperthyroidism; * diabetes; * pheochromocytoma (tumor of the adrenal gland);
* liver or kidney disease; * a stomach ulcer; * asthma or chronic pulmonary disease;
* chronic nasal problems (e.g. nasal allergies, rhinitis, nasal polyps or growths, and sinusitis) (may affect safe use of nicotine nasal spray);
* mouth or dental problems (may affect safe use of nicotine gum or lozenges); or
* a skin condition (may affect safe use of nicotine transdermal patches) .

You may not be able to use nicotine, or you may require a dosage adjustment or special monitoring if you have any of the conditions listed above.The Commit 2 mg and 4 mg oral lozenges each contain 3.4 mg of phenylalanine. Individuals with phenylketonuria may need to monitor their intake of this additive.Transdermal, nasal spray and inhaled nicotine are in the FDA pregnancy category D. This category means that nicotine is known to be harmful to an unborn baby. Increased heart rate, decreased breathing movements, and miscarriage have been reported when nicotine has been used during the third trimester. It is not known whether nicotine lozenges will be harmful to an unborn baby. Do not use nicotine without first talking to your doctor if you are pregnant or could become pregnant during treatment.Nicotine passes into breast milk and may affect a nursing infant. Do not use nicotine without first talking to your doctor if you are breast-feeding a baby.
How should I take nicotine?

Use nicotine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.Stop smoking as soon as you begin treatment with nicotine. Smoking while using this medication can be dangerous.All nicotine products come with patient information. You should refer to this information for directions for use.

To use the patches:

* Rotate the site of the patch at each application. Do not use the same site within 7 days.
* Apply the Habitrol patches to a non-hairy, clean, dry site on the upper outer arm or the upper body. Remove the patch after 24 hours and replace it with a new one.
* Apply the Nicotrol and Nicoderm CQ patches to dry, clean, and hairless skin. If you are using the Nicotrol patches, apply a new patch each morning and remove it at bedtime. Do not wear the patch while you are sleeping. If you are using the Nicoderm CQ patch, you may wear the patch for 16 or 24 hours. If you crave cigarettes when you wake up, you may wear the patch for 24 hours. Remove the Nicoderm CQ patch at bedtime if you experience vivid dreams or sleep disturbances.

To use the chewing gum or oral lozenges:

* Place a piece of gum or a lozenge in the mouth.
* Chew the gum slowly several times and stop chewing when you notice a tingling sensation or a peppery taste in the mouth (usually after about 15 chews). "Park" the gum between the cheek and gum and leave it there until the taste or tinging sensation is almost gone. Then slowly chew a few more times until the taste or sensation returns. Park the gum again in a different place in your mouth. Continue this chewing and parking process until the taste or tingle no longer returns when the gum is chewed, usually 30 minutes. Chewing too much or too quickly or will cause too much nicotine to be released and can cause nausea, hiccups, and stomach problems. * Allow the lozenge to dissolve slowly (usually 20-30 minutes), without chewing or swallowing. You may notice a warm or tingling sensation in the mouth. Occasionally, shift the lozenge from one side of the mouth to the other. * Do not eat or drink for 15 minutes before or while using the gum or lozenges.

To use the nasal spray:

* Remove cap: press in circles on sides of bottle. Pull off cap. To prime the pump before first us: Get a tissue or paper towel. Hold bottle and press up on bottom with thumb. Pump into tissue until you see a fine spray (6 to 8 pumps). Throw tissue away out of the reach of children or pets.
* Blow nose if it is not clear. Tilt head back slightly. Insert tip of bottle into nostril - as far as comfortable. Breathe through mouth. Spray once in each nostril. Do not sniff, swallow, or inhale while spraying. If nose runs, gently sniff to keep nasal spray in nose. Wait 2 or 3 minutes before blowing nose. Do not use more of the medication than is directed.
* Place cap back on bottle after each use. If you don't use the nasal spray for 24 hours, prime the pump in a tissue 1 or 2 times. Avoid excessive priming as this will reduce the amount of medicine available for use. * Avoid contact with skin, eyes, and mouth. If bottle breaks, wear rubber gloves, wipe up with a paper towel and wash surfaces thoroughly. Do not let nicotine comes into contact with skin, mouth or eyes. If it does, rinse with plain water immediately. Nicotine overdose can occur when nicotine is absorbed through the skin.

To use the inhaler:

* Remove the mouthpiece from the plastic wrap. Align the marks and pull off the top. Press a cartridge firmly into bottom of mouthpiece until seal breaks. Put top on mouthpiece. Align marks to close. Press down firmly to break top seal of cartridge. Twist top to mis-align marks and secure. Store cartridges in plastic cases when not in use.
* Inhale deeply into back of throat or puff in short breaths. As you inhale or puff through the mouthpiece, nicotine turns into a vapor and is absorbed into the mouth and throat.
* Nicotine in cartridges is used up after about 20 minutes of active puffing.

Do not use more of a nicotine product than is directed.

Dispose of each patch or piece of gum in its wrapper. Keep used and unused nicotine systems out of the reach of children and pets to prevent poisoning. Used bottles of nasal spray should be thrown away with their child-resistant caps in place.

Store nicotine products at room temperature away from moisture, heat, and direct sunlight.
What happens if I miss a dose?

If it is needed, use or apply the missed dose as soon as you remember.
What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a nicotine overdose include nausea; vomiting; watering mouth; diarrhea; abdominal pain; cold sweat; headache; dizziness; disturbed hearing and vision; confusion; weakness; weak, irregular heartbeats; chest pain; seizures; and death.
What should I avoid while taking nicotine?

Stop smoking as soon as you begin treatment with nicotine. Smoking while using this medication can be dangerous.

Keep used and unused nicotine systems out of the reach of children and pets to prevent poisoning.
What are the possible side effects of nicotine?

If you experience any of the following serious side effects, stop using nicotine and seek emergency medical attention or contact your doctor immediately:

* an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
* seizures; or
* chest pain or irregular heartbeats.

Other, less serious side effects may be more likely to occur. Continue to use nicotine and talk to your doctor if you experience

* dizziness; * belching or hiccups; * stomach upset or nausea; * mouth or throat soreness; * dry or watering mouth; * watering eyes; * headache;
* runny nose (rhinitis) and nasal congestion (nasal spray); * stomatitis (inflammation of the lining of the mouth) (inhaler); * constipation;
* sneezing and coughing; * changes in taste; or * redness, itching, or burning at the patch application site.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect nicotine?

Nicotine may alter the effects of other medicines. Before using nicotine to stop smoking, talk to your doctor if you are taking any of the following medicines:

* imipramine (Tofranil);
* oxazepam (Serax);
* propranolol (Inderal), labetalol (Normodyne, Trandate), or prazosin (Minipress);
* theophylline (Theo-Dur, Theochron, Theolair, others);
* pentazocine (Talwin), or
* insulin.

You may need a dosage adjustment or special monitoring if you are taking any of the medications listed above.

Drugs other than those listed here may also interact with nicotine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.
Where can I get more information?

Your pharmacist has additional information about nicotine written for health professionals that you may read.
What does my medication look like?

Nicotine is available with a prescription and over-the-counter under several brand names in skin patch, inhaler, nasal spray, gum, and lozenge formulations. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.

Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.

The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.