Nicorette - instructions for use, reviews, analogs and forms of release (nicotine patch, chewing gum, inhalation solution in the inhaler, 2 mg tablets) drugs for smoking dependence in adults, children and pregnancy

In this article, you can read the instructions for using the drug Nicorette. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Nicorette in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Nicorette in the presence of existing structural analogues.Use for the treatment of nicotine addiction and quitting smoking in adults, children, as well as during pregnancy and lactation.

Nicorette - a remedy for the treatment of nicotine addiction. After a sharp quitting in patients who use tobacco products daily for a long time, a withdrawal syndrome may develop, which includes: dysphoria, insomnia, increased irritability, anxiety, impaired concentration, decreased heart rate, increased appetite, or weight gain. An important symptom of withdrawal syndrome is also the desire to smoke.

In the treatment of tobacco dependence, nicotine replacement therapy can reduce the need for smoking (and the number of cigarettes smoked), reduce the symptoms of withdrawal symptoms that occur with complete quitting in those who choose to quit smoking. It facilitates temporary abstinence from smoking and helps to reduce the number of smoked cigarettes for those who can not or do not want to completely quit smoking.

Composition

Nicotine + excipients.

Nicotine-polymer complex + auxiliary substances (chewing gum Nicorette).

Pharmacokinetics

The pharmacokinetics of nicotine is comparable when applying a patch on the skin of the hand or thigh. Quickly absorbed through the oral mucosa and detected in the blood after 5-7 minutes (using a chewing gum or solution for inhalation).

After applying a patch with nicotine on the skin of the hand or thigh, approximately 95% of the released nicotine enters the systemic circulation. The remainder evaporates around the edges of the patch. All patches indicate the average amount of nicotine, which is absorbed by the average patient for 16 hours.

The binding of nicotine to plasma proteins is less than 5%. In this regard, violations of the binding of nicotine with the simultaneous use of other drugs or changes in the amount of protein in the plasma for various diseases should not have a significant effect on the kinetics of nicotine. With repeated use of the patch, nicotine concentration does not significantly exceed that after its single application.

Nicotine is metabolized in the liver, kidneys and lungs. It is excreted mainly by the liver.

Indications

• treatment of tobacco dependence by reducing the need for nicotine;
• withdrawal of withdrawal symptoms arising from quitting in patients with appropriate motivation.

Forms of release

Transdermal therapeutic system (nicotine patch) 5 mg, 10 mg and 15 mg.

Chewing gum (chewing gum) Nicorette 2 mg and 4 mg with different flavors.

Solution for inhalation in cartridges for the inhaler 4 mg.

Tablets of sublingual 2 mg.

Instructions for use and how to use them

Patch

In adults (including those in the elderly) treatment begins with the use of 1 patch 15 mg / 16 h (30 cm2), which is applied to the intact skin every morning (immediately after awakening) and removed before bed.

The duration of the initial period of therapy is determined individually, and usually it is at least 3 months. Then, substitution therapy is gradually canceled. At the same time, one 10 mg / 16 h (20 cm2) patch is applied daily for 2-3 weeks, and 5 mg / 16 h (10 cm2) one patch for the next 2-3 weeks.

Applying patches for more than 6 months is usually not recommended.

In some cases, those who quit smoking may require longer-term therapy.

Where to paste a plaster?

Nicotine nicotine patch can be glued on the skin of the thigh or arm.

Chewing gum

Depending on the severity of addiction to smoking used chewing gum Nicorette with a different concentration of active substance.

If the patient smokes 20 or fewer cigarettes a day or smokes the first cigarette 30 minutes after waking, then chewing gum with nicotine content of 2 mg should be used.

If a patient smokes more than 20 cigarettes a day or fails to quit using a chewing gum with a nicotine content of 2 mg, then a chewing gum with a nicotine content of 4 mg is recommended.

Nicolette should be used in all cases when there is an irresistible desire to smoke. The gum should be chewed slowly until a sharp taste appears, then the chewing should be stopped and put the gum between the gum and the inside of the cheek. After the disappearance of the taste, chew should be resumed. For 1 reception should use only 1 chewing gum.

With complete cessation of smoking, the average daily dose is 8-12 gum, the maximum - 15 gum.It is necessary to continuously use the drug in the first 3 months after quitting. Then you should gradually reduce the amount of consumed gum. When the daily intake of the drug drops to 1-2 gum, its use should be discontinued.

With a reduction in the number of cigarettes smoked, chewing gum should be used between smoking episodes to extend the intervals between cigarette smoking in order to minimize cigarette consumption. The patient should be warned that if after 6 weeks of using the drug it was not possible to reduce the daily consumption of cigarettes, you should consult a specialist doctor.

The patient should try to stop smoking when he is ready for it, but no later than 6 months after the start of treatment. If within 9 months after the beginning of therapy to quit smoking failed, you should consult a specialist.

It is not recommended to use the chewing gum Nicoretta for more than 12 months. However, some patients may need longer treatment to prevent a return to smoking or not return to the previous level of tobacco use.

Chewing gum can be used in periods when it is necessary to temporarily give up smoking, for example, when staying in places where smoking is prohibited, or in other situations when it is necessary to refrain from smoking.

Consultations of a specialist and psychological support contribute to the effectiveness of therapy.

Solution for inhalation

A solution for inhalation should be used at a time when there is an irresistible desire to smoke. The dose is selected individually, taking into account the degree of severity of the patient's nicotine addiction. However, do not use more than 12 cartridges per day. This maximum daily dose can be used for 6-12 weeks, after which it should be reduced.

The more often an inhaler is used, the easier it is to quit smoking for a long time.

The recommended dose for adults (including elderly patients) is 6-12 cartridges per day - 1 cartridge replaces 4 cigarettes. If a patient smoked 20 cigarettes a day, then he should use 6 cartridges per day. Each cartridge can be used in approximately 4 receptions, each lasting about 20 minutes.

With a complete cessation of smoking, the course is conducted for at least 3 months. Then you should start to gradually reduce the number of used cartridges. It is recommended to have a few additional cartridges with you, because there may be an unexpected desire to smoke.

With a reduction in the number of cigarettes smoked, the inhaler should be used in breaks between smoking to increase their duration and to reduce the number of cigarettes smoked as much as possible. The patient should be warned that if after 6 weeks the number of cigarettes smoked per day is not decreased, you should consult a doctor.

As a rule, it is not recommended to use the inhaler for more than 6 months. Some patients who quit smoking require a longer use of the inhaler to prevent a return to smoking.

The patient should try to quit when he is ready for it, but no later than 6 months after the start of treatment. If within 9 months after the beginning of therapy to quit smoking failed, you should consult a specialist.

Consultations of a specialist and psychological support contribute to the effectiveness of therapy.

Side effect

• dizziness;
• headache;
• insomnia;
• can increase the incidence of aphthous stomatitis;
• moderately pronounced redness;
• itching;
• a feeling of palpitations;
• atrial fibrillation;
• nausea, vomiting;
• slight irritation of the throat and increased salivation (chewing gum);
• hives;
• itching in the first weeks of treatment;
• erythema.

Contraindications

• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

The question of the possibility of using the drug during pregnancy is decided individually.

Nicotine penetrates the placental barrier and affects the respiratory system and fetal circulation (depending on the dose). The risk to the fetus associated with the use of the drug in pregnancy is not fully understood. The benefits of nicotine replacement therapy for pregnant women who can not quit smoking significantly outweigh the risks associated with continuing smoking.

Nicotine (even when used in therapeutic doses) in small amounts is excreted in breast milk and can affect the newborn. If it is necessary to use the drug during lactation, breastfeeding should be stopped.

Use in children

The question of prescribing the drug to patients under the age of 18 is decided by the doctor individually. The experience of using a patch in this age group is limited.

special instructions

Patients with diabetes after smoking cessation may need to lower their insulin doses.

Drug Interactions

Smoking (but not the use of nicotine) causes an increase in the activity of the isoenzyme CYP1A2. After smoking cessation, the substrate clearance of this enzyme may decrease, which may lead to an increase in the concentration of certain drugs in the blood plasma, which has potential clinical significance while using drugs with a low therapeutic breadth (theophylline, tacrine, clozapine, ropinirole).

After cessation of smoking in the plasma, concentrations of other drugs that are partially metabolized by the CYP1A2 isoenzyme (such as imipramine, olanzapine, clomipramine, fluvoxamine) may increase, although evidence to support this is not available, and the possible clinical significance of this interaction is not known.

Limited evidence suggests that smoking can induce the metabolism of flecainide and pentazocine.

Analogues of the drug Nicorette

Structural analogs for the active substance:

• Niquitine;
• Nikvitin Mini;
• Nicotine USP;
• Nicotinell.

Analogues for the group of drugs for the treatment of nicotine dependence:

• Maurer's original balm;
• Bioline Stop Smokin;
• Bullfighting;
• Mebikara tablets;
• Mebiks;
• Polivit Geriatric;
• Polivit;
• Tabex;
• Three-V-Plus;
• Champix.

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