Nicorette - McNeil Products Ltd

Contraindications

Not recommended in pregnancy and while breast feeding, but is prefereable to smoking. Use with caution in renal and hepatic impairment. 

Preparations Available

Nasal spray, Oral spray, Sublingual tablet, Transdermal patch, Chewing gum, Lozenge, Inhalation vapour

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.

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.

Inhalation cartridges
The cartridges can be used when there is an urge to smoke or to prevent cravings. Patients should not exceed 12 cartridges of the 10 mg strength daily, or six cartridges of the 15 mg strength daily.

Insert the cartridge into the device and draw air through the mouthpiece. Each session can last for approximately 5 minutes. The amount of nicotine from 1 puff of the cartridge is less than that from one puff of a cigarette, so it is necessary to inhale more often. A single 10 mg cartridge lasts for approximately 20 minutes and a single 15 mg cartridge approximately 40 minutes.

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.

Sublingual tablets
Fewer than 20 cigarettes per day: 1 tablet/hour, increasing to 2 tablets/hour if necessary.

More than 20 cigarettes per day: 2 tablets/hour.

Patients should not exceed 40 tablets daily.

If attempting smoking cessation, treatment should continue for up to three months before reducing the dose.
Each tablet should be placed under the tongue and allowed to dissolve.

Oral spray
Use 1–2 sprays in the mouth when the urge to smoke occurs or to prevent cravings.

Individuals should not exceed two sprays per episode, four sprays every hour or 64 sprays daily.

The oral spray should be released into the mouth, holding the spray as close to the mouth as possible and avoiding the lips. The patient should not inhale while spraying and avoid swallowing for a few seconds after use.

Nasal spray
Patients can use one spray in each nostril when the urge to smoke occurs, up to twice every hour for 16 hours daily (with a maximum of 64 sprays daily).

If attempting smoking cessation, treatment should continue for eight weeks before reducing the dose.

Initially one spray should be used in both nostrils but when withdrawing from therapy, the dose can be gradually reduced to one spray in one nostril.

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.

Sizes Available

Nasal spray
Nicorette 500 mcg/dose, 10 ml 

Mouth spray (sugar free)
Nicorette QuickMist 1 mg/dose, 13.2 ml (cool berry and fresh mint)
Nicorette QuickMist 1 mg/dose, 26.4 ml (cool berry and fresh mint)
Nicorette QuickMist SmartTrack, 1 mg/dose, 13.2 ml
Nicorette QuickMist SmartTrack, 1 mg/dose, 26.4 ml

Sublingual tablets (sugar free)
Nicorette Microtab 2 mg, pack of 100

Patches
Nicorette invisi 10 mg/16 hours, 7 patches 
Nicorette invisi 15 mg/16 hours, 7 patches 
Nicorette invisi 25 mg/16 hours, 7 patches 
Nicorette invisi 25 mg/16 hours, 14 patches

Chewing gum (sugar free)
Nicorette Freshmint 2 mg, 25 pieces
Nicorette Freshmint 2 mg, 30 pieces
Nicorette Freshmint 2 mg, 105 pieces
Nicorette Freshmint 2 mg, 210 pieces
Nicorette Fruitfusion 2 mg, 30 pieces
Nicorette Fruitfusion 2 mg, 105 pieces
Nicorette Icy White 2 mg, 25 pieces
Nicorette Icy White 2 mg, 30 pieces
Nicorette Icy White 2 mg, 70 pieces
Nicorette Icy White 2 mg, 105 pieces
Nicorette Icy White 2 mg, 210 pieces
Nicorette Original 2 mg, 105 pieces
Nicorette Original 2 mg, 210 piece
Nicorette Freshmint 4 mg, 25 pieces
Nicorette Freshmint 4 mg, 30 pieces
Nicorette Freshmint 4 mg, 105 pieces
Nicorette Freshmint 4 mg, 210 pieces
Nicorette Fruitfusion 4 mg, 105 pieces
Nicorette Icy White 4 mg, 105 pieces
Nicorette Original 4 mg, 105 pieces
Nicorette Original 4 mg, 210 pieces

Lozenges (sugar free)
Nicorette Cools 2 mg, pack of 20
Nicorette Cools 2 mg, pack of 80
Nicorette Fruit 2 mg, pack of 80
Nicorette Cools 4 mg, pack of 80

Inhalation vapour
Nicorette 15 mg, 4 cartridges 
Nicorette 15 mg, 20 cartridges 
Nicorette 15 mg, 36 cartridges 

More on: Smoking cessation