Nicorette Peppermint, 4 mg 20 pcs.

Treatment of tobacco addiction and relief of symptoms arising from smoking cessation.

Composition

1 tablet of nicotine resinate 21 mg, which corresponds to the nicotine content of 4 mg

Excipients: mannitol – 538.5 mg, xanthan gum – 12 mg, Winterfresh RDE4-149 flavoring – 8 mg, sodium carbonate – 7 mg, sucralose – 1 mg, acesulfame K – 0 mg.

Tablet shell: Hypromellose – 16.8 mg, Winterfresh RDE4-149 flavoring – 2.5 mg, titanium dioxide – 2.5 mg, sucralose – 2.1 mg, acesulfame potassium – 1 mg, polysorbate-80 – 0.1 mg, polishing agent Sepifilm Gloss – 1 mg.

How to take, the dosage

Set individually, depending on the degree of dependence on tobacco and the drug form used.

Interaction

Smoking (but not nicotine) causes increased activity of CYP1A2 enzyme. After smoking cessation, a decrease in clearance of substrates of this enzyme may be observed. This may lead to increased plasma levels of some drugs, which has potential clinical significance in the use of drugs characterized by low therapeutic latency, such as theophylline, tacrine, clozapine and ropinirole.

Plasma concentrations of other active substances metabolized with cytochrome CYT1A2 (such as caffeine, paracetamol, phenazone, phenylbutazone, pentazocine, lidocaine, benzodiazepines, warfarin, estrogens, vitamin B12) may also increase.

Smoking may decrease the analgesic effect of propoxyphene, decrease the diuretic effect of furosemide, weaken the effects of propranololol on BP and HR, and lead to delayed ulcer scarring with H2-antagonists.

Cortisol and catecholamine blood levels may increase under the influence of smoking and nicotine administration, i.e.i.e., this may lead to a reduction in the effect of nifedipine or adrenergic receptor antagonists and an increase in the effect of adrenoreceptor agonists.

As a result of increased subcutaneous insulin absorption that occurs after smoking cessation, patients may need to reduce the insulin dose.

Special Instructions

Patients with diabetes mellitus after stopping smoking and since the start of nicotine replacement therapy are recommended to monitor blood glucose concentration more carefully, since a decrease in catecholamines, the release of which is induced by nicotine, may affect carbohydrate metabolism. Patients with diabetes may need to reduce their insulin doses after stopping smoking.

Polycyclic aromatic hydrocarbons in tobacco smoke induce the metabolism of drugs metabolized by the CYP1A2 isoenzyme (and possibly CYP1A1). Smoking cessation may cause slower metabolism and, consequently, increased blood concentrations of these drugs. This has potential clinical implications for drugs with a narrow therapeutic index – such as theophylline, tacrine, clozapine, and ropinirole.

Nicotine is used in experimental pharmacology to analyze the effects of substances. Due to the widespread use of tobacco smoking, nicotine is of considerable interest in toxicological terms. In medical practice, its use is limited to use to facilitate smoking cessation.

Contraindications

Hypersensitivity to nicotine; severe arrhythmia, arterial hypertension, unstable angina, myocardial infarction and cerebral circulation disorders (recently suffered); pregnancy and breast-feeding – depending on the dosage form; children and adolescents under 18 years – depending on the dosage form.

With caution: patients who have undergone bypass surgery or angioplasty within the last month; patients with moderate or severe liver function abnormalities, severe renal failure; exacerbation of esophagitis, duodenal and gastric ulcers; with inflammatory diseases of the mouth or throat; patients with diseases of cerebral vessels.

Nicotine, entering the body during substitution therapy or smoking, causes release of catecholamines from the cerebral adrenal layer. Therefore, this drug should be used with caution in patients with uncontrolled hyperthyroidism, pheochromocytoma, diabetes mellitus.