Для лечения табачной зависимости путем снижения потребности в никотине:
Уменьшение симптомов отмены, возникающих при полном отказе от курения у пациентов, решивших бросить курить
При временном отказе от курения
Для уменьшения количества выкуриваемых сигарет у тех, кто не может или не хочет полностью отказаться от курения
Противопоказания
— повышенная чувствительность к никотину и другим компонентам препарата. С осторожностью и только после консультации с врачом следует применять препарат пациентам с нарушениями сердечно-сосудистой системы, в т.ч. перенесшим сердечно-сосудистое заболевание в течение 1 месяца перед началом применения (в т.ч. инсульт, инфаркт миокарда, нестабильная стенокардия, ...
Средство для лечения никотиновой зависимости. После резкого отказа от курения у пациентов, ежедневно использующих табакосодержащие продукты в течение длительного времени, возможно развитие синдрома отмены, который включает в себя: дисфорию, бессонницу, повышенную раздражительность, тревогу, нарушение концентрации внимания, снижение ЧСС, увеличение аппетита или прибавку в весе. Важным симптомом синдрома отмены является также желание курить. При лечении табачной зависимости заместительная терапия никотином может снижать потребность в курении (и количество выкуриваемых сигарет), уменьшать выраженность симптомов отмены, возникающих при полном отказе от курения у тех, кто решил бросить курить. Облегчает временное воздержание от курения и способствует уменьшению количества выкуриваемых сигарет у тех, кто не может или не хочет полностью отказаться от курения. Способствует удалению пигментированного налета на зубах, обладает отбеливающим эффектом.
Показания к применению
Для лечения табачной зависимости путем снижения потребности в никотине:
Уменьшение симптомов отмены, возникающих при полном отказе от курения у пациентов, решивших бросить курить
При временном отказе от курения
Для уменьшения количества выкуриваемых сигарет у тех, кто не может или не хочет полностью отказаться от курения
Противопоказания
— повышенная чувствительность к никотину и другим компонентам препарата. С осторожностью и только после консультации с врачом следует применять препарат пациентам с нарушениями сердечно-сосудистой системы, в т.ч. перенесшим сердечно-сосудистое заболевание в течение 1 месяца перед началом применения (в т.ч. инсульт, инфаркт миокарда, нестабильная стенокардия, аритмия, аортокоронарное шунтирование, ангиопластика), или с неконтролируемой артериальной гипертензией. С осторожностью следует назначать препарат больным с умеренными или выраженными нарушениями функции печени, тяжелой почечной недостаточностью, обострением язвенной болезни желудка и двенадцатиперстной кишки. С осторожностью следует применять препарат пациентам с неконтролируемым гипертиреозом, феохромоцитомой (в связи с тем, что никотин вызывает высвобождение катехоламинов из мозгового слоя надпочечников), а также с сахарным диабетом.
Применение при беременности и в период грудного вскармливания
Никотин проникает через плацентарный барьер и может оказывать отрицательное влияние на плод. Курение может нанести вред плоду, поэтому пациенток следует попытаться убедить о необходимости отказа от курения без использования заместительной терапии никотиносодержащими препаратами. При безуспешности таких попыток решение о проведении терапии принимается после сопоставления возможного положительного эффекта и потенциального вреда. Никотин в небольших количествах выделяется с грудным молоком даже при приеме в терапевтических дозах и может оказывать неблагоприятное влияние на грудного ребенка при приеме препарата кормящей матерью. С целью уменьшения отрицательного влияния никотина на ребенка препарат Никоретте следует применять сразу же после кормления и не позднее, чем за 2 ч до очередного кормления.
Способ применения и дозы
В зависимости от выраженности пристрастия к курению применяют резинки жевательные Никоретте с различной концентрацией активного вещества. Если пациент выкуривает 20 или менее сигарет в сутки или выкуривает первую сигарету через 30 мин после пробуждения, то следует использовать резинку жевательную с содержанием никотина 2 мг. Если пациент выкуривает более 20 сигарет в сутки или ему не удалось бросить курить при использовании резинкок жевательных с содержанием никотина 2 мг, то рекомендуется использовать резинки жевательные с содержанием никотина 4 мг. Никоретте следует применять во всех случаях, когда возникает непреодолимое желание курить. Резинку следует медленно жевать до появления резкого вкуса, затем жевание следует прекратить и поместить резинку между десной и внутренней стороной щеки. После исчезновения привкуса следует возобновить жевание. За 1 прием следует использовать только 1 резинку жевательную. При полном отказе от курения средняя суточная доза составляет 8-12 резинок, максимальная - 15 резинок. Необходимо непрерывно использовать препарат в первые 3 мес после отказа от курения. Затем следует постепенно снижать количество потребляемых резинок. Когда суточное потребление препарата снизится до 1-2 резинок, применение его следует прекратить. При сокращении количества выкуриваемых сигарет резинку жевательную следует использовать между эпизодами курения для удлинения интервалов между выкуриванием сигарет, чтобы максимально снизить потребление сигарет. Пациент должен быть предупрежден, что если через 6 недель применения препарата не удалось добиться снижения суточного потребления сигарет, следует проконсультироваться у врача-специалиста. Пациент должен попытаться бросить курить, когда он будет к этому готов, но не позже чем через 6 мес после начала лечения. Если в течение 9 мес после начала терапии бросить курить не удалось, следует обратиться за консультацией к специалисту. Не рекомендуется применять резинки жевательные Никоретте более 12 мес. Однако некоторым пациентам может потребоваться более длительное лечение для предотвращения возврата к курению или прежнему уровню потребления табака. Резинку жевательную можно применять в периоды, когда необходимо временно отказаться от курения, например при нахождении в местах, где запрещено курить, или в других ситуациях, когда нужно воздержаться от курения. Консультации специалиста и психологическая поддержка способствуют повышению эффективности терапии. Применение в комбинации с ТТС (пластырем) Никоретте: Если не удается добиться отказа от курения только при применении жевательных резинок, либо при необходимости снижения суточного потребления резинок жевательных из-за местных побочных реакций, можно применять Никоретте в форме пластыря (ТТС) вместе с резинкой жевательной 2 мг. Начальная терапия. Лечение следует начинать с одного пластыря 15 мг/16 ч, который каждый день помещают на неповрежденный участок кожи после пробуждения утром и удаляют перед сном, в комбинации с жевательной резинкой 2 мг. Применяют как минимум 4 резинки жевательные 2 мг в сутки; обычно бывает достаточно 5-6 резинок жевательных. Не следует использовать более 15 резинок жевательных в сут. Полную дозу следует применять в течение 6-12 недель, после этого следует постепенно отвыкать от препарата. Отвыкание от комбинации препаратов проводится двумя способами. Первый способ: с помощью применения пластыря меньшей дозировки, т.е. применение пластыря 10 мг/16 ч в течение 3-6 недель и последующее применение в течение 3-6 недель пластыря 5 мг/16 ч с тем же количеством резинок жевательных по 2 мг, как при начальной терапии, а затем постепенно снижая количество резинок жевательных по 2 мг в течение 12 мес. Второй способ заключается в прекращении применения пластыря и постепенном снижении количества резинок жевательных 2 мг в течение 12 мес.
Побочное действие
В рекомендуемой дозе Никоретте не вызывает серьезных неблагоприятных эффектов. В начале лечения содержащийся в жевательной резинке никотин иногда может вызывать слабое раздражение горла и усиленное слюноотделение, при проглатывании чрезмерного количества растворенного никотина возможна икота. При чрезмерном употреблении препарата лицами, не привыкшими к вдыханию табачного дыма, возможны тошнота, слабость, головная боль (аналогично симптомам, возникающим у таких пациентов при вдыхании табачного дыма). Со стороны ЦНС: очень часто - головная боль; часто - головокружение. Со стороны сердечно-сосудистой системы: иногда – учащенное сердцебиение; очень редко – предсердные нарушения ритма. Со стороны пищеварительной системы: очень часто – желудочно-кишечный дискомфорт, икота, тошнота; часто - рвота. Дерматологические реакции: иногда – эритема, крапивница. Прочие: очень часто – боль в горле или во рту, боли в жевательных мышцах; редко - аллергические реакции, включая ангионевротический отек. Некоторые симптомы, такие как головокружение, головная боль, нарушения сна, могут быть проявлениями синдрома отмены, вызванного отказом от курения. При отказе от курения может увеличиваться частота возникновения афтозного стоматита. При применении жевательной резинки с содержанием никотина 4 мг у пациентов, предрасположенных к расстройству пищеварения возможны незначительные расстройства пищеварения или изжога. Обычно эта проблема устраняется при более медленном жевании резинки или использования резинки, содержащей 2 мг никотина (при необходимости с меньшим интервалом).
Передозировка
Чрезмерное поступление никотина при заместительной терапии и/или курении может вызвать появление симптомов передозировки. Симптомы: тошнота, повышенное слюноотделение, боли в животе, диарея, гипергидроз, головная боль, головокружение, нарушение слуха и выраженная общая слабость; при приеме высоких доз никотина - артериальная гипотензия, слабый и неритмичный пульс, затрудненное дыхание, сосудистый коллапс и генерализованные судороги, т.е. симптомы острого отравления никотином. Дозы никотина, которые хорошо переносятся в ходе лечения взрослыми курильщиками, могут вызвать симптомы тяжелого отравления у маленьких детей и даже привести к летальному исходу. Лечение: следует немедленно прекратить прием никотина и начать симптоматическое лечение. Активированный уголь снижает всасывание никотина в ЖКТ. При необходимости - искусственное дыхание и кислород.
Особые указания
Применение препарата Никоретте сопровождается меньшим риском, чем курение. Пациент должен быть информирован о том, что ему следует носить резинку жевательную Никоретте с собой, чтобы воспользоваться ею, если ему неожиданно захочется курить. Больным сахарным диабетом после прекращения курения может потребоваться снижение доз инсулина. Пациентам с нарушением жевательной функции рекомендуется применять другие лекарственные формы. Использование в педиатрии: Опыт применения Никоретте у подростков моложе 18 лет отсутствует, поэтому препарат должен применяться строго по назначению врача. Влияние на способность к вождению автотранспорта и управлению механизмами: Негативное влияние на способность к вождению автомобиля и работы с механизмами не установлено.
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Вспомогательные вещества: β-циклодекстрин (Бетадекс) - 69.55 мг, кросповидон - 2 мг, магния стеарат - 0.9 мг, кремния диоксид коллоидный - 0.45 мг."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Средство для лечения никотиновой зависимости. После резкого отказа от курения у пациентов, ежедневно использующих табакосодержащие продукты в течение длительного времени, возможно развитие синдрома отмены, который включает в себя: дисфорию, бессонницу, повышенную раздражительность, тревогу, нарушение концентрации внимания, снижение ЧСС, увеличение аппетита или прибавку в весе. Важным симптомом синдрома отмены является также желание курить. При лечении табачной зависимости заместительная терапия никотином может снижать потребность в курении (и количество выкуриваемых сигарет), уменьшать выраженность симптомов отмены, возникающих при полном отказе от курения у тех, кто решил бросить курить. Облегчает временное воздержание от курения и способствует уменьшению количества выкуриваемых сигарет у тех, кто не может или не хочет полностью отказаться от курения. Способствует удалению пигментированного налета на зубах, обладает отбеливающим эффектом."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Для лечения табачной зависимости путем снижения потребности в никотине:"}},{"type":"list","data":{"style":"unordered","items":["Уменьшение симптомов отмены, возникающих при полном отказе от курения у пациентов, решивших бросить курить","При временном отказе от курения","Для уменьшения количества выкуриваемых сигарет у тех, кто не может или не хочет полностью отказаться от курения"]}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"— повышенная чувствительность к никотину и другим компонентам препарата. С осторожностью и только после консультации с врачом следует применять препарат пациентам с нарушениями сердечно-сосудистой системы, в т.ч. перенесшим сердечно-сосудистое заболевание в течение 1 месяца перед началом применения (в т.ч. инсульт, инфаркт миокарда, нестабильная стенокардия, аритмия, аортокоронарное шунтирование, ангиопластика), или с неконтролируемой артериальной гипертензией. С осторожностью следует назначать препарат больным с умеренными или выраженными нарушениями функции печени, тяжелой почечной недостаточностью, обострением язвенной болезни желудка и двенадцатиперстной кишки. С осторожностью следует применять препарат пациентам с неконтролируемым гипертиреозом, феохромоцитомой (в связи с тем, что никотин вызывает высвобождение катехоламинов из мозгового слоя надпочечников), а также с сахарным диабетом."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Никотин проникает через плацентарный барьер и может оказывать отрицательное влияние на плод. Курение может нанести вред плоду, поэтому пациенток следует попытаться убедить о необходимости отказа от курения без использования заместительной терапии никотиносодержащими препаратами. При безуспешности таких попыток решение о проведении терапии принимается после сопоставления возможного положительного эффекта и потенциального вреда. Никотин в небольших количествах выделяется с грудным молоком даже при приеме в терапевтических дозах и может оказывать неблагоприятное влияние на грудного ребенка при приеме препарата кормящей матерью. С целью уменьшения отрицательного влияния никотина на ребенка препарат Никоретте следует применять сразу же после кормления и не позднее, чем за 2 ч до очередного кормления."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В зависимости от выраженности пристрастия к курению применяют резинки жевательные Никоретте с различной концентрацией активного вещества. Если пациент выкуривает 20 или менее сигарет в сутки или выкуривает первую сигарету через 30 мин после пробуждения, то следует использовать резинку жевательную с содержанием никотина 2 мг. Если пациент выкуривает более 20 сигарет в сутки или ему не удалось бросить курить при использовании резинкок жевательных с содержанием никотина 2 мг, то рекомендуется использовать резинки жевательные с содержанием никотина 4 мг. Никоретте следует применять во всех случаях, когда возникает непреодолимое желание курить. Резинку следует медленно жевать до появления резкого вкуса, затем жевание следует прекратить и поместить резинку между десной и внутренней стороной щеки. После исчезновения привкуса следует возобновить жевание. За 1 прием следует использовать только 1 резинку жевательную. При полном отказе от курения средняя суточная доза составляет 8-12 резинок, максимальная - 15 резинок. Необходимо непрерывно использовать препарат в первые 3 мес после отказа от курения. Затем следует постепенно снижать количество потребляемых резинок. Когда суточное потребление препарата снизится до 1-2 резинок, применение его следует прекратить. При сокращении количества выкуриваемых сигарет резинку жевательную следует использовать между эпизодами курения для удлинения интервалов между выкуриванием сигарет, чтобы максимально снизить потребление сигарет. Пациент должен быть предупрежден, что если через 6 недель применения препарата не удалось добиться снижения суточного потребления сигарет, следует проконсультироваться у врача-специалиста. Пациент должен попытаться бросить курить, когда он будет к этому готов, но не позже чем через 6 мес после начала лечения. Если в течение 9 мес после начала терапии бросить курить не удалось, следует обратиться за консультацией к специалисту. Не рекомендуется применять резинки жевательные Никоретте более 12 мес. Однако некоторым пациентам может потребоваться более длительное лечение для предотвращения возврата к курению или прежнему уровню потребления табака. Резинку жевательную можно применять в периоды, когда необходимо временно отказаться от курения, например при нахождении в местах, где запрещено курить, или в других ситуациях, когда нужно воздержаться от курения. Консультации специалиста и психологическая поддержка способствуют повышению эффективности терапии. Применение в комбинации с ТТС (пластырем) Никоретте: Если не удается добиться отказа от курения только при применении жевательных резинок, либо при необходимости снижения суточного потребления резинок жевательных из-за местных побочных реакций, можно применять Никоретте в форме пластыря (ТТС) вместе с резинкой жевательной 2 мг. Начальная терапия. Лечение следует начинать с одного пластыря 15 мг/16 ч, который каждый день помещают на неповрежденный участок кожи после пробуждения утром и удаляют перед сном, в комбинации с жевательной резинкой 2 мг. Применяют как минимум 4 резинки жевательные 2 мг в сутки; обычно бывает достаточно 5-6 резинок жевательных. Не следует использовать более 15 резинок жевательных в сут. Полную дозу следует применять в течение 6-12 недель, после этого следует постепенно отвыкать от препарата. Отвыкание от комбинации препаратов проводится двумя способами. Первый способ: с помощью применения пластыря меньшей дозировки, т.е. применение пластыря 10 мг/16 ч в течение 3-6 недель и последующее применение в течение 3-6 недель пластыря 5 мг/16 ч с тем же количеством резинок жевательных по 2 мг, как при начальной терапии, а затем постепенно снижая количество резинок жевательных по 2 мг в течение 12 мес. Второй способ заключается в прекращении применения пластыря и постепенном снижении количества резинок жевательных 2 мг в течение 12 мес."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В рекомендуемой дозе Никоретте не вызывает серьезных неблагоприятных эффектов. В начале лечения содержащийся в жевательной резинке никотин иногда может вызывать слабое раздражение горла и усиленное слюноотделение, при проглатывании чрезмерного количества растворенного никотина возможна икота. При чрезмерном употреблении препарата лицами, не привыкшими к вдыханию табачного дыма, возможны тошнота, слабость, головная боль (аналогично симптомам, возникающим у таких пациентов при вдыхании табачного дыма). Со стороны ЦНС: очень часто - головная боль; часто - головокружение. Со стороны сердечно-сосудистой системы: иногда – учащенное сердцебиение; очень редко – предсердные нарушения ритма. Со стороны пищеварительной системы: очень часто – желудочно-кишечный дискомфорт, икота, тошнота; часто - рвота. Дерматологические реакции: иногда – эритема, крапивница. Прочие: очень часто – боль в горле или во рту, боли в жевательных мышцах; редко - аллергические реакции, включая ангионевротический отек. Некоторые симптомы, такие как головокружение, головная боль, нарушения сна, могут быть проявлениями синдрома отмены, вызванного отказом от курения. При отказе от курения может увеличиваться частота возникновения афтозного стоматита. При применении жевательной резинки с содержанием никотина 4 мг у пациентов, предрасположенных к расстройству пищеварения возможны незначительные расстройства пищеварения или изжога. Обычно эта проблема устраняется при более медленном жевании резинки или использования резинки, содержащей 2 мг никотина (при необходимости с меньшим интервалом)."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Чрезмерное поступление никотина при заместительной терапии и/или курении может вызвать появление симптомов передозировки. Симптомы: тошнота, повышенное слюноотделение, боли в животе, диарея, гипергидроз, головная боль, головокружение, нарушение слуха и выраженная общая слабость; при приеме высоких доз никотина - артериальная гипотензия, слабый и неритмичный пульс, затрудненное дыхание, сосудистый коллапс и генерализованные судороги, т.е. симптомы острого отравления никотином. Дозы никотина, которые хорошо переносятся в ходе лечения взрослыми курильщиками, могут вызвать симптомы тяжелого отравления у маленьких детей и даже привести к летальному исходу. Лечение: следует немедленно прекратить прием никотина и начать симптоматическое лечение. Активированный уголь снижает всасывание никотина в ЖКТ. При необходимости - искусственное дыхание и кислород."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Применение препарата Никоретте сопровождается меньшим риском, чем курение. Пациент должен быть информирован о том, что ему следует носить резинку жевательную Никоретте с собой, чтобы воспользоваться ею, если ему неожиданно захочется курить. Больным сахарным диабетом после прекращения курения может потребоваться снижение доз инсулина. Пациентам с нарушением жевательной функции рекомендуется применять другие лекарственные формы. Использование в педиатрии: Опыт применения Никоретте у подростков моложе 18 лет отсутствует, поэтому препарат должен применяться строго по назначению врача. Влияние на способность к вождению автотранспорта и управлению механизмами: Негативное влияние на способность к вождению автомобиля и работы с механизмами не установлено."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Средство для лечения никотиновой зависимости. 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