Document: Nicotinell Peppermint medicated chewing gum ENG PL change

• Nicotinell Peppermint medicated chewing-gum PL
• Nicotinell Peppermint medicated chewing gum ENG PL

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Package leaflet: Information for the user

Nicotinell Peppermint 2 mg medicated chewing-gum

Nicotinell Peppermint 4 mg medicated chewing-gum

nicotine

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

This medicine is available without prescription. However, you still need to use Nicotinell Peppermint medicated chewing-gum carefully to get the best results from it.

Always take this medicine exactly as described in this leaflet or as your pharmacist has told you.

• Keep this leaflet. You may need to read it again.

• Ask your doctor or pharmacist if you need more information or advice.

• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

1What Nicotinell Peppermint chewing-gumis and what it is used for

Nicotinell belongs to a group of medicines which are used to help you stop smoking.

Nicotinell Peppermint chewing-gum contains nicotine. When chewed, nicotine is released slowly and absorbed through the lining of the mouth. This medicinal product is used to relieve nicotine craving and withdrawal symptoms in nicotine dependency. It thereby
- counteracts the relapse in smoking in smokers who are motivated to stop or
- facilitate smoking reduction in smokers who cannot or are reluctant to stop.

2What you need to know before you take Nicotinell Peppermint chewing-gum

Do not take Nicotinell Peppermint

• if you are allergic (hypersensitive) to any of the ingredients of this medicine (listed in section 6).

• if you are a non-smoker.

Warnings and precautions

Talk to your doctor before using Nicotinell Peppermint if you have:

• recently had a heart attack or stroke,

• any heart disease,

• high blood pressure,

• diabetes,

• overactive thyroid glands,

• overactive adrenal glands (pheochromocytoma),

• impaired kidney and/or liver function,

• peptic ulcer

In these conditions it is not sure that it is suitable for you to use Nicotinell Peppermint.

People having problems with the joint of the jawbone and denture wearers may experience difficulty in chewing the gum. If you do, it is recommended that you use a different pharmaceutical form of nicotine replacement therapy.

Do not smoke while taking Nicotinell Peppermint, since you may obtain so high a concentration of nicotine that you will feel bad.

Children and adolescents

The correct dose for adults could seriously poison or be fatal to small children. It is therefore essential that you keep Nicotinell Peppermint out of reach and sight of children at all times.

Other medicines and Nicotinell Peppermint chewing-gum

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

No information is available on interactions between Nicotinell Peppermint chewing-gum and other medicines. However, the action of some drugs may be affected if you stop smoking. This is particularly important if you use drugs containing

• theophyllin (a medicine used for the treatment of bronchial asthma) ,

• tacrine (a medicine used to treat Alzheimer's disease),

• olanzapine and clozapine(for the treatment of schizophrenia).

Nicotinell Peppermint with food and drink

Coffee, acidic and soft drinks may decrease the absorption of nicotine and should be avoided for 15 minutes before chewing a Nicotinell Peppermint chewing gum.

Pregnancy and breast-feeding

Nicotine may affect your unborn baby. Nicotinell Peppermint should only be usedduring pregnancy after prescription by a doctor.

Nicotine is transferred to breast milk and there is a risk that the breast-fed child will be affected. Nicotinell Peppermint should only be usedduring breast-feeding after prescription by a doctor.

Driving and using machines

There is no evidence of risk associated with driving or operating machinery if Nicotinell Peppermint chewing-gum is taken according to the recommended dose but remember that smoking cessation can cause behavioral changes.

Nicotinell Peppermint chewing-gum contains sorbitol, butylhydroxytoluene and sodium

Because Nicotinell Peppermint chewing gum contains sorbitol: if you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking Nicotinell Peppermint chewing gum.

Each piece of chewing gum contains 0.1 g sorbitol, a source of 0.02 g fructose. Calorific value 1.2 kcal/piece of chewing-gum.

The gum contains butylhydroxytoluene (E321) which may cause local irritation to mucous membranes in the mouth.

Nicotinell Peppermint chewing-gum contains 11 mg of sodium per piece. To be taken into consideration by people on a controlled sodium diet.

3How to take use Nicotinell Peppermint chewing-gum

Always use this medicine exactly as described in this leaflet or as your doctor has told you. Check with your doctor if you are not sure.

The appropriate dose will depend on your nicotine dependence. You should use the 4 mg Nicotinell Peppermint chewing-gum if

• you are a smoker with a strong nicotine dependency,

• you have previously failed to stop smoking with the 2 mg chewing-gum.

Otherwise 2 mg Nicotinell Peppermint chewing-gum should be used.

Select your optimal dosage from the following table:

If an adverse event occurs with the use of the high dose (4 mg), use of the low dose (2 mg) should be considered.

It is important to chew the chewing-gum in a correct way to avoid discomfort (e.g. hiccups and heart burn).

Instructions for use:

Do not swallow the chewing-gum.

Dosage for adults over 18 years:

Chew one piece of gum when you feel the urge to smoke.

At the beginning of the treatment, in general, one piece of chewing-gum should be chewed every one or two hours. Normally 8-12 pieces of chewing-gum per day are sufficient, irrespective of strength. Do not exceed 25 pieces a day of 2 mg chewing-gum or 15 pieces per day of 4 mg chewing-gum.

Smoking cessation:

The treatment duration is individual. Normally, treatment should continue for at least 3 months. After 3 months, you should gradually reduce the number of pieces of gum chewed each day. Treatment should be stopped when you have reduced your use of the gum to 1-2 chewing-gums per day.

It is generally not recommended to use Nicotinell Peppermint chewing-gum for longer than 1 year. However, some ex-smokers may need treatment with the chewing-gum for longer to avoid returning to smoking.

Counselling may improve your chances of giving up smoking.

Smoking reduction:

Nicotinell Peppermint is used between periods of smoking in order to prolong smoke-free intervals and with the intention to reduce smoking as much as possible. If a reduction in the number of cigarettes per day has not been achieved after 6 weeks, professional advice should be sought. Aquit attempt should be made as soon as the smoker feels ready, but not later than 6 months after start of treatment. If a quit attempt cannot be made within 9 months after starting treatment, professional advice should be sought.

Counselling may improve your chances of giving up smoking.

Use in children and adolescents

Nicotinell should not be used by people under 18 years of age without recommendation from a doctor.

If you take more Nicotinell Peppermint than you should

Chewing too many chewing-gum pieces can result in the same symptoms as smoking too much. The general symptoms of nicotine overdose include weakness, sweating, increased production of saliva, throat burn, nausea, vomiting, diarrhoea, pain in the abdomen, disturbance of hearing and vision, headache, fast or other disturbance in heart beat, shortness of breath.

If you have taken more of the drug than you should, or if a child has taken the drug by mistake, contact a doctor or hospital for assessment of risk and advice.

If poisoning is suspected in a child, a doctor must be consulted immediately. Even small quantities of nicotine are dangerous in children and may result in severe symptoms or death.

If you forget to use Nicotinell Peppermint

Do not take double dose to compensate for a forgotten dose.

4Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Some effects you may notice in the first few days are dizziness, headache and sleep disturbances. These may be withdrawal symptoms in connection with smoking cessation and may be caused by insufficient administration of nicotine.

Stop taking Nicotinell Peppermint and contact immediately a doctor if you get any of the following symptoms of a serious allergic reaction (angioedema or anaphylactic reaction)

Other side effects that may occur:

Common (may affect up to 1 in 10 people)

• dizziness, headache and sleep disturbances

• hiccups, stomach issues, nausea, vomiting, increased saliva production, and inflammation of the mouth mucous. Mouth, throat and jaw muscle ache may also occur, especially as a result of intense chewing. Slower chewing will usually overcome these problems.

Uncommon (may affect up to 1 in 100 people)

• palpitations,

• red skin rash (erythema) and itching of raised bumps of the skin (urticaria).

Rare (may affect up to 1 in 1,000 people)

• disturbances in heart beat rhythm

• hypersensitivity reaction

Mouth ulcers may be related to quitting smoking and not to your treatment.

The gum can stick to and very rarely damage dentures or other dental work.

Reporting of side effects

If you get any side effects, talk to your pharmacist.This includes any possible side effects not listed in this leaflet.You can also report side effects directly via the national reporting system listed in Appendix V*. By reporting side effects you can help provide more information on the safety of this medicine.

5How to store Nicotinell Peppermint chewing-gum

Keep this medicine out of the sight and reach of children.

Do not use Nicotinell Peppermint after the expiry date which is stated on the label of the package after “EXP”. The expiry date refers to the last day of that month.

Do not store above 25°C.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6Contents of the pack and other information

What Nicotinell Peppermint contains

Nicotinell Peppermint medicated chewing-gum is available in two strengths.

The active substance is nicotine.

Each piece of Nicotinell Peppermint chewing-gum contains 2 mg or 4 mg nicotine (as 10 mg or 20 mg nicotine polacrilin (1:4)).

The other ingredients are:

Nicotinell Peppermint medicated chewing gum is sugar free.

What Nicotinell Peppermint looks like and contents of the pack

Each piece of coated chewing-gum is off-white in colour and rectangular in shape.

The chewing-gums are packed in blisters containing 12 chewing-gums. The blisters are packed in boxes containing 12, 24, 84, 96 or 204 pieces of chewing-gum.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

<To be completed nationally>

For Sweden:

Marketing Authorisation Holder

Novartis Sverige AB, Box 1150, 183 11 Täby, tel. 08-732 32 00.

<To be completed nationally>

For Sweden:

Manufacturer

FAMAR S.A., 48^th km National Road Athens-Lamia, 19011, Avlonas, Attiki, Greece

Novartis Sverige AB, Box 1150, 183 11 Täby

This medicinal product is authorised in the Member States of the EEA under the following names:

AT	Nicotinell MintFrisch 2 mg - Kaugummi
BE	Nicotinell Cool Mint, 2 mg, kauwgom
DE	Nicotinell Kaugummi 2 mg Mint
DK	Nicotinell Icemint
EE	Nicotinell Cool Mint
EL	Nicotinell Cool Mint 2 mg medicated chewing-gum
ES	Nicotinell Cool mint 2 mg chicle medicamentoso
FI	Nicotinell Icemint 2 mg lääkepurukumi
FR	NICOTINELL MENTHE FRAICHEUR 2 mg SANS SUCRE, gomme à mâcher médicamenteuse
HU	Nicotinell Fresh Mint 2 mg gyógyszeres rágógumi
IE	Nicotinell Cool Mint 2mg Medicated Chewing Gum
IS	Nicotinell Icemint 2 mg lyfjatyggigúmmí
LT	Nicotinell Mint 2 mg medicated chewing-gum
LU	Nicotinell Cool Mint 2 mg, gomme à mâcher médicamenteuse
LV	Nicotinell Cool Mint 2 mg medicated chewing gum
NL	Nicotinell Cool Mint 2 mg, kauwgom
NO	Nicotinell medisinsk tyggegummi Icemint
PT	Nicotinell FreshMint 2 mg
SE	Nicotinell Peppermint 2 mg.
UK	Nicotinell Ice Mint 2mg Medicated Chewing Gum.

AT	Nicotinell MintFrisch 4 mg - Kaugummi
BE	Nicotinell Cool Mint, 4 mg, kauwgom
DE	Nicotinell Kaugummi 4 mg Cool Mint
DK	Nicotinell Icemint
EE	Nicotinell Cool Mint
EL	Nicotinell Cool Mint 4 mg medicated chewing-gum
ES	Nicotinell Cool mint 4 mg chicle medicamentoso
FI	Nicotinell Icemint 4 mg lääkepurukumi
FR	NICOTINELL MENTHE FRAICHEUR 4 mg SANS SUCRE, gomme à mâcher médicamenteuse
IE	Nicotinell Cool Mint 4mg Medicated Chewing Gum.
IS	Nicotinell Icemint 4 mg lyfjatyggigúmmí
LT	Nicotinell Mint 4 mg medicated chewing-gum
LU	Nicotinell Cool Mint, 4 mg, gomme à mâcher médicamenteuse
LV	Nicotinell Cool Mint 4 mg medicated chewing gum
NL	Nicotinell Cool Mint, 4 mg, kauwgom
NO	Nicotinell medisinsk tyggegummi Icemint
PT	Nicotinell FreshMint 4 mg
SE	Nicotinell Peppermint 4 mg.
UK	Nicotinell Ice Mint 4mg Medicated Chewing Gum.

This leaflet was last revised in 2015-02-27