II. Indications

III. Efficacy

  1. One year quit rate 23% (13% for Placebo)

IV. Preparations

  1. Available over the counter in the United States
  2. Gum 2 mg: Use <25 Cigarettes/day (some references use <15 Cigarettes/day)
  3. Gum 4 mg: Use >25 Cigarettes/day (some references use >15 Cigarettes/day)

V. Technique

  1. Stop smoking first before starting gum
  2. Avoid food or drink 15 minutes before gum
    1. Avoid acidic foods and beverages 30 minutes prior to use
  3. Chew one piece of gum
    1. Urge to smoke
    2. Withdrawal symptoms
  4. Chew slowly 30 minutes/piece
    1. Keep gum in buccal area
    2. Chew 1-2 times every few minutes
    3. Excessive chewing results in adverse effects
    4. Park piece between gum and cheek between chewing

VI. Dosing

  1. Timing
    1. Chew one piece slowly every 1-2 hours
  2. Prescribing
    1. Write for 2 boxes of gum initially
    2. Taper dose after 3 months, off gum by 6 months
  3. Taper schedule for those on 4 mg chew
    1. Initial: 10-15 pieces per day (4 mg dose) for 2 weeks
      1. Maximum dose: 20 pieces per day (4 mg dose)
    2. After 2 weeks: 10-15 pieces per day (2 mg dose)

VII. Adverse Effects: Gastrointestinal affects

  1. Prevented by chewing gum slowly (see protocol above)
  2. Nausea
  3. Dyspepsia
  4. Pharyngitis

VIII. Precautions

  1. Pregnancy Category C

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Cost: Medications

nicorette (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
NICORETTE 2 MG CHEWING GUM Generic OTC $0.21 each
NICORETTE 2 MG LOZENGE Generic OTC $0.35 each
NICORETTE 2 MG MINI LOZENGE Generic OTC $0.35 each
NICORETTE 4 MG CHEWING GUM Generic OTC $0.27 each
NICORETTE 4 MG LOZENGE Generic OTC $0.35 each
NICORETTE 4 MG MINI LOZENGE Generic OTC $0.35 each

Ontology: nicotine polacrilex (C0068722)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D061485
SnomedCT 77544001
English nicotine polacrilex (medication), nicotine polacrilex [Chemical/Ingredient], Nicotine Polacrilices, Nicotine Polacrilex, Polacrilex, Nicotine, Polacrilices, Nicotine, nicotine polacrilex, Nicotine polacrilex, Nicotine polacrilex (substance), NICOTINE POLACRILEX
French Polacrilex de nicotine, Nicotine Polacrilex
German Nikotin Polacrilex
Spanish nicotina polacrilex (sustancia), nicotina polacrilex

Ontology: Nicotine Chewing Gum (C0599654)

Definition (NCI_NCI-GLOSS) A chewing gum that contains a small dose of nicotine, which enters the blood by being absorbed through the lining of the mouth. This helps stop nicotine cravings and relieves symptoms that occur when a person is trying to quit smoking. A prescription is not needed for nicotine gum.
Definition (NCI) A chewing gum containing nicotine used as a substitute for the active ingredient in tobacco. Nicotine chewing gum reduces the withdrawal symptoms associated with smoking cessation.
Concepts Clinical Drug (T200)
MSH D061485
SnomedCT 346593007
LNC LA14322-4
English nicotine gum, gum nicotine, Nicotine Chewing Gum, Nicotine Chewing Gums, Chewing Gum, Nicotine, Chewing Gums, Nicotine, Gum, Nicotine Chewing, Gums, Nicotine Chewing, Nicotine gum, Nicotine chewing gum, Nicotine chewing gum (product), Nicotine chewing gum (substance), Nicotine Gum
French Chewing-gum à la nicotine, Gomme à la nicotine, Gomme à mâcher à la nicotine
Czech žvýkačka nikotinová
German Nikotinkaugummi, Nikotin-Kaugummi
Norwegian Nikotintyggegummi
Spanish nicotina, chicle (producto), nicotina, chicle, nicotina, goma de mascar

Ontology: Nicorette (C0701400)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D061485
English nicorette, Nicorette
French Nicorette
Czech Nicorette
German Nicorette
Norwegian Nicorette