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Nicotine Gum
Aka: Nicotine Gum, Nicotine Chewing Gum, Nicorette, Nicotine Polacrilex
- See Also
- Tobacco Abuse
- Nicotine Replacement
- Indications
- Tobacco Cessation
- Efficacy
- One year quit rate 23% (13% for Placebo)
- Preparations
- Available over the counter in the United States
- Gum 2 mg: Use <25 Cigarettes/day (some references use <15 Cigarettes/day)
- Gum 4 mg: Use >25 Cigarettes/day (some references use >15 Cigarettes/day)
- Technique
- Stop smoking first before starting gum
- Avoid food or drink 15 minutes before gum
- Avoid acidic foods and beverages 30 minutes prior to use
- Chew one piece of gum
- Urge to smoke
- Withdrawal symptoms
- Chew slowly 30 minutes/piece
- Keep gum in buccal area
- Chew 1-2 times every few minutes
- Excessive chewing results in adverse effects
- Park piece between gum and cheek between chewing
- Dosing
- Timing
- Chew one piece slowly every 1-2 hours
- Prescribing
- Write for 2 boxes of gum initially
- Taper dose after 3 months, off gum by 6 months
- Taper schedule for those on 4 mg chew
- Initial: 10-15 pieces per day (4 mg dose) for 2 weeks
- Maximum dose: 20 pieces per day (4 mg dose)
- After 2 weeks: 10-15 pieces per day (2 mg dose)
- Adverse Effects: Gastrointestinal affects
- Prevented by chewing gum slowly (see protocol above)
- Nausea
- Dyspepsia
- Pharyngitis
- Precautions
- Pregnancy Category C
- References
- Larzelere (2012) Am Fam Physician 85(6):591-8 [PubMed]
- Mallin (2002) Am Fam Physician 65:1107-17 [PubMed]