Nicotine (Systemic)

Brand name(s): Commit

Proper Use of This Medicine

For patients using the chewing gum:

• Nicotine gum usually comes with patient directions. Read the directions carefully before using this medicine.
• Use nicotine gum exactly as directed on the label . Remember that it is also important to participate in a stop-smoking program during treatment. This may make it easier for you to stop smoking.
• When you feel the urge to smoke, chew one piece of gum very slowly until you taste it or feel a slight tingling in your mouth. Stop chewing, and place ("park") the chewing gum between your cheek and gum until the taste or tingling is almost gone. Then chew slowly until you taste it again. Continue chewing and stopping ("parking") in this way for about 30 minutes in order to get the full dose of nicotine.
• Do not chew too fast, do not chew more than one piece at a time, and do not chew more than one piece of gum within an hour. To do so may cause unpleasant side effects or an overdose. Also, slower chewing will reduce the possibility of belching.
• You should not drink acidic beverages, such as citrus fruit juices, coffee, soft drinks, or tea within 15 minutes before or while chewing a piece of gum. The acid will prevent the nicotine from being released from the gum.
• As your urge to smoke becomes less frequent, gradually reduce the number of pieces of gum you chew each day until you are chewing three to six pieces a day. This may be possible within 2 to 3 months.
• Remember to carry nicotine gum with you at all times in case you feel the sudden urge to smoke. One cigarette may be enough to start you on the smoking habit again.
• Using hard sugarless candy between doses of gum may help to relieve any nicotine cravings you may have between doses of gum.

For patients using the lozenge:

• Nicotine lozenges usually come with patient directions. Read the directions carefully before using this medicine.
• Use nicotine lozenges exactly as directed on the label. Remember that it is also important to participate in a stop-smoking program during treatment. This may make it easier for you to stop smoking.
• Do not eat or drink for 15 minutes before using a nicotine lozenge.
• When you feel the urge to smoke, suck one lozenge slowly until it dissolves.Do not bite or chew the lozenge like a hard candy. Do not swallow the lozenge.
• As your urge to smoke becomes less frequent, gradually reduce the number of lozenges you use each day until you are using three to six lozenges a day. This should be possible within 12 weeks.
• Remember to carry nicotine lozenges with you at all times in case you feel the sudden urge to smoke. One cigarette may be enough to start you on the smoking habit again.

For patients using the transdermal system (skin patch) :

• Nicotine patches usually come with patient instructions. Read them carefully before using this medicine. Nicotine patches will work only if applied correctly.
• Remember that it is also important to participate in a stop-smoking program during treatment. This may make it easier for you to stop smoking.
• Do not remove the patch from its sealed pouch until you are ready to put it on your skin. The patch may not work as well if it is unwrapped too soon.
• Do not try to trim or cut the adhesive patch to adjust the dosage. Check with your healthcare professional if you think the medicine is not working as it should.
• Apply the patch to a clean, dry area of skin on your upper arm, chest, or back. Choose an area that is not very oily, has little or no hair, and is free of scars, cuts, burns, or any other skin irritations.
• Press the patch firmly in place with the palm of your hand for about 10 seconds. Make sure there is good contact with your skin, especially around the edges of the patch.
• The patch should stay in place even when you are showering, bathing, or swimming. Apply a new patch if one falls off.
• Rinse your hands with plain water after you have finished applying the patch to your skin. Nicotine on your hands could get into your eyes and nose and cause stinging, redness, or more serious problems. Using soap to wash your hands will increase the amount of nicotine that passes through your skin.
• After 16 or 24 hours, depending on which product you are using, remove the patch. Choose a different place on your skin to apply the next patch. Do not put a new patch in the same place for at least 1 week. Do not leave the patch on for more than 24 hours. It will not work as well after that time and it may irritate your skin.
• After removing a used patch, fold the patch in half with the sticky sides together. Place the folded, used patch in its protective pouch or in aluminum foil. Make sure to dispose of it out of the reach of children and pets.
• Try to change the patch at the same time each day. If you want to change the time when you put on your patch, just remove the patch you are wearing and put on a new patch. After that, apply a fresh patch at the new time each day.
• Nicotine patches should be removed from the skin during strenuous exercise. If a patch is left on, too much nicotine may pass through your skin into your blood stream.
• If you are using a 24-hour patch and begin having unusual dreams or disturbed sleep, you may take the patch off before going to bed and put a new one on after you wake up the next morning.

Dosing-

The dose of nicotine will be different for different patients. Follow your healthcare professional's orders or the directions on the label. The following information includes only the average doses of nicotine. If your dose is different, do not change it unless your healthcare professional tells you to do so.

• For the oral dosage form (chewing gum):
  • To help you stop smoking:
    • Adults and teenagers-The usual dose is one piece of chewing gum every one to two hours for six weeks, one piece of chewing gum every two to four hours for three weeks, then one piece of chewing gum every four to eight hours for three weeks. You should not chew more than 24 pieces of gum a day.
    • Children-Use and dose must be determined by your healthcare professional.
• For the oral dosage form (lozenge):
  • To help you stop smoking:
    • Adults and teenagers-The usual dose is suck slowly one lozenge until it dissolves every one to two hours for six weeks, suck one lozenge every two to four hours for three weeks, then suck one lozenge every four to eight hours for three weeks. You should not use more than 20 lozenges a day.
    • Children-Use and dose must be determined by your healthcare professional.
• For the transdermal (stick-on) skin patch:
  • To help you stop smoking:
    • Adults and teenagers-The dose you receive will be based on your body weight, how often you have the urge to smoke, and the brand and strength of the patch you use. This dose will be provided on the package label.
    • Children-Use and dose must be determined by your healthcare professional.

Storage-

To store this medicine:

• Keep out of the reach of children because even small doses of nicotine can cause serious harm in children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children and pets.

Last Revised: 04/21/2003

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