Nicorette Icy Mint Gum Special Precautions

Smokers who wear dentures may experience difficulty in chewing Nicorette chewing gum. The chewing gum may stick to, and may in rare cases damage dentures.
A risk-benefit assessment should be made by an appropriate healthcare professional for patients with the following conditions: Dependent smokers with a recent myocardial infarction, unstable or worsening angina including Prinzmetal's angina, severe cardiac arrhythmias, recent cerebrovascular accident, and/or who suffer with uncontrolled hypertension should be encouraged to stop smoking with non-pharmacological interventions (such as counselling). If this fails, the Nicorette chewing gum may be considered but as data on safety in this patient group are limited, initiation should only be under close medical supervision.
Patients with diabetes mellitus should be advised to monitor their blood sugar levels more closely than usual when smoking is stopped and NRT is initiated, as reductions in nicotine-induced catecholamine release can affect carbohydrate metabolism.
Use with caution in patients with moderate to severe hepatic impairment and/or severe renal impairment as the clearance of nicotine or its metabolites may be decreased with the potential for increased adverse effects.
Use with caution in patients with uncontrolled hyperthyroidism or phaeochromocytoma as nicotine causes release of catecholamines.
Nicotine may exacerbate symptoms in patients suffering from oesophagitis, gastric or peptic ulcers and NRT preparations should be used with caution in these conditions.
Doses of nicotine tolerated by smokers can produce severe toxicity in children that may be fatal. Products containing nicotine should not be left where they may be handled or ingested by children, see Overdosage.
Nicotine dependence may continue but at a lower level. However use of pure nicotine is less harmful than tobacco.