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Classification
Pharmacy Only Medicine
Dosage
Which Strength of Nicorette Patch to use and how long it should be used for
There are three different strengths of Nicorette Patch. The patch is applied on waking (usually in the morning) and removed 16 hours later (usually at bedtime). The patch is not intended to be worn while you are sleeping.
When you first start to use the Nicorette Patch you should use the highest strength. This is the 15mg/16hr Nicorette Patch. You should use this strength patch daily for 8 weeks.
Then you should reduce the amount of nicotine you are using by changing the strength of the patch you use. Use the next lower strength patch (10mg/16hr) applied daily for 2 weeks, then use the lowest strength patch (5mg/16hr) applied daily for two weeks.
If you have been unable to quit smoking after this time, then further use of the Nicorette Patch may be considered after advice from your doctor or pharmacist.
How to combine use of Nicorette patch and Gum or Inhaler
Normally Nicorette Patch or Gum or Inhaler alone would provide enough nicotine to help most people control their craving for cigarettes. However, some people may find that even though they are using nicotine replacement therapy (NRT) they still have intense or frequent cravings they find difficult to cope with. If you are one of these people you may benefit from combining Nicorette Patch with either Nicorette 2mg Gum or Nicorette 10mg Inhaler.
Each morning apply a Nicorette 15mg/16h Patch to an intact area of skin. The Nicorette Patch should be removed before going to bed. After applying the Nicorette Patch use Nicorette 2mg Gum or Nicorette Inhaler whenever a craving occurs.
If you are using Nicorette 2mg Gum try to chew at least 4 pieces of gum every day. Most people will use 5-6 pieces. If you are using Nicorette Inhaler try to use 4-5 cartridges every day.
The combination of Nicorette Patch and Nicorette Gum or Inhaler should be used in this way for 6-12 weeks. After this time if required you can wean yourself off NRT by either:
1. Use the Nicorette 10mg/16h Patch for 3-6 weeks and then use the Nicorette 5mg/16hr patch for 3-6 weeks while using the same number of pieces of Nicorette Gum or Inhaler cartridges in a day that you have routinely used. Then when a patch is no longer needed, gradually reduce the number of pieces of gum or inhaler cartridges until you no longer need them. OR
2. Stop use of the Nicorette 15mg/16hr Patch and then gradually reduce the number of pieces of Nicorette 2mg Gum or inhaler cartridges that are used until you no longer need them.
The Combined Solution approved dosage and weaning programme are as follows:
Initial treatment:
The treatment should begin with one 15 mg/16 hour patch daily, applied to an intact area of the skin upon waking up in the morning and removed at bedtime, combined with either the 2mg gum or 10mg inhaler. Use a minimum of 4 x 2 mg gums per day; usually 5 - 6 gums will be adequate for effect. Do not use more than 24 gums per day. Usually 4 - 5 inhaler cartridges will be adequate for effect. Do not use more than 12 inhaler cartridges per day. This full dose should be used for 6 - 12 weeks whereafter gradual weaning from the products should be initiated.
Weaning from combination:
This can be done in two ways, either by using lower strength patches I.e. 3 - 6 weeks on 10 mg/16 hour patches and then 3 - 6 weeks on 5 mg/16 hour patches, using the same amount of gum 2mg/inhaler 10mg as the initial treatment period, and then gradually reduce the amount of gum/inhaler up to 12 months. Alternatively stop using the patch and gradually reduce the number of gums/inhaler cartridges up to 12 months.
Recommended dosage:
Initial treatment
First 6-12 weeks:
Patch: 1 patch 15 mg/16 hour per day
Gum 2mg: Ad. libitum Recommended 5 - 6 gums per day
Inhaler 10mg: Ad libitum Recommended 4 - 5 cartridges per day
Weaning - alternative 1
Next 3 - 6 weeks
Patch: 1 patch 10 mg/16 hour per day
Gum 2mg: Continue to use gum as needed
Inhaler 10mg: Continue to use inhaler as needed
Following 3 - 6 weeks
Patch: 1 patch 5 mg/16 hour per day
Gum 2mg: Continue to use gum as needed
Inhaler 10mg: Continue to use inhaler as needed
Up to 12 months
No Patch
Gum 2mg: Gradually wean from gum use
Inhaler 10mg: Gradually wean from inhaler use
Weaning - alternative 2
Up to 12 months
No Patch
Gum 2mg: Continue to gradually wean from gum use
Inhaler 10mg: Continue to gradually wean from inhaler use
Ingredients
Nicorette patches 15mg contain Nicotine 15mg/16hours.
Purpose/Usage
What Nicorette Patch is used for
Nicorette Patch helps you to give up smoking by relieving the desire to smoke, as well as some of the unpleasant effects, which smokers experience when they stop smoking.
How Nicorette Patch works
It is your body's dependence on nicotine, which causes with-drawal symptoms when you suddenly stop smoking. Nicotine is an addictive substance. Symptoms may include irritability, restlessness, depression, weight gain, and craving for cigarettes.
Nicorette Patch is intended to ease such withdrawal symptoms by providing your body with nicotine. This leaves your mind free to concentrate on overcoming your psychological desire to smoke.
Nicorette patch has been designed to slowly allow nicotine to be absorbed through your skin. The amount of nicotine in the Nicorette Patch is sufficient to help overcome the withdrawal symptoms but is lower than the amount of nicotine which you get from smoking.
Nicorette Patch is intended to help you to give up smoking, but you will only be successful in becoming a non-smoker if you are determined to quit.
Precautions
When you must not use Nicorette Patch
Do not use Nicorette Patch If:
You are pregnant or intend to become pregnant
There is medical evidence that nicotine in any form may be harmful to an unborn child. Therefore it is recommended that you do not use Nicorette if you are pregnant or intend to become pregnant, unless you are unable to stop smokig without nicotine replacement. Talk to your doctor before using Nicorette Patch during pregnancy.
You are breast-feeding or intend to breast-feed
Nicotine passes freely into breastmilk, and can affect the health of the baby. Therefore it is recommended that you do not use Nicorette Patch if you are breast-feeding or intend to breast-feed.
You have had a recent heart attack or stroke
You have heart disease such as palpitations (fast or irregular heart beats) or uncontrolled angina (chest pain)
You are a non-smoker
You are under 18 Years old
There is not enough information about the use of Nicorette Gum in children.
You are allergic to nicotine or may be sensitive to the patch adhesive.
Before you start to use Nicorette Patches
If you have had any of the following, you should ask for your doctor or pharmacist's advice before using Nicorette Patch.
The medical conditions include:
Angina (chest pain) or any other problem with your heart or blood vessels such as pain in one or more legs when you walk
High Blood Pressure
Previous Stroke
Kidney disease
Liver disease
Stomach ulcer or pain
Hyperthyroidism (a disorder of the thryroid gland)
Phaeochromocytoma (a tumour of the adrenal gland)
Diabetes
Taking Other medicines
If you are taking any other medicines, including medicines that you buy without a prescription, in a pharmacy, supermarket or health food shop, the way these medicines work may be affected once you stop smoking.
These medicines may include:
Theophylline (asthma medication)
Insulin
Imipramine (antidepressant)
Pentazocine (pain medication).
If you use too much (overdose) or in accidental poisoning
Overdosage can occur if more than one patch is used, or you smoke or use other nicotine containing products while you are wearing a patch.
Symptoms of overdose or poisoning include:
Nausea and vomiting
Salivating
Diarrhoea
Abdominal Pain
Cold sweats
Weakness
Disturbed hearing
Headache
Breathing difficulties
Weak, rapid or irregular pulse
Loss of consciousness.
In the event of yourself or someone else showing symptoms seek medical advice.
You can also help by doing the following:
Remove all the nicotine patches
Flush the skin with water and dry it.
Adverse Effects
Nicotine like all other medicines may cause unwanted side effects in some people.
Seek professional advice from your doctor or pharmacist as soon as possible if you do not feel well while you are using Nicorette Patch. Most of the undesirable effects reported by users of Nicorette occur during the first weeks after beginning treatment.
You may notice the following:
Redness or itching of the skin where the patch has been
Headache
Nausea and/or vomiting
General skin redness and hives
Dizziness
Sleeplessness
Some effects, such as dizziness, headache and sleeplessness may be withdrawal symptoms due to low nicotine levels.
If any of these effects do not go away, or you have any other undesirable effects during use, tell your doctor or pharmacist.
Manufactured by:
Pharmacia AB, Sweden
Distributed by:
Pharmacia
14 Normanby Road
Mt Eden
Auckland
Medicines have benefits and some may have risks. Always read the label
carefully and use strictly as directed. If symptoms continue or you have
side effects consult your pharmacist or doctor immediately.
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