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Nicotinell Lozenge, 204 x 1mg

£9.9£99Clearance
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Signs and symptoms of an overdose from nicotine lozenge would be expected to be the same as those of acute nicotine poisoning, including: weakness, perspiration, pallor, hyperhidrosis, salivation, throat burn, nausea, vomiting, diarrhoea, abdominal pain, hearing and visual disturbances (sensory disturbance), headache, tachycardia and cardiac arrhythmia, dyspnoea, dizziness, tremor, confusional state and asthenia. Prostration, hypotension, circulatory collapse, coma, respiratory failure and terminal convulsions may ensue with large overdoses. Treatment should begin with one patch 21 mg/24 hours in combination with Nicotinell 1mg Lozenge. At least 4 pieces of lozenge (1 mg) per day should be used. In most cases, 5-6 lozenges are enough. Not more than 15 pieces of lozenge a day should be used. In normal cases, the treatment may last for 6-12 weeks. Thereafter, the nicotine dose is reduced gradually.

Excessive consumption of lozenges by subjects who have not been in the habit of inhaling tobacco smoke, could possibly lead to nausea, faintness and headache. If an adverse event occurs with the use of the high dose form (2 mg lozenge), use of the low dose form (1 mg lozenge) should be considered. Seizures: potential risks and benefits of nicotine should be carefully evaluated before use in subjects taking anti-convulsant therapy or with a history of epilepsy as cases of convulsions have been reported in association with nicotine. The absorbed amount of nicotine depends on the amount released into the mouth and absorbed through the buccal mucosa.Diabetes mellitus: blood glucose levels may be more variable during smoking cessation, with or without nicotine replacement therapy. So, it is important for diabetics to closely monitor their blood glucose levels while using this product. The following undesirable effects detailed in Table 1 are nicotine-related adverse events for all oral dosage forms. Nicotinell Lozenge can cause adverse reactions similar to those associated with nicotine administered by smoking. These can be attributed to the pharmacological effects of nicotine, which are dose-dependent. Non dose-dependent adverse reactions are as follows: hypersensitivity, angioneurotic oedema and anaphylactic reactions. Use with caution in patients with moderate to severe renal impairment and/or moderate to severe hepatic impairment as the clearance of nicotine or its metabolites maybe decreased with the potential for increased adverse effects. People who have failed when treated with only Nicotinell Lozenge can use Nicotinell Patches together with Nicotinell 1 mg Lozenge.

Danger in small children: doses of nicotine that are tolerated by adult smokers during treatment may produce severe symptoms of poisoning in small children and may prove fatal (please see Section 4.9). Each Nicotinell Mint 1 mg Lozenge contains 10 mg aspartame (E951), a source of phenylalanine equivalent to 5 mg/dose and may be harmful for people with phenylketonuria. Certain symptoms which have been reported such as dizziness, headache and insomnia may be ascribed to withdrawal symptoms in connection with smoking cessation and may be due to insufficient administration of nicotine. The use of Nicotinell Patches together with Nicotinell 1 mg Lozenge is recommended for smokers with moderate to very strong dependency, i.e. over 20 cigarettes per day. It is strongly recommended that the combination therapy is used in conjunction with the advice and support from a health care professional.Alternative 1: Use of the patches of a lower strength, i.e. 14 mg/24 hours patches for 3-6 weeks followed by 7 mg/24 hours for another 3-6 weeks together with the initial dose of Nicotinell 1 mg Lozenge. Thereafter, the number of lozenges is reduced gradually. It is generally not recommended to use Nicotinell Mint Lozenge for longer than 6 months. However, some ex-smokers may need treatment for longer to avoid returning to smoking but it should not be more than9 months. For undesirable effects for the Nicotinell Patch, see the Summary of Product Characteristics for the specific product. More than 20 metabolites have been identified, all believed to be less active than nicotine. The main metabolite is cotinine which has a half-life of 15-20 hours and with approximately 10 times higher plasma concentration than nicotine. Nicotine's plasma-protein binding is less than 5%. Changes in nicotine binding from the use of concomitant medicinal products or due to altered disease state are not expected to have significant effect on nicotine kinetics. The main metabolite in urine is cotinine (15% of the dose) and trans-3-hydroxy cotinine (45% of the dose). Nicotinell Lozenges should be used with caution in patients with: hypertension, stable angina pectoris, cerebrovascular disease, occlusive peripheral arterial disease, heart failure, hyperthyroidism or pheochromocytoma. Women who are pregnant should first be advised to stop smoking without the assistance of nicotine replacement therapy. If this fails, the use of nicotine replacement therapy should only be used after advice from a health care professional.

Nicotinell Mint 1 mg Lozenge is recommended in smokers with a low to moderate nicotine dependency. It is not recommended in the case of smokers with a strong or very strong nicotine dependency. Smoking during pregnancy is associated with risks such as intra-uterine growth retardation, premature birth or stillbirth. Stopping smoking is the single most effective intervention for improving the health of both the pregnant smoker and her baby. The earlier abstinence is achieved the better. Nicotine passes to the foetus and affects its breathing movements and circulation. The effect on the circulation is dose-dependent.Initially, 1 lozenge should be taken every 1-2 hours. The usual dosage is 8-12 lozenges per day. For smoking cessation and smoking reduction with Nicotinell Lozenge, the maximum daily dose is 24 lozenges. Do not use more than one lozenge per hour. Distribution volume after intravenous administration of nicotine is approximately 2-3 1/kg and the half-life is 2 hours. Nicotine is metabolised principally in the liver and the plasma clearance is approximately 1.2 l/min; nicotine also metabolises in the kidney and lungs. Nicotine crosses the blood-brain barrier. This medicinal product contains less than 1 mmol (23 mg) per lozenge, that is to say essentially 'sodium-free'. Even small quantities of nicotine are dangerous in children, and may result in severe symptoms of poisoning which may prove fatal. If poisoning is suspected in a child, a doctor must be consulted immediately. Increased subcutaneous absorption of insulin which occurs upon smoking cessation may necessitate a reduction in insulin dose.

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