Warning!

Nicorette gum should be chewed in the special way explained in the instructions in the package leaflet. If you chew the gum continuously, the nicotine is released too quickly and may be swallowed. This can cause side effects such as throat and stomach irritation, indigestion or hiccups.

Do not exceed the recommended dose of this medicine, which will be stated in the product packaging or information leaflet supplied with the medicine.

Acidic drinks such as coffee, sodas and fruit juices can reduce the amount of nicotine that is absorbed from the mouth if you drink them in the 15 minutes prior to chewing nicotine gum.

Smokers who wear dentures may experience problems chewing Nicorette gum. The chewing gum may stick to, and may in rare cases damage dentures. These people may find that other forms of nicotine replacement, such as nasal sprays, sublingual tablets or lozenges, are more suitable.

Make sure you do not leave unused or used Nicorette gum where children can reach it. Doses of nicotine that are tolerated by adult smokers during treatment can produce severe symptoms of poisoning in small children and may prove fatal. Dispose of Nicorette gum carefully.

Use with caution in

Adolescents aged 12 to 18 years old (If you are in this age group you should not use NRT for longer than 12 weeks without consulting a doctor, pharmacist or nurse for advice)

Disease involving the heart and blood vessels (cardiovascular disease) (Using NRT is much less hazardous than continuing to smoke. However, if you are in hospital because you have recently had a heart attack or stroke or you have severe irregular heart beats, you should ideally try to stop smoking without using NRT. Seek advice from your doctor.)

• Diabetes (monitor your blood sugar more closely when starting NRT)

• Peptic ulcer

• Inflamed stomach lining (gastritis)

• Inflammation of the food pipe (oesophagitis)

• Inflammation of the mouth or throat

• Hyperthyroidism

• Tumour of the adrenal gland (phaeochromocytoma)

• Severely decreased kidney function

• Moderate to severely decreased liver function

• Rare hereditary problems of fructose intolerance (Nicorette gum contains sorbitol)

• This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

Nicotine in any form should ideally not be used during pregnancy, as it has been shown to adversely affect the development of the baby, both in the womb and after birth. However, for pregnant women who are unable to give up smoking without a smoking cessation aid, NRT may deliver less nicotine (and none of the other potentially disease-causing agents) than would be obtained from cigarettes. As a result it is considered that NRT poses less of a risk to the foetus than continuing to smoke. Pregnant women who smoke should discuss the risks and benefits of NRT with their doctor as early as possible in their pregnancy and only use this medicine on their advice. The aim should be to stop using NRT as soon as possible, preferably after two to three months.

Nicotine taken in any form passes into breast milk and is harmful to the nursing infant. However, for women who are unable to give up smoking without a smoking cessation aid, NRT may deliver less nicotine (and none of the other potentially disease-causing agents) than would be obtained from cigarettes. It is also less hazardous than the second-hand smoke that the infant would be exposed to if the mother continued to smoke. This medicine can therefore be used during breastfeeding. Wherever possible, the gum should be chewed immediately after breastfeeding and not in the two hours before breastfeeding, in order to reduce the amount of nicotine that the infant is exposed to.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Sore mouth or throat

• Throat irritation

• Increased salivation

• Hiccups

• Dizziness

• Headache

• Nausea

• Heartburn or indigestion (slower chewing or using 2mg gum may reduce this problem)

• Jaw ache

• Awareness of your heartbeat (palpitations)

• Mouth ulcers

The side effects listed above may not include all of the side effects reported by the drug’s manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

People with diabetes who smoke normally need more insulin, as smoking reduces the amount of insulin that is absorbed into the blood from an injection under the skin. If you have diabetes and are giving up smoking, you may subsequently need a reduction in your insulin dose. People with diabetes should monitor their blood sugar levels more closely when stopping smoking. Discuss this with your doctor.

Using nicotine replacement therapy in combination with bupropion (Zyban) is not currently recommended. You can, however, use a combination of different NRT products if you find this is helpful. Ask your pharmacist for advice.

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