Nicorette Chewing Gum Fresh Mint, 2 mg 30pcs

Pharmacodynamics:

After abrupt smoking cessation in patients who have used tobacco-containing products daily for a long time, withdrawal syndrome may develop, which includes: dysphoria, insomnia, increased irritability, anxiety, impaired concentration, reduced heart rate, increased appetite or weight gain. An important symptom of withdrawal syndrome is also a desire to smoke.

In the treatment of tobacco addiction nicotine replacement therapy reduces the number of cigarettes smoked, reduces the severity of withdrawal symptoms arising from complete cessation of smoking in those who decided to quit smoking; facilitates temporary abstinence from smoking and also helps to reduce the number of cigarettes smoked by those who can not or do not want to give up smoking completely.

Pharmacokinetics:

Nicotine from chewing gum is quickly absorbed through the mucous membrane of the cheek and detected in the blood in 5-7 minutes. The maximum concentration of nicotine is reached after 30 minutes after the beginning of chewing.

The distribution volume of nicotine during intravenous administration is about 2-3 liters/kg, and the half-life is about 2 hours. Nicotine is mainly excreted by the liver, its average plasma clearance is about 70 l/h. Nicotine is also metabolized in the kidneys and lungs. More than 20 nicotine metabolites have been identified that are inferior to it in activity.

The binding of nicotine to plasma proteins is less than 5%.
Primary metabolite of nicotine in plasma – cotinine – has a half-life of 15-20 hours, and its concentration is 10 times higher than that of nicotine.

Urinary excretion is primarily cotinine (15% of the dose) and trans-3-hydroxy-cotinine (45% of the dose). Between 10% and 30% of the dose of nicotine is excreted unchanged in the urine.

Progressive deterioration of renal function is accompanied by a decrease in total clearance of nicotine. Its pharmacokinetics does not change in cirrhotic patients with mild impairment of liver function (Child-Pugh index 5) and decreases in cirrhotic patients with moderate impairment of liver function (Child-Pugh index 7). Smokers treated with hemodialysis have increased plasma nicotine concentrations.

Elderly patients have a slight decrease in total nicotine clearance, which does not require dose adjustment.

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