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NICOTINELL FRUIT 4MG MEDICATED CHEWING GUM

Active substance: NICOTINE

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155mm

PACKAGE LEAFLET: INFORMATION FOR THE USER

NICOTINE

FRUIT 4 mg
MINT 4 mg

Medicated chewing-gums

Read all of this leaflet carefully because it
contains important information for you.
This medicine is available without prescription.
However, you still need to use Nicotinell chewinggum carefully to get the best results from it.
• Keep this leaflet. You may need to read it again.
• Ask your doctor, nurse or pharmacist if you need
more information or advice.
• If any of the side effects gets serious, or if you
notice any side effect not listed in this leaflet,
please tell your doctor or pharmacist.
In this leaflet:
1. What Nicotinell chewing-gum is and what it is
used for
2. Before you take Nicotinell chewing-gum
3. How to take Nicotinell chewing-gum
4. Possible side effects
5. How to store Nicotinell chewing-gum
6. Further information

385mm

1 What Nicotinell chewing-gum is and what it
is used for
Nicotinell medicated chewing-gum is a nicotine
replacement therapy (NRT) which is used to help you
to stop smoking. It is available in two strengths (2 mg
and 4 mg) and five flavours (Fruit, Mint, Icemint,
Liquorice and Classic). This leaflet is for Nicotinell
Fruit and Mint, 4 mg medicated chewing-gums.
The chewing-gum contains nicotine, which is one of
the substances in tobacco. When chewed, nicotine
is released slowly and absorbed through the lining
of the mouth. Nicotinell chewing-gum does not
contain the other harmful substances found in
tobacco smoke such as tar and carbon monoxide.
Nicotinell 4mg gum can be used to help you:
• stop smoking completely
• cut down the amount you smoke - perhaps
before you go on to stop completely.
In addition, they may be used when you:
• do not wish to smoke. For example in confined
spaces (in the car: in the house) or where others
(such as children) could be harmed by tobacco
smoke
• are unable to smoke
• develop cravings once you have stopped smoking.
Reducing the number of cigarettes smoked can
increase the chances that you will move on to quit
completely.
Nicotinell 4 mg gum is for smokers smoking more than
30 cigarettes per day. It can also be used by smokers
smoking between 20 and 30 cigarettes per day, and by
those who have previously failed to stop smoking with
the aid of nicotine replacement therapy.
If you smoke less than 20 cigarettes per day then you
should use Nicotinell 2 mg medicated chewing-gum.
Smokers of more than 20 cigarettes per day, who are
reducing their smoking prior to a quit attempt, should
use the lower strength Nicotinell 2mg gums once they
have successfully reduced the number of cigarettes
smoked per day.
Nicotinell 2mg and 4mg gums can also be used to
relieve breakthrough cravings of smokers attempting to
quit by following a patch programme.
You might feel a sudden craving to smoke long after
you have given up smoking and stopped using
Nicotinell gums.Remember you can use any nicotine
replacement therapy again if this should happen.
If you need advice before starting to use Nicotinell
gum, talk to your doctor, nurse, pharmacist or
trained counsellor.
To help quit smoking you should also try to use a
behavioural support programme to increase your
chances of success. Talk to your doctor, nurse,
pharmacist or a trained counsellor about this.
2 Before you take Nicotinell chewing-gum
Do NOT take Nicotinell chewing-gum if you are
• allergic (hypersensitive) to nicotine or any of the
other ingredients of the chewing-gum
• a non-smoker or occasional smoker

• under 12 years of age, except on the advice of
a doctor.
Take special care with Nicotinell chewing-gum
Please speak with your doctor, nurse or pharmacist
before taking the chewing-gum if you:
• have heart disease, (e.g. heart attack, worsening
chest pain, disorders of the hart rate and/or rhythm)
• have uncontrolled high blood pressure
• have recently had a stroke
• have serious liver or kidney disease
• have or had a stomach ulcer
• have persistent indigestion
• have a severe sore throat or inflammation of
the mouth
• are diabetic (see next section)
• have an overactive thyroid gland
• have a tumour of the adrenal glands
(pheochromocytoma)
• are fructose intolerant
• are on a low-sodium diet
• are taking any other medicines (see next
section)
• are pregnant or breast-feeding (see
Pregnancy/Breast-feeding sections).
People having problems with the jawbone and
some denture wearers may experience difficulty in
chewing the gum. If you do, it is recommended
that you use a different form of nicotine replacement
therapy, such as a patch or lozenge. Ask your
doctor or pharmacist for advice.
Using nicotine replacement therapy is better than
continuing to smoke.
Taking other medicines
Please tell your doctor or pharmacist if you are
taking or have recently taken any other medicines,
including medicines obtained without a
prescription.
The effect of some medicines can be altered when
you stop smoking.
• If you are already taking regular medication
you should tell your doctor, nurse or pharmacist.
• Diabetics should monitor their blood sugar
levels more often than usual when taking
chewing gum because your insulin/medication
requirements may alter.
Taking Nicotinell chewing-gum with food and
drink
Coffee, juices, acidic and fizzy drinks may reduce
the absorption of nicotine and should not be taken
for 15 minutes before chewing the gum.
Pregnancy
Smoking during pregnancy is associated with risks
such as poor growth of the baby before birth,
premature birth or still birth. Stopping smoking is
the single most effective way to improve both your
health and that of your baby. The earlier smoking
stops, the better.
Ideally, stopping smoking during pregnancy should
be done without nicotine replacement therapy.
However, if you have tried and this is not possible,
nicotine replacement therapy may be used
because the risk to the developing baby is less
than that expected from continued smoking.
The decision to use nicotine replacement therapy
should be made as early on in the pregnancy as
possible with the aim of discontinuing use after
2-3 months.
Ask your doctor for advice before taking any
medicine.
Breast-feeding
It is better to use nicotine replacement therapy
products that can be taken intermittently (not
patches). Try to breast-feed at a time just before
you take the product to ensure that the baby gets
the smallest amount of nicotine possible.
If you need to use nicotine replacement therapy to
help you give up smoking, the amount of nicotine
that the baby may receive is considerably smaller
and less harmful than the second-hand smoke they
would otherwise be breathing in.

Driving and using machines
The chewing gum is unlikely to affect your ability
to drive or operate machinery.

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• under 12 years of age, except on the advice of
a doctor.
Take special care with Nicotinell chewing-gum
Please speak with your doctor, nurse or pharmacist
before taking the chewing-gum if you:
• have heart disease, (e.g. heart attack, worsening
chest pain, disorders of the hart rate and/or rhythm)
• have uncontrolled high blood pressure
• have recently had a stroke
• have serious liver or kidney disease
• have or had a stomach ulcer
• have persistent indigestion
• have a severe sore throat or inflammation of
the mouth
• are diabetic (see next section)
• have an overactive thyroid gland
• have a tumour of the adrenal glands
(pheochromocytoma)
• are fructose intolerant
• are on a low-sodium diet
• are taking any other medicines (see next
section)
• are pregnant or breast-feeding (see
Pregnancy/Breast-feeding sections).
People having problems with the jawbone and
some denture wearers may experience difficulty in
chewing the gum. If you do, it is recommended
that you use a different form of nicotine replacement
therapy, such as a patch or lozenge. Ask your
doctor or pharmacist for advice.
Using nicotine replacement therapy is better than
continuing to smoke.
Taking other medicines
Please tell your doctor or pharmacist if you are
taking or have recently taken any other medicines,
including medicines obtained without a
prescription.
The effect of some medicines can be altered when
you stop smoking.
• If you are already taking regular medication
you should tell your doctor, nurse or pharmacist.
• Diabetics should monitor their blood sugar
levels more often than usual when taking
chewing gum because your insulin/medication
requirements may alter.
Taking Nicotinell chewing-gum with food and
drink
Coffee, juices, acidic and fizzy drinks may reduce
the absorption of nicotine and should not be taken
for 15 minutes before chewing the gum.
Pregnancy
Smoking during pregnancy is associated with risks
such as poor growth of the baby before birth,
premature birth or still birth. Stopping smoking is
the single most effective way to improve both your
health and that of your baby. The earlier smoking
stops, the better.
Ideally, stopping smoking during pregnancy should
be done without nicotine replacement therapy.
However, if you have tried and this is not possible,
nicotine replacement therapy may be used
because the risk to the developing baby is less
than that expected from continued smoking.
The decision to use nicotine replacement therapy
should be made as early on in the pregnancy as
possible with the aim of discontinuing use after
2-3 months.
Ask your doctor for advice before taking any
medicine.
Breast-feeding
It is better to use nicotine replacement therapy
products that can be taken intermittently (not
patches). Try to breast-feed at a time just before
you take the product to ensure that the baby gets
the smallest amount of nicotine possible.
If you need to use nicotine replacement therapy to
help you give up smoking, the amount of nicotine
that the baby may receive is considerably smaller
and less harmful than the second-hand smoke they
would otherwise be breathing in.

Important information about some of the
ingredients of Nicotinell Medicated chewing gum
These chewing-gums contain some ingredients of
which you may need to be aware of:
• sorbitol: if you have been told by your doctor
that you have an intolerance to some sugars,
contact your doctor before taking this medicine.
Each piece of fruit and mint flavour gum
contains 0.2g, a source of 0.04 g fructose.
Each piece of Ice mint flavour gum contains
0.1g, a source of 0.02 g fructose.
• sodium: Each piece of fruit and mint flavour
gum contains 11.5 mg per piece. Each piece of
Icemint flavour gum contains 11.45 mg per
piece.To be taken into consideration by those
on a controlled sodium diet
• butylhydroxytoluene (E321): an ingredient of
the gum base which may cause local irritation
to the lining of the mouth.
For other ingredients see Section 6.
3 How to take Nicotinell chewing-gum
Chew one piece of gum when you feel the urge to
smoke. It is important to chew the gum correctly,
not like ordinary chewing-gum. Follow the
instructions below and do NOT swallow the gum:
Chewing technique:
1. Chew one piece of gum slowly until the taste
becomes strong.
2. Rest between your gum and cheek.
3. Chew again when taste has faded.
4. Repeat this chewing routine for about 30 minutes.
Most people use 8 – 12 pieces of 4 mg gum a day.
Do NOT use more than 1 piece of gum at a time
or more than 15 pieces of 4 mg gum a day.
Remember not to drink certain drinks 15 minutes
before chewing the gum (see Section 2).
The gum can stick to and very rarely damage
dentures or other dental work. You may prefer to
use a patch or lozenge.
After 3 months, you should gradually reduce the
number of pieces of gum chewed each day. You
should stop using the gum when you are only
taking 1-2 pieces of gum per day.
For the relief of breakthrough cravings:
If you are attempting to quit smoking using a
patch programme, you can use these gums to
relieve any breakthrough cravings you may
experience. Chew one piece of gum if you feel the
need to smoke.
Counselling may improve your chances of giving
up smoking.
Children and adolescents (12 -18 years) should
only use the gum for 12 weeks. If longer is
required then talk to your doctor, nurse or
pharmacist.
Children under 12 years should not use the gum
unless advised by a doctor.
If you take more Nicotinell chewing-gums than
you should
If you accidentally take too many, or if a child has
eaten any, contact your doctor or nearest hospital
casualty department immediately, take the pack
or leaflet with you if possible. Nicotine ingestion
by a child may result in severe poisoning.
The general symptoms of nicotine overdose include:
• weakness, sweating, increased production of
saliva, throat burn, headache, sickness,
diarrhoea stomach pains, disturbed hearing and
vision, disturbance in heartbeat, shortness of
breath and circulatory problems
If you forget to use Nicotinell chewing-gums
Only chew the gum when you need to. Do NOT
use more than 1 piece of gum at a time or more
than 15 pieces of 4 mg gum a day.
If you have any further questions on the use of this
product, ask your doctor or pharmacist.
4 Possible side effects
Like all medicines, Nicotinell chewing-gums can
cause side effects, although not everybody gets them.
STOP using the gum and seek medical help
immediately if you have any of the following
which may be signs of an allergic reaction:
• difficulty breathing or swallowing, swelling of
the mouth, face, lips, tongue or throat.
• severe itching of the skin, with a red rash or
raised lumps.

Some side 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 (occur in 1 to 10 users in 100)
• 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. Check that you are
following the correct chewing technique if you
experience these effects.
Uncommon side effects (occur in 1 to 10 users in
1,000)
• palpitations.
• red skin rash (erythema) and itching of raised
bumps of the skin (urticaria).
Rare side effects (occur in 1 to 10 users in 10,000)
• disturbances in heart beat rhythm and allergic
reactions.
Mouth ulcers may be related to quitting smoking
and not to your treatment.
The chewing-gum 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.
Also you can help to make sure that medicines
remain as safe as possible by reporting any
unwanted side effects via the internet at
www.mhra.gov.uk/yellowcard. Alternatively you
can call Freephone 0808 100 3352 (available from
10 a.m. to 2 p.m. Mondays to Fridays) or fill in a
paper form available from your local pharmacy.
5 How to store Nicotinell chewing-gum
Keep out of the reach and sight of children.
Do not use Nicotinell gums after the expiry date
which is stated on the blister pack and box after
“EXP”. The expiry date refers to the last day of that
month.
Do not store above 25°C.
To dispose of used gum, wrap in paper before
putting into a waste bin. Ask your pharmacist how
to dispose of medicines no longer required. These
measures will help to protect the environment.
6 Further information
What Nicotinell chewing-gum contains
The active substance is nicotine.
Each piece of Nicotinell medicated chewing-gum
contains 4 mg of nicotine in a resin complex (as
20 mg nicotine polacrilin).
The other ingredients of Nicotinell Fruit and Mint
flavoured gums are
• gum base, calcium carbonate (E170), sorbitol
(E420), sodium carbonate anhydrous, sodium
hydrogen carbonate (E500), glycerol (E422),
levomenthol, butylhydroxytoluene (E321),
saccharin, saccharin sodium (E954), acesulfame
potassium (E950), xylitol (E967), mannitol (E421),
gelatin, titanium dioxide (E171), carnauba wax
(E903), talc (E553b), water.
(see also Section 2 for further ingredient information).
What Nicotinell chewing-gum looks like and
contents of the pack
Each piece of chewing-gum is off-white in colour
and rectangular in shape.
The Fruit and Mint 4 mg Gums are packed in
blisters inside boxes containing 12, 24, 36, 72, 96,
120 and 204 pieces of gum. Not all pack sizes may
be marketed.
Marketing Authorisation Holder
Novartis Consumer Health, Camberley, GU15 3YL, UK.
Marketing Authorisation Holder
FAMAR S.A., 48th km Athens-Lamia, 19011, Avlona,
Greece.
Help/Advice
You can also find additional information and support
@ www.smokefree.nhs.uk or by calling the NHS
helpline on 0800 0224322.
This leaflet was last approved June 2013.

GB_307825
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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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