Nicotine Gum

Nicotine chewing gum is used to help people stop smoking cigarettes. Nicotine chewing gum should be used together with a smoking cessation program, which may include support groups, counseling, or specific behavioral change techniques. Nicotine gum is in a class of medications called smoking cessation aids. It works by providing nicotine to your body to decrease the withdrawal symptoms experienced when smoking is stopped and as a substitute oral activity to reduce the urge to smoke.

Nicotine gum is used by mouth as a chewing gum and should not be swallowed. Follow the directions on your package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use nicotine gum exactly as directed. Do not use more or less of it or use it more often than directed on the package label or as recommended by your doctor.

If you smoke your first cigarette more than 30 minutes after waking up, use the 2-mg gum. People who smoke their first cigarette within 30 minutes of waking up should use the 4-mg gum. Nicotine gum may be used regularly by chewing one piece of gum every 1 to 2 hours for the first 6 weeks, followed by one piece every 2 to 4 hours for 3 weeks, and then one piece every 4 to 8 hours for 3 weeks. If you have strong or frequent cravings, you may chew a second piece within one hour. To improve your chances of quitting smoking, chew at least 9 pieces of nicotine gum each day for the first 6 weeks.

Chew nicotine gum slowly until you can taste the nicotine or feel a slight tingling in your mouth. Then stop chewing and place (park) the chewing gum between your cheek and gum. When the tingling is almost gone (about 1 minute), start chewing again; repeat this procedure for about 30 minutes. Avoid eating and drinking for 15 minutes before and during chewing of nicotine gum.

Do not chew nicotine gum too fast, do not chew more than one piece of gum at a time, and do not chew one piece too soon after another. Chewing one piece of gum after another continuously may cause hiccups, heartburn, nausea, or other side effects.

Do not chew more than 24 pieces a day.

You should stop using nicotine gum after 12 weeks of use. If you still feel the need to use nicotine gum after 12 weeks, talk to your doctor.

Before using nicotine gum,

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using nicotine gum. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had a heart attack, heart disease, irregular heart rate, ulcers, diabetes, or high blood pressure not controlled by medication; if you are under 18 years of age; or if you are on a sodium-restricted diet.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using nicotine gum, stop using it and call your doctor.
• do not smoke cigarettes or use other nicotine products while using nicotine gum because nicotine overdose can occur.

Unless your doctor tells you otherwise, continue your normal diet.

Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use 2 pieces of gum at once or one after the other to make up for a missed dose.

If you experience any of the following symptoms, stop using nicotine gum and call your doctor immediately or get emergency medical treatment:

• mouth, tooth, or jaw problems
• dizziness
• nausea
• vomiting
• diarrhea
• weakness
• fast, pounding, or irregular heartbeat
• difficulty breathing
• rash
• blisters in the mouth

Nicotine gum may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children and pets. Wrap used pieces of nicotine gum in paper and throw them away in the trash. Store nicotine gum at room temperature and away from light, excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor.

Ask your pharmacist any questions you have about nicotine gum.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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