Package leaflet: Information for the user Nicabate Extra Fresh Mint 2 mg or 4mg medicated chewing gum

Nicotine

Read all of this leaflet carefully before you start using this medicine because it contains important

information for you.

Always use this medicine exactly as described in this leaflet or as your healthcare professional has told you.

-    Keep this leaflet. You may need to read it again.

-    Ask a healthcare professional e.g. doctor, nurse, smoking cessation advisor or pharmacist if you need more information or advice.

-    If you get any side effects, talk to your healthcare professional. This includes any possible side effects not listed in this leaflet. See section 4.

-    You must talk to a doctor if you have not been able to stop smoking after 9 months of treatment with Nicabate Extra Fresh Mint 2 mg or 4mg Medicated Chewing Gums.

-    Throughout this leaflet Nicabate Extra Fresh Mint 2 mg and 4 mg Medicated Chewing Gums are referred to as Nicabate Extra Fresh Mint Gums.

What is in this leaflet

1.    What Nicabate Extra Fresh Mint Gums are and what they are used for

2.    What you need to know before you use Nicabate Extra Fresh Mint Gums

3.    How to use Nicabate Extra Fresh Mint Gums

4.    Possible side effects

5.    How to store Nicabate Extra Fresh Mint Gums

6.    Contents of the pack and other information

1. What Nicabate Extra Fresh Mint Gums are and what they are used for

Nicabate Extra Fresh Mint Gums are used to help people stop smoking. This type of treatment is called Nicotine Replacement Therapy or NRT.

It is the nicotine in cigarettes that can make you physically addicted to them.

•    Nicabate Extra Fresh Mint Gums help you to give up smoking by replacing some of the nicotine you get from cigarettes.

•    This nicotine relieves some of the unpleasant symptoms that smokers may have when they try to give up. These include feeling ill or irritable.

•    The nicotine can also relieve your cravings for a cigarette and help you to resist the urge to smoke.

Nicabate Extra Fresh Mint Gums do not have the health dangers of tobacco. This is because they do not contain the tar, carbon monoxide or other toxins in cigarette smoke. Some people worry that after stopping smoking, they may become dependent on nicotine gums instead. This is very rare, and if it did happen, it is less harmful than continuing to smoke. It is also an easier habit to break.

Your chances of stopping smoking will be improved if you take part in a support programme. These "stop smoking programmes" are known as behavioural support. For information on stop smoking programmes please talk to a healthcare professional or a pharmacist.

There are no health benefits to smoking. It is always better to give up smoking. Using Nicotine Replacement Therapy (NRT), like Nicabate Extra Fresh Mint Gums, can help. In general, any possible side effects associated with NRT are far outweighed by the well known dangers of continuing to smoke.

2. What you need to know before you use Nicabate Extra Fresh Mint Gums Do not use Nicabate Extra Fresh Mint Gums:

•    If you are allergic to nicotine or any of the other ingredients of this medicine (listed in section 6).

•    If you are under the age of 12 years.

Warnings and precautions

Talk to your healthcare professional before using Nicabate Extra Fresh Mint Gums:

•    If you have had a recent heart attack or stroke, or you suffer from severe heart rhythm problems, unstable or worsening angina (chest pain) high blood pressure which is not controlled by medication or resting angina you should try to quit smoking without using any NRT products unless your doctor tells you to use them.

•    If you have diabetes you should monitor your blood sugar levels more often than usual when you start using Nicabate Extra Fresh Mint Gums. Your insulin or medicine requirements may change.

•    If you have ever had allergic reactions that involve swelling of the lips, face and throat (angioedema) or itchy skin rash (urticaria). Using NRT can sometimes trigger this type of reaction.

•    If you wear dentures as you may experience difficulties in chewing.

•    Nicotine replacement Therapy (NRT) is not suitable for children under 12. The effects of nicotine affect children more than adults. It could cause a severe poisoning in children which can cause death.

Do not interchange between Nicabate Extra Fresh Mint Gums and nicotine lozenges during any attempt to

quit smoking.

Get help and advice from a healthcare professional if you have:

•    Severe or moderate liver or severe or moderate kidney problems - because you may be more likely to get side effects.

•    Uncontrolled overactive thyroid gland or phaeochromocytoma (a tumour of the adrenal gland that can affect blood pressure) - your doctor will have told you this - because nicotine may make your symptoms worse.

•    Stomach or duodenal ulcer or an inflamed oesophagus or gullet (the passage between the mouth and the stomach) because swallowing nicotine can make your symptoms worse. It may also cause mouth ulcers. If your symptoms do get worse you should talk to your doctor. You might want to use a nonoral form of NRT instead, such as patches.

Children (under 12 years)

The correct dose for adults could seriously poison or be fatal to small children. It is therefore essential that

you keep Nicabate Extra Fresh Mint Gums out of sight and reach of children at all times.

Other medicines and Nicabate Extra Fresh Mint Gums

Tell your healthcare professional if you are using, have recently used or might use any other medicines.

Stopping smoking may alter the effects of other medicines you may be taking. If you have any questions or concerns about this talk to a healthcare professional.

This is especially important if you use other medicines which contain:

-    theophylline (to treat asthma)

-    tacrine (for Alzheimer's disease)

-    clozapine (for schizophrenia)

-    ropinirole (to treat Parkinson's disease)

Nicabate Extra Fresh Mint Gums with food and drink

You should not eat or drink while Nicabate Extra Fresh Mint Gums are in your mouth.

Acidic drinks (e.g. fruit juice, coffee or soda) influence the uptake of nicotine in the mouth cavity.

To make sure that the best effect is achieved, you should avoid such drinks approximately 15 minutes prior to using Nicabate Extra Fresh Mint Gums.

Pregnancy, breast-feeding and fertility

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your healthcare professional for advice before using this medicine.

Smoking during pregnancy has risks for the baby. These include poor growth before birth, premature birth or stillbirth. Stopping smoking is the best way to improve both your health and that of your baby. The earlier you stop smoking the better.

Ideally, if you are pregnant, you should stop smoking without using NRT. However, if you have tried and this has not worked, NRT may be recommended by a healthcare professional to help you stop smoking. This is because it is better for your developing baby than if you carry on smoking. The decision to use NRT should be made as early on as possible in your pregnancy. You should aim to use it for only 2-3 months. Remember, the most important thing is to stop smoking. Products such as gums may be preferable to nicotine patches. This is because with gums, you do not get the nicotine all the time. However, patches may be preferred if you have nausea or sickness.

If you are breast feeding tobacco smoke causes breathing difficulties and other problems in babies and children. Ideally you should stop smoking without using NRT. However, if you have tried and this has not worked, NRT may be recommended by a healthcare professional. If you need to use NRT to help you quit, the amount of nicotine your baby may get is small. It is best to use NRT products that are taken at certain times of the day (such as gums or lozenges, rather than patches). It is also better to breast feed just before you take the product. This helps your baby to get the smallest amount of nicotine possible.

Driving and using machines

There are no known effects of Nicabate Extra Fresh Mint Gums on your ability to drive or use machines. However, you should be aware that giving up smoking can cause behavioural changes that could affect your ability to drive or use machines.

Nicabate Extra Fresh Mint Gums contain

• Sodium - This medicinal product contains less than 1 mmol sodium (23 mg) per piece of gum, i.e. essentially 'sodium-free'.

•    Sorbitol (E420) -If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

•    Butylated hydroxytoluene (E321) - this may cause irritation of mucous membranes.

3. How to use Nicabate Extra Fresh Mint Gums

Always use this medicine exactly as described in this leaflet or as your healthcare professional has told you. Check with your healthcare professional if you are not sure.

During any attempt to give up smoking using Nicabate Extra Fresh Mint Gums it is important that you make every effort to stop smoking completely. However, if you do smoke a cigarette while you are using NRT, you should continue your quit attempt. If you continue to have difficulty stopping smoking talking to your doctor, nurse, smoking cessation advisor or pharmacist may help.

Nicabate Extra Fresh Mint Gums 2mg are for smokers who smoke less than 20 cigarettes a day.

Nicabate Extra Fresh Mint Gums 4mg are for smokers who smoke 20 or more cigarettes a day.

Do not chew Nicabate Extra Fresh Mint Gum as ordinary chewing-gum. If Nicabate Extra Fresh Mint Gum is chewed too quickly and without breaks, nicotine is released too quickly. This may cause discomfort (e.g. heartburn and hiccups).

You should use Nicabate Extra Fresh Mint Gums by peeling the paper off and pushing a piece of gum out. Then put one gum in your mouth and chew slowly until the taste becomes strong (about 1 minute) then stop and rest the gum against your cheek. When the taste fades, chew a few times until the taste gets strong then rest the gum again. After about 30 minutes of such use, the gum will be exhausted. You should not eat or drink while a gum is in your mouth as this may reduce the uptake of the nicotine. Do not use more than 15 gums a day. If you feel the need to use Nicabate Extra Fresh Mint Gums for longer than 9 months in total, you should ask a healthcare professional for advice.

Nicabate Extra Fresh Mint Gums can be used according to the following timetable which is designed to gradually reduce the number of pieces of gum you use.

Adults (18 years and over)

•    Start by using 8 to 12 gums a day. Chew gum whenever you have an urge to smoke.

•    Use the gums like this for up to 3 months, then gradually cut down the number of gums you use a day (see table below).

•    Once you are using only 1 or 2 gums a day, stop using them altogether

After you have given up you may sometimes feel a sudden craving for a cigarette. You can use a gum again if it happens.

STEP 1
	STEP 2
		STEP 3
Initial treatment	Step down	Support treatment
period	treatment period
Chew 1 piece of	Gradually reduce	Chew a piece of
gum whenever	gum use to 1-2	gum if sudden

there is an urge to	pieces/day.	cravings tempt you
smoke. Use 8-12	Then stop	to smoke.
pieces/day for up to	treatment.
3 months.

Use in children and adolescents Adolescents (12-17 years inclusive)

Adolescents should not use Nicabate Extra Fresh Gums without recommendation from a doctor.

Do not exceed the stated dose. Do not smoke or use any other nicotine containing product at the same time. Follow the instruction carefully and do not use more than 15 gum pieces in one day (24 hours).

Children under 12 years

Children under 12 years of age must not use Nicabate Extra Fresh Mint Gums.

If you are tempted to start smoking again

If you are worried that you may start smoking again or finding it difficult to stop using the gums completely, talk to a healthcare professional. If you do start to smoke again, they can advise you on how to get the best results from further courses of NRT.

If you use more Nicabate Extra Fresh Mint Gums than you should

If you use too many Nicabate Extra Fresh Mint Gums you may start to feel sick, dizzy and unwell. Stop using the gums and get advice straightaway from a doctor or hospital casualty department. If possible, show them the packet or this leaflet.

The gums are not suitable for children under 12. If the gums are used by children they may show signs of nicotine overdose. These include headache, sickness, stomach pains and diarrhoea. If a child has used or eaten any of the gums, contact your doctor or nearest hospital casualty department straightaway as this may be very dangerous and even fatal. If possible show them the packet or this leaflet.

If you have any further questions on the use of this product, ask your healthcare professional.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. At the recommended doses Nicabate Extra Fresh Mint Gums have not been found to cause any serious side effects.

Stopping smoking itself can cause symptoms such as dizziness, headache, sleep disturbances, cough, coldlike symptoms. Symptoms such as depression, irritability, anxiety and insomnia may also be related to withdrawal symptoms associated with giving up smoking.

Stop taking Nicabate Extra Fresh Mint Gums and see a doctor immediately if you experience any of the following symptoms of allergic reactions, which can be serious:

Rare side effects (may affect up to 1 in 1,000 people)

•    swollen face, tongue or throat

•    difficulty to swallow

hives and difficulties with breathing irregular heartbeat

Other side effects are listed below - they are based on the likelihood with which they can occur.

Common (may affect up to 1 in 10 people)

•    feeling sick, gastro-intestinal discomfort

•    sore throat, sore/dry mouth, mouth irritation or ulceration, pharyngitis, cough

•    sleep disturbance, headache, irritability, dizziness

•    being sick, hiccups, indigestion, flatulence, diarrhoea, constipation

•    jaw pain

None of the above effects are serious and often wear off after a few days treatment.

Uncommon side effects (may affect up to 1 in 100 people)

•    an increase in your heart rate or awareness of your heart beat

•    feeling lightheaded

•    difficulty breathing, chest pain

•    taste disturbance/distortion

•    itching or a rash, redness of the skin, increased sweating

•    pain in muscles/joint or swelling

•    inflammation of the mucous lining of the mouth

•    tremor

•    feeling unwell

Very rare effects (may affect up to 1 in 10,000 people)

• severe allergic reaction symptoms of which include sudden wheeziness or tightness of chest, rash and feeling faint.

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell a healthcare professional.

Reporting of side effects

If you get any side effects, talk to pharmacist, nurse or smoking cessation advisor. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Nicabate Extra Fresh Mint Gums

•    Keep this medicine out of the sight and reach of children.

•    Do not use this medicine after the expiry date which is stated on the blister and carton after EXP. The expiry date refers to the last day of that month.

•    Do not store above 25°C.

•    Store in the original container.

•    Do not throw any medicine via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Nicabate Extra Fresh Mint Gums contain:

•    The active substance is nicotine. Each gum piece contains 2 mg or 4 mg (in the form of a resin complex called nicotine resinate).

•    The other ingredients are:

o Gum contains Butylated hydroxytoluene (E321), Sorbitol (E420), Xylitol (E967), Calcium Carbonate (E170), Sodium Carbonate Anhydrous (E500), Glycerol (E422), Acesulfame Potassium (E950), Mannitol (E421), Acacia (E414), Sucralose (E955), Titanium Dioxide (E171), and Flavours: Optacool, Eucamenthol and Levomenthol

What Nicabate Extra Fresh Mint Gums look like and contents of the pack

White to off-white rectangular shaped chewing gum Each blister contains 4 or 10 gum pieces.

Pack contains 4, 10, 30, 100 or 200 gum pieces.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

GlaxoSmithKline Consumer Healthcare

Brentford

TW8 9GS

This medicinal product is authorised in the Member States of the EEA under the following names:

NiQuitin Minze 2 mg & 4mg wirkstoffhaltiges Kaugummi NiQuitin freshmint 2 mg & 4mg Gomme a macher medicamenteuse NiQuitin GUM Icy Fresh Mint 2 mg & 4mg Ijekovita guma za zvakanje NiQuitin Freshmint 2 mg & 4mg leciva zvykad guma NiQuitin Extra Fresh Mint 2 mg & 4mg medicinsk tyggegummi NiQuitin Finland    Niquitin Freshmint 2 mg & 4mg laakepurukumi

NiQuitin Minze 2 mg & 4mg wirkstoffhaltiges Kaugummi NiQuitin Extra Fresh Mint

NiQuitin Icy Fresh Mint 2 mg & 4mg gyogyszeres ragogumi

NiQuitin Fresh Mint 2mg & 4mg Medicated Chewing Gum

Niquitin Extra Fresh Mint

NiQuitin 2 mg & 4mg Medicated Chewing Gum

NiQuitin Extra Fresh Mint 2 mg & 4mg vaistine kramtomoji guma

NiQuitin freshmint 2 mg & 4mg Gomme a macher medicamenteuse

NiQuitin Mint 2 mg & 4 mg Kauwgom

Nicabate

NiQuitin Menthol

NiQuitin Menta Fresca 2mg & 4 mg gomas para mascar medicamentosas

NIQUITIN FRESH MINT 2 mg & 4 mg, guma masticabila medicamentoasa

NiQuitin Mint 2 mg & 4 mg zuvacie tablety

NiQuitin Extra Fresh Mint 2 mg & 4 mg chicles medicamentosos

NiQuitin Mentolmint 2 mg & 4 mg medicinskt tuggummi

Nicabate Extra Fresh Mint 2 mg Medicated Chewing Gum

This leaflet was last revised in April 2015