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Nicotinell Fruit 2mg Chewing Gum

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PACKAGE LEAFLET: INFORMATION FOR THE USER

Nicotinell Fruit 2 mg medicated chewing-gum

Nicotine

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

This medicine is available without prescription. However, you still need to use Nicotinell Fruit 2 mg medicated chewing-gum carefully to get the best results from it.

Always take this medicine exactly as described in this leaflet or as your pharmacist has told you.

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

•    Ask your pharmacist if you need more information or advice.

•    You must contact a doctor if you still need to use Nicotinell after 9 months.

•    If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

In this leaflet:

1.    What Nicotinell is and what it is used for

2.    What you need to know before you take Nicotinell

3.    How to take Nicotinell

4.    Possible side effects

5.    How to store Nicotinell

6.    Content of the pack and other information

1.    What Nicotinell is and what it is used for

Nicotinell belongs to a group of medicines which are used to help you to stop smoking.

Nicotinell contains nicotine, which is one of the substances contained in tobacco.

When chewed, nicotine is released slowly and absorbed through the lining of the mouth.

This medicinal product is used to relieve the nicotine withdrawal symptoms in nicotine dependency, as an aid to smoking cessation.

Patient counselling and support normally improve the success rate.

2.    What you need to know before you take Nicotinell Do not take Nicotinell

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

•    If you are a non-smoker.

Warnings and precautions

Talk to your doctor or pharmacist before taking Nicotinell if you have:

•    heart disease, e.g. heart attack, heart failure, angina, Prinzmetal’s angina or abnormalities in heart beat rhythm,

•    had a “stroke” (cerebrovascular accident),

•    high blood pressure (uncontrolled hypertension),

•    problems with your circulation,

•    diabetes (monitor your blood sugar levels more often when starting to use Nicotinell as you may find your insulin or medication requirements alter)

•    overactive thyroid glands (hyperthyroidism),

•    overactive adrenal glands (pheochromocytoma),

•    kidney or liver disease,

•    oesophagitis, inflammation in the mouth or throat, gastritis or peptic ulcer,

•    fructose intolerance.

Even small quantities of nicotine are dangerous in children and may result in severe symptoms or death. It is therefore essential that you keep Nicotinell out of reach and sight of children at all times

People having problems with the joint of the jawbone and some denture wearers may experience difficulty in chewing the gum. If you do, it is recommended that you use a different pharmaceutical form of nicotine replacement therapy. Ask your doctor or pharmacist for advice.

Other medicines and Nicotinell

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. If you stop smoking and if you are using other medicines, your doctor may want to adjust the dose.

No information is available on interactions between Nicotinell and other medicines. However, apart from nicotine, other substances in cigarettes may have an effect on certain medicine.

Stopping smoking can affect the action of certain medicines e.g.:

•    theophyllin (a medicine used for the treatment of bronchial asthma)

•    tacrine (medicine used to treat Alzheimer's disease)

•    olanzapine and clozapine (for the treatment of schizophrenia)

•    Insulin dose (medicine used for the treatment of diabetes) may need to be adjusted

Nicotinell with food and drink

Coffee, acidic drinks (e.g. fruit juice) and soft drinks may decrease the absorption of nicotine and should be avoided for 15 minutes before chewing Nicotinell.

Pregnancy and breast-feeding

It is very important to stop smoking during pregnancy because it can result in poor growth of your baby. It can also lead to premature births and even stillbirths. Ideally you should try to give up smoking without the use of medicines. If you cannot manage this, Nicotinell may be recommended to help as the risk to the developing baby is less than that expected from continued smoking. Nicotine in any form may cause harm to your unborn baby. Nicotinell should only be used after consulting the healthcare professional who is managing your pregnancy, or a doctor that is specialised in helping people quit smoking.

Nicotinell like smoking itself should be avoided during breast-feeding as nicotine may be found in breast milk. If your doctor has recommended that you should take this medicinal product, the medicated chewing-gum should be taken just after breast-feeding and not during the two hours before breast-feeding.

Driving and using machines

There is no evidence of risk associated with driving or operating machinery if Nicotinell is taken according to the recommended dose but remember that smoking cessation can cause behavioural changes.

Nicotinell contains sorbitol, butylhydroxyltoluene and sodium

Because Nicotinell Fruit contains sorbitol: if you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

The gum base contains butylhydroxytoluene (E321) which may cause local irritation to mucous membranes.

Each piece of Nicotinell Fruit 2 mg contains sweeteners, including sorbitol (E420) 0.2 g, a source of 0.04 g fructose. Calorific value 1.0 kcal/piece.

Nicotinell Fruit 2 mg contains 11.50 mg of sodium per piece. To be taken into consideration by patients on a controlled sodium diet.

3. How to take Nicotinell

Always take this medicine exactly as described in this package leaflet or as your doctor or pharmacist has told. Check with your doctor or pharmacist if you are not sure.

To improve your chances of giving up smoking you should stop smoking completely when you start to use Nicotinell and for the whole treatment duration.

Nicotinell is available in two strengths: 2 and 4 mg. The appropriate dose will depend on your previous smoking habits. You should use Nicotinell 4 mg if:

•    you are a smoker with a strong or very strong nicotine dependency,

•    you have previously failed to stop smoking with Nicotinell 2 mg,

•    your withdrawal symptoms remain so strong as to threaten relapse.

Otherwise Nicotinell 2 mg should be used.

Select your optimal dosage from the following table:

Low to moderate

Moderate to strong dependency

Strong to very strong

dependency

dependency

Low dosage forms acceptable

High dosage fo

ms acceptable

Less than 20 cigarettes / day

From 20 to 30 cigarettes / day

Over 30 cigarettes / day

Nicotinell 2 mg is preferable)

Low (Nicotinell 2 mg) or high (Nicotinell

Nicotinell 4 mg is

4 mg) dose forms depending on patient

preferable)

characteristics and preference.

If an adverse event occurs with the use of the high dose (Nicotinell 4 mg), use of the low dose (Nicotinell 2 mg) should be considered.

Instructions for use:

1.    Chew one piece of Nicotinell slowly until the taste becomes strong.

2.    Allow Nicotinell to rest between your gum and cheek.

3.    Chew again when taste has faded.

4.    Repeat this routine for about 30 minutes, to get a gradual release of nicotine.

Do not swallow.

The recommended dose for adults over 18 years and older people is:

Chew one piece of Nicotinell when you feel the urge to smoke. In general one piece should be chewed every one or two hours. Normally 8-12 pieces per day are sufficient. If you still experience an urge to smoke, you can chew additional pieces of Nicotinell. Do not exceed 25 pieces a day of Nicotinell 2 mg

The treatment duration is individual. Normally, treatment should continue for at least 3 months. After 3 months, you should gradually reduce the number of pieces of Nicotinell chewed each day. Treatment should be stopped when you have reduced your use of Nicotinell to 1-2 pieces per day. It is generally not recommended to use Nicotinell for longer than 6 months. However, some ex-smokers may need treatment with Nicotinell for longer to avoid returning to smoking.

If you are still using Nicotinell after 9 months, you should speak to your doctor or pharmacist. Counselling may improve your chances of giving up smoking.

Use in children and adolescents(< 18 yrs)

Nicotinell should not be used by people under 18 years of age without recommendation from a doctor.

If you take more Nicotinell than you should

Chewing too many Nicotinell pieces can result in the same symptoms as smoking too much. The general symptoms of nicotine overdose include weakness, sweating, increased production of saliva, dizziness, throat burn, nausea, vomiting, diarrhoea, pain in the abdomen, disturbance of hearing and vision, headache, fast or other disturbance in heart beat (tachycardia and cardiac arrhyhtmia), shortness of breath, prostration, circulatory problems, coma and terminal convulsions.

You should consult your doctor or pharmacist if you experience any problems.

If poisoning is suspected in a child, a doctor must be consulted immediately. Even small quantities of nicotine are dangerous in children and may result in severe symptoms or death.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Some effects you may notice in the first few days are dizziness, headache and sleep disturbances. These may be withdrawal symptoms in connection with smoking cessation and may be caused by insufficient administration of nicotine.

Common side effects (may affect up to 1 in 10 people)

•    dizziness and headache.

•    Hiccups, stomach trouble such as nausea, flatulence, vomiting, heartburn, increased saliva production, irritation of the mouth and throat and jaw muscle ache may also occur, especially as a result of intense chewing.

Slower chewing will usually overcome these problems.

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

•    palpitations.

•    red skin rash (erythema) and itching of raised bumps of the skin (urticaria). .

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

•    disturbances in heart beat rhythm and allergic reactions. These reactions may in very few cases be serious and include swelling of the skin, swelling of the face and mouth, low blood pressure and difficulty in breathing.

Mouth ulcers may be related to quitting smoking and not to your treatment.

Nicotinell can stick to and very rarely damage dentures or other dental work.

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

Reporting of side effects

If you get any side effects, talk to your pharmacist. 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 Nicotinell

Keep out of the sight and reach of children.

Do not use Nicotinell after the expiry date which is stated on the label after “EXP”. The expiry date refers to the last day of that month.

Do not store above 25°C.

Used Nicotinell should be disposed of with care.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6.    Contents of the pack and other information

What Nicotinell contains

The active substance is nicotine.

Each piece of Nicotinell medicated chewing-gum contains 2 mg of nicotine (as 10 mg nicotine-polacrilin).

The other ingredients are

• gum base (containing butylhydroxytoluene (E321)), calcium carbonate, sorbitol (E420), sodium carbonate anhydrous, sodium hydrogen carbonate, polacrilin, glycerol (E422), purified water, levomenthol, tutti flavour, saccharin, sodium saccharin, acesulfame potassium, xylitol (E967), mannitol (E421), gelatin, titanium dioxide (E171), carnauba wax and talc. See section 2 “Nicotinell contains sorbitol, butylhydroxytoluene and sodium”

What Nicotinell looks like and contents of the pack

Each piece of coated medicated chewing-gum is off-white in colour and rectangular in shape.

Nicotinell medicated chewing-gum is available in two strengths (2 and 4 mg) and four flavours (Fruit, Mint, Liquorice and Classic). This package leaflet deals with Nicotinell Fruit 2 mg medicated chewing-gums.

The blisters are packed in boxes containing 2, 12, 24, 36, 48, 60, 72, 96, 120 or 204 pieces of medicated chewing-gum. Not all pack sizes may be marketed.

Marketing Authorisation Holder

Novartis Consumer Health UK Ltd

Park View

Watchmoor Park

Camberley

Surrey

GU15 3YL

Manufacturer

FAMAR S.A., 48th km National Road Athens-Lamia, 19011, Avlonas, Attiki, Greece

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

AT

Nicotinell Fruit 2 mg - wirkstoffhaltige Kaugummis zur Raucherentwohnung

BE

Nicotinell Fruit, 2 mg, kauwgom

DK

Nicotinell Fruit, medicinsk tyggegummi

EE

Nicotinell Fruit

EL

Nicotinell Fruit

ES

Nicotinell fruit 2 mg chicle medicamentoso

FI

Nicotinell Fruit 2 mg laakepurukumi

FR

NICOTINELL FRUIT 2 mg SANS SUCRE, gomme a macher medicamenteuse

HU

Nicotinell Fruit 2 mg gyogyszeres ragogumi

IE

Nicotinell Fruit 2mg Medicated Chewing Gum.

LT

Nicotinell Fruit 2 mg vaistine kramtomoji guma

LU

Nicotinell Fruit, 2 mg, gomme a macher medicamenteuse

LV

Nicotinell Fruit 2 mg arstnieciska koslajama gumija

NL

Nicotinell Fruit, 2 mg, kauwgom

NO

Nicotinell medisinsk tyggegummi med fruktsmak

PT

Nicotinell Fruit 2 mg

SE

Nicotinell Fruit 2 mg medicinskt tuggummi

UK

Nicotinell Fruit 2mg Medicated Chewing Gum.

This leaflet was last approved on 05/05/2015.