Nicorette gum chewable freshfruit 2mg N30
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Active ingredients
Nicotine
Release form
Chewing gum
Composition
Active ingredient: Nicotine (nicotine) Active ingredient concentration (mg): 2
Pharmacological effect
A drug for the treatment of nicotine addiction. After abrupt smoking cessation, patients who use tobacco-containing products for a long time every day may develop withdrawal syndrome, which includes: dysphoria, insomnia, irritability, anxiety, impaired concentration, decreased heart rate, increased appetite or weight gain. An important symptom of withdrawal is the desire to smoke. When treating tobacco addiction, nicotine replacement therapy can reduce the need for the number of cigarettes smoked, reduce the severity of symptoms of withdrawal symptoms that arise when people quit smoking completely. It facilitates temporary abstinence from smoking, and also helps to reduce the number of cigarettes smoked by those who cannot or do not want to completely quit smoking.
Pharmacokinetics
Nicotine absorption from chewing gum is quickly absorbed through the buccal mucosa and is found in the blood after 5-7 min. Cmax of nicotine in the blood plasma is reached 30 min after the start of chewing gum use. l / kg The binding of nicotine to plasma proteins is less than 5%. In this regard, violations of nicotine binding with simultaneous use of other drugs or changes in the amount of protein in plasma in various diseases should not have a significant impact on the kinetics of nicotine. Metabolism Nicotine is metabolized in the liver, kidneys and lungs. Identified more than 20 metabolites that are inferior in activity to nicotine. The concentration of the primary metabolite - cotinine - exceeds the concentration of nicotine by 10 times. Excretion is excreted mainly by the liver. The average plasma clearance is about 70 l / h. T1 / 2 - about 2 hours. With urine mainly cotinine is excreted (15% of the dose, T1 / 2 - 15-20 hours) and trans-3-hydroxy-cotinine (45% of the dose). 10-30% of the dose of nicotine is excreted in the urine unchanged. Pharmacokinetics in special clinical situations. Progressive deterioration of renal function.accompanied by a decrease in the overall clearance of nicotine. The pharmacokinetics of nicotine does not change significantly in patients with cirrhosis of the liver with slightly pronounced impaired liver function (5 points on the Child-Pugh scale) and decreases in patients with cirrhosis of the liver with moderately pronounced impaired liver function (7 points on the Child - I drink). In patients on hemodialysis, an increase in plasma nicotine concentration was noted. In elderly patients, there was a slight decrease in the total clearance of nicotine, which does not require dose adjustment.
Indications
To alleviate withdrawal symptoms (withdrawal syndrome) associated with cessation of tobacco smoking.
Contraindications
Unstable angina, severe arrhythmias, recent cerebral circulation disorder, erosive and ulcerative gastrointestinal disorders in the acute phase, pregnancy, lactation.
Precautionary measures
Do not exceed the recommended dose. With caution, the drug should be prescribed to patients with moderate or severe liver dysfunction, severe renal failure, exacerbation of gastric ulcer and duodenal ulcer. Caution should be used in patients with uncontrolled hyperthyroidism, pheochromocytoma (due to the fact that nicotine causes the release of catecholamines from the adrenal medulla), as well as diabetes.
Use during pregnancy and lactation
Nicotine penetrates the placental barrier and can have a negative effect on the fetus. Smoking can harm the fetus, so patients should try to be convinced about the need to quit smoking without using replacement therapy with nicotine-containing drugs. When such attempts fail, the decision to conduct therapy is made after comparing the possible positive effect and potential harm. Nicotine is released in small amounts with breast milk even when taken in therapeutic doses and may have an adverse effect on the infant when the drug is taken by a nursing mother. In order to reduce the negative effects of nicotine on a child, Nicorette should be used immediately after feeding.
Dosage and administration
Dose set individually, depending on the degree of dependence on tobacco and used dosage forms.
Side effects
On the part of the central nervous system: dizziness, headache, anxiety. On the part of the digestive system: nausea, abdominal pain, irritation of the oral mucosa, hiccups, flatulence, soreness or irritation of the tongue; when using chewing gum - pain in the chewing muscles, stomatitis, damage to the tooth enamel when chewing gum sticks to it. From the cardiovascular system: arrhythmias; rarely - tachycardia, skin hyperemia. Dermatological reactions: when using transdermal therapeutic systems - itching, erythema, dermatitis, blisters on the skin, urticaria. Others: allergic reactions, pharyngitis.
Overdose
Excessive intake of nicotine during replacement therapy and / or smoking can cause overdose symptoms. Symptoms are similar to those in acute nicotine poisoning: nausea, increased salivation, abdominal pain, diarrhea, hyperhidrosis, headache, dizziness, hearing loss, and severe general weakness; when taking high doses of nicotine - hypotension, weak and irregular pulse, difficulty breathing, vascular collapse and generalized seizures, i.e. symptoms of acute nicotine poisoning. Doses of nicotine, which are well tolerated during treatment by adult smokers, can cause symptoms of severe poisoning in young children and even be fatal. Treatment: Stop taking nicotine immediately and start symptomatic treatment. Activated carbon reduces the absorption of nicotine from the gastrointestinal tract. If necessary, mechanical ventilation and oxygen.
Interaction with other drugs
Smoking (but not the use of nicotine) causes an increase in CYP1A2 activity. After cessation of smoking, a decrease in the substrate clearance of this enzyme is possible, which may lead to an increase in the concentration of certain drugs in the blood plasma, which has potential clinical significance with the simultaneous use of drugs characterized by a narrow therapeutic range (theophylline, takrin, clozapine, ropinirole). Limited data show that smoking may induce the metabolism of flekainida and pentazocine.
special instructions
Nicorette chewing gum has a lower risk than smoking. The patient should be informed that he should carry the Nicorette chewing gum with him to use it if he suddenly wants to smoke. Patients with diabetes after stopping smoking may need to lower their insulin doses. The patient should be informed that if the drug has become unusable or the expiration date has expired, then it should not be thrown into the wastewater or on the street. It is necessary to put the drug in the bag and put it in the trash. These measures will help protect the environment. Use in pediatricsU patients under the age of 18 gum chewing Nicorette Fresh fruit can be used only on the recommendation of a doctor. Effect on the ability to drive vehicles and control mechanisms Negative impact on the ability to drive a car and work with mechanisms is not installed.