Nicotine Gum

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

Usually treatment to stop smoking is started by using the 2-mg nicotine gum as suggested by your doctor or pharmacist. Heavy smokers (those smoking more than 25 cigarettes per day) may start by using the 4-mg nicotine gum (consulting a doctor is strongly advised). Nicotine gum may be used regularly by chewing one piece of gum every 1-2 hours at first, or it may be used by chewing one piece of gum whenever you have the urge to smoke.

Nicotine gum should be chewed 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.

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.

If you are using the 2-mg gum, do not chew more than 30 pieces a day if you are under the supervision of a doctor or 24 pieces a day if you are not under the supervision of a doctor. If you are using the 4-mg gum, do not chew more than 24 pieces a day.

Gradually begin reducing the amount of nicotine gum used after 2-3 months. This reduced use over time will help prevent nicotine-withdrawal symptoms.

Suggested tips to help reduce your use of nicotine gum gradually include:

• Decrease the total number of pieces used per day by about 1 piece every 4-7 days.
• Decrease the chewing time with each piece from the normal 30 minutes to 10-15 minutes for 4-7 days. Then gradually decrease the total number of pieces used per day.
• Substitute one or more pieces of sugarless gum for an equal number of pieces of nicotine gum. Increase the number of pieces of sugarless gum substituted for nicotine gum every 4-7 days.
• Replace 4-mg gum with 2-mg gum and apply any of the previous steps.
• Consider stopping use of nicotine gum when your craving for nicotine is satisfied by one or two pieces of gum per day.

Use of nicotine gum for longer than 3 months is discouraged. Do not use nicotine gum longer than 6 months without talking with your doctor.

What special precautions should I follow?

Before using nicotine gum,

• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially acetaminophen (Tylenol), caffeine, diuretics ('water pills'), imipramine (Tofranil), insulin, medications for high blood pressure, oxazepam (Serax), pentazocine (Talwin, Talwin NX, Talacen), propoxyphene (Darvon, E-Lor), propranolol (Inderal), theophylline (Theo-Dur), and vitamins.
• do not smoke cigarettes or use other nicotine products while using nicotine gum because nicotine overdose can occur.
• tell your doctor if you have or have ever had a heart attack, irregular heart rate, angina, ulcers, uncontrolled high blood pressure, overactive thyroid, pheochromocytoma, or a dental condition or disorder.
• 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 immediately. Nicotine and nicotine gum may cause harm to the fetus.