Nicotine Patch

The nicotine patch (Habitrol, NicoDerm, CQ, Nicotrol) is a nicotine replacement medicine. The nicotine patch slowly releases nicotine to your body through your skin. This keeps the nicotine in your body steady throughout the day to ease withdrawal symptoms. This allows you to focus on breaking your smoking routines and learn new coping skills. Nicotine patches are available over-the- counter.

There are three different strengths of the nicotine patch: 21mg, 14mg or 7mg. The dose and duration recommendations vary by individual.

Follow the directions on the label, and ask your doctor or pharmacist to explain any part you do not understand. Use the nicotine patch exactly as directed.

 

How to Apply the Patch

  1. Choose a non-hairy, clean, dry area of skin; do not apply lotion or sunscreen on this area.
    • Avoid placing the patch over joints (ankles, knees, elbows) or skin that is burned, broken out, cut or irritated in any way.
    • Wait at least seven days before applying the patch to a previously used skin site.
  2. Apply the sticky side of the patch to your skin. Press firmly for at least 10 seconds.
    • If needed, apply medical adhesive tape over the patch to help keep it in place.
  3. Wash your hands when you have finished.

 

How to Remove the Patch

  1. Remove the patch after 24 hours of use. If wearing the patch disturbs your sleep, remove it about 30 minutes before bedtime.
  2. Carefully dispose of the used patch so it will be out of reach of children and pets. Wash your hands.

 

Notes on Use

  • It is normal to feel some tingling or burning for the first hour after you put on the patch. Your skin may be red after you take off the patch. Your skin should not stay red for more than a day. If redness continues, contact your doctor.
  • You can take a shower or bath, or swim for short periods of time while wearing the nicotine patch. You can use medical or sports tape if needed to keep the patch in place.
  • It is OK to wear the nicotine patch with mild to moderate exercise. However, it is recommended that you remove the patch with vigorous exercise.

 

Warnings

Tell your doctor if you have or have ever had:

  • Heart attack, irregular heart rate, angina or uncontrolled high blood pressure
  • Ulcers
  • Pheochromocytoma
  • Overactive thyroid
  • Allergies to bandages or tape
  • Skin rashes or skin diseases
  • Diabetes
  • Kidney or liver disease

IMPORTANT NOTE: Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using the nicotine patch, stop using it and call your doctor immediately. Nicotine and the nicotine patch may cause harm to your baby.

 

Ask a doctor or pharmacist before use if you are:

  • using prescription and/or nonprescription medication(s), especially acetaminophen (Tylenol), caffeine, diuretics ('water pills'), imipramine (Tofranil), insulin, medications for high blood pressure, oxazepam (Serax), pentazocine (Talwin, Talwin NX, Talacen), propoxyphene (Darvon, E-Lor), propranolol (Inderal), theophylline (Theo-Dur, Slo-bid), and vitamins.

IMPORTANT NOTE: Be sure to stop smoking on the day you start using the patch. Smoking or using other forms of tobacco while you're using the patch may lead to an overdose on nicotine. Call your doctor if you get too much nicotine (an overdose). Signs of an overdose may include dizziness, upset stomach, bad headaches, vomiting, cold sweats, confusion, blurred vision, hearing problems, weakness or fainting. If you experience any of these problems, take off the patch and call your doctor.

 

If you experience any of the following symptoms, call your doctor immediately:

  • Seizures
  • Heart rhythm disturbances
  • Difficulty breathing

IMPORTANT NOTE: Side effects or overdose symptoms of nicotine are quite rare. Make sure to use the patch as directed.

 

Effectiveness

The patch has been found in many studies to be safe and can double your chances to quit successfully.


References

Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence:  2008 Update.  Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

Medioni, J., Berlin, L., & Mallet, A. (2005). Increased risk of relapse after stopping nicotine replacement therapies: a mathematical modeling approach. Addiction, 100, 247-254.

US Department of Health and Human Services. (2000). Reducing Tobacco Use: A report of the surgeon general. Atlanta, Georgia: USDHHS, Center for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health, Office on Smoking and Health.

 

Please note, National Jewish Health does not endorse specific products. The names of NRT products are included to familiarize the consumer with the various products that are available.

 

This information has been approved by Amy Lukowski, PsyD (October 2010).

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