Nicotinell

Contraindications

Manufacturer advises caution in renal and hepatic impairment. Should be avoided in pregnancy and breastfeeding, but is preferred over smoking. 

Preparations Available

Transdermal patch, Chewing gum, Lozenge

The selection of preparation should be made according to the smoker’s likely adherence, previous experience with aids, contraindications and side-effects, and the smoker’s preference. It is widely accepted that there are no circumstances in which it is safer to smoke than use NRT.

All preparations are licensed for adults and children over 12 years (with the exception of Nicotinell® lozenges, which are licensed for children under 18 years only when recommended by a doctor).

The use of NRT in pregnancy is preferable to smoking, but it should only be used if smoking cessation without NRT fails. Nicotine can be present in breast milk, however the amount is low and is less hazardous than second-hand smoke. Use with caution in both hepatic and renal impairment.

Transdermal patches
More than 10 cigarettes per day: apply a high-strength patch daily for 6–8 weeks, followed by a medium-strength patch for 2 weeks, and then a low-strength patch for the final 2 weeks.

Fewer than 10 cigarettes per day: start with a medium-strength patch for 6–8 weeks, followed by a low-strength patch for 2–4 weeks.

A slower titration schedule can be used in patients who are not ready to quit but who want to reduce cigarette consumption before a quit attempt.

If abstinence is not achieved, or if withdrawal symptoms are experienced, the strength of the patch used should be maintained or increased until the patient is stabilised. Patients using the high-strength patch who experience excessive side-effects, that do not resolve within a few days, should change to a medium-strength patch for the remainder of the initial period and then use the low-strength patch for 2–4 weeks.

Patches should be applied on waking to dry, non-hairy skin on the hip, trunk, or upper arm and held in position for 10–20 seconds to ensure adhesion; place next patch on a different area and avoid using the same site for several days.

Lozenges
Fewer than 20 cigarettes per day: use the lower-strength lozenges.

More than 20 cigarettes per day and those who fail to stop smoking with the low-strength lozenges: use the higher-strength lozenges.

One lozenge should be used every 1–2 hours when the urge to smoke occurs, but patients should not exceed 15 lozenges daily.

If attempting smoking cessation, treatment should continue for 6–12 weeks before attempting a reduction in dose.

Slowly allow each lozenge to dissolve in the mouth, periodically moving the lozenge from one side of the mouth to the other. Lozenges last for 10–30 minutes, depending on their size.

Chewing gum
Fewer than 20 cigarettes per day: 1 piece of 2 mg strength gum when the urge to smoke occurs or to prevent cravings.

More than 20 cigarettes per day or those who require more than 15 pieces of 2 mg strength gum each day: 1 piece of 4 mg strength gum when the urge to smoke occurs or to prevent cravings. Patients should not exceed 15 pieces of 4 mg strength gum daily.

If attempting smoking cessation, treatment should continue for 3 months before reducing the dose.

Chew the gum until the taste becomes strong, then rest it between the cheek and gum. When the taste starts to fade, repeat this process. One piece of gum lasts for approximately 30 minutes.

Sizes Available

Patches
Nicotinell TTS 10 7 mg/24 hours, 7 patches 
Nicotinell TTS 20 14 mg/24 hours, 7 patches 
Nicotinell TTS 30 21 mg/24 hours, 7 patches 
Nicotinell TTS 30 21 mg/24 hours, 21 patches

Chewing gum
Nicotinell Fruit 2 mg, 96 pieces, sugar free
Nicotinell Fruit 2 mg, 204 pieces, sugar free
Nicotinell Mint 2 mg, 96 pieces, sugar free
Nicotinell Mint 2 mg, 204 pieces, sugar free
Nicotinell Fruit 4 mg, 96 pieces, sugar free
Nicotinell Mint 4 mg, 96 pieces, sugar free

Lozenge
Nicotinell 1 mg, pack of 12
Nicotinell 1 mg, pack of 96 
Nicotinell 1 mg, pack of 144
Nicotinell 2 mg, pack of 96
Nicotinell 2 mg, pack of 144
Nicotinell 2 mg, pack of 204

More on: Smoking cessation