Nicotine gum is an over-the-counter product used for nicotine replacement in patients who wish to stop smoking. The medication helps relieve the symptoms of nicotine withdrawal, including cravings, irritability, headache and insomnia. The nicotine gum is packaged with specific instructions on how to use the medication. The patient should follow all instructions exactly as directed. However, the drug may not be safe in everyone and the patient should speak with a physician before starting therapy.
Exacerbating Heart Problems
The nicotine gum should be used with caution in patients with heart disease. "Pharmacotherapy: A Pathophysiologic Approach" states that patients who have had a heart attack in the past two weeks should not use the drug. Patient with serious or worsening chest pain and irregular heartbeats should also avoid the nicotine gum or use with extreme caution.
Dangerously High Blood Pressure
Patients who have uncontrolled blood pressure should be cautious with nicotine gum. Nicotine is a stimulant that may raise the blood pressure dangerously high in these patients, which requires medical intervention. Symptoms may include a severe headache, chest pain, and shortness of breath. Patients who experience these symptoms should go to an emergency room right away.
Nicotine Overdose
Nicotine gum should not be used with other nicotine or tobacco products, because nicotine overdose may occur. According to the "Drug Information Handbook," symptoms of nicotine overdose include nausea, vomiting, stomach pain, confusion and increased heart rate. The patient should discontinue the medication and should consume a lower dose of the medication or increase the time between doses. If the patient experiences severe overdose symptoms, he should seek medical attention immediately.
Exacerbating Dental Problems or Gum Disease
Nicotine gum is chewed slowly and placed between the gum and cheek. Patients with dental or gum conditions or disease should use caution. The medication is contraindicated in patients with temporomandibular joint disease, which is inflammation of the joint between the jaw and skull. The patient should discuss her entire medication history with a physician to make sure the drug is safe to use.
Unknown Effects on Fetus and Breast Millk
Nicotine is classified as pregnancy category C, meaning that there are not enough studies to indicate fetal harm. The nicotine gum is not contraindicated in pregnancy but should be used cautiously, explains "Pharmacotherapy." Women who are breastfeeding should also use caution; it is not known whether nicotine enters breast milk. Patients should discuss their options with a health care provider.
Allergic Reaction
Nicotine gum is contraindicated in patients who have an allergy to nicotine or any component of the medication. Allergic reactions may be characterized by rash, itchiness, redness and peeling of the skin. Swelling of the hands, lips or mouth and difficulty breathing may also be signs of an allergy. If the patient suspects he is experiencing an allergy, he should stop the medication and contact a physician.
References
- "Pharmacotherapy: A Pathophysiologic Approach"; Joseph T. Dipiro et al.; 2008
- "Drug Information Handbook"; Charles F. Lacy et al.; 2009
