Nicotine patch

Nicotine patch
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Disclaimer

WikiDoc MAKES NO GUARANTEE OF VALIDITY. WikiDoc is not a professional health care provider, nor is it a suitable replacement for a licensed healthcare provider. WikiDoc is intended to be an educational tool, not a tool for any form of healthcare delivery. The educational content on WikiDoc drug pages is based upon the FDA package insert, National Library of Medicine content and practice guidelines / consensus statements. WikiDoc does not promote the administration of any medication or device that is not consistent with its labeling. Please read our full disclaimer here.

Overview

Nicotine patch is {{{aOrAn}}} {{{drugClass}}} that is FDA approved for the {{{indicationType}}} of {{{indication}}}. Common adverse reactions include {{{adverseReactions}}}.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

There is limited information regarding Nicotine patch FDA-Labeled Indications and Dosage (Adult) in the drug label.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Nicotine patch in adult patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Nicotine patch in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

There is limited information regarding Nicotine patch FDA-Labeled Indications and Dosage (Pediatric) in the drug label.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Nicotine patch in pediatric patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Nicotine patch in pediatric patients.

Contraindications

There is limited information regarding Nicotine patch Contraindications in the drug label.

Warnings

There is limited information regarding Nicotine patch Warnings' in the drug label.

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Nicotine patch Clinical Trials Experience in the drug label.

Postmarketing Experience

There is limited information regarding Nicotine patch Postmarketing Experience in the drug label.

Drug Interactions

There is limited information regarding Nicotine patch Drug Interactions in the drug label.

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): There is no FDA guidance on usage of Nicotine patch in women who are pregnant.
Pregnancy Category (AUS): There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Nicotine patch in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Nicotine patch during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Nicotine patch in women who are nursing.

Pediatric Use

There is no FDA guidance on the use of Nicotine patch in pediatric settings.

Geriatic Use

There is no FDA guidance on the use of Nicotine patch in geriatric settings.

Gender

There is no FDA guidance on the use of Nicotine patch with respect to specific gender populations.

Race

There is no FDA guidance on the use of Nicotine patch with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Nicotine patch in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Nicotine patch in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Nicotine patch in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Nicotine patch in patients who are immunocompromised.

Administration and Monitoring

Administration

There is limited information regarding Nicotine patch Administration in the drug label.

Monitoring

There is limited information regarding Nicotine patch Monitoring in the drug label.

IV Compatibility

There is limited information regarding the compatibility of Nicotine patch and IV administrations.

Overdosage

There is limited information regarding Nicotine patch overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.

Pharmacology

There is limited information regarding Nicotine patch Pharmacology in the drug label.

Mechanism of Action

There is limited information regarding Nicotine patch Mechanism of Action in the drug label.

Structure

There is limited information regarding Nicotine patch Structure in the drug label.

Pharmacodynamics

There is limited information regarding Nicotine patch Pharmacodynamics in the drug label.

Pharmacokinetics

There is limited information regarding Nicotine patch Pharmacokinetics in the drug label.

Nonclinical Toxicology

There is limited information regarding Nicotine patch Nonclinical Toxicology in the drug label.

Clinical Studies

There is limited information regarding Nicotine patch Clinical Studies in the drug label.

How Supplied

There is limited information regarding Nicotine patch How Supplied in the drug label.

Storage

There is limited information regarding Nicotine patch Storage in the drug label.

Images

Drug Images

{{#ask: Page Name::Nicotine patch |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}

Package and Label Display Panel

{{#ask: Label Page::Nicotine patch |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}

Patient Counseling Information

There is limited information regarding Nicotine patch Patient Counseling Information in the drug label.

Precautions with Alcohol

Alcohol-Nicotine patch interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

There is limited information regarding Nicotine patch Brand Names in the drug label.

Look-Alike Drug Names

There is limited information regarding Nicotine patch Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

A nicotine patch is a transdermal patch that releases nicotine into the body through the skin. It is usually used as a method to quit smoking.

General information

A 21 mg dose Nicoderm CQ patch applied to the left arm

Nicotine patches come in several steps so that users can phase out nicotine use; for example, 21, 14, and 7 mg. A cigarette delivers roughly 1 mg of nicotine, so someone who used to smoke a pack (20 cigarettes) per day or more could start with the "step I" 21 mg patch, while someone who smoked less could start with "step II." After several weeks (6 is recommended) at step I, new non-smokers move on to step II (usually two weeks) and step III (two weeks).

For most users, there are few or no short-term health problems associated with using the patch, so users should not rush themselves through the steps; rather, users can phase out nicotine use on their own schedules.

The nicotine patch was invented by New Mexico Tech neuropsychopharmacology professor Dr. Frank T. Etscorn III; the patent was licensed by Ciba-Geigy, later merged with Novartis.

Cost

In the U.S., the nicotine patch costs roughly $20 to $30 per week, although some municipalities, schools or health plans offer subsidized or free nicotine patches. Depending on local tax rates, the cash cost of the patch compares favorably to the cost of cigarettes.

CVS has begun marketing their own brand of nicotine patches under the name of "Nicotine Transdermal System." They are approximately 25 to 30% cheaper than the Nicoderm CQ Patches next to which they are shelved.

In the U.K. nicotine patches cost approximately £15 for a week's supply. For heavy smokers, this compares favourably with cigarettes at £5 for 20 (prices Jan 2007), however light smokers may find that nicotine patches are more expensive than their tobacco habit.

Cost cutting

The main difference between each level is not the amount of nicotine placed between the backing and the adhesive, but the size of the patch. This is due to the nature of the adhesive. For the adhesive to maintain its hold properly, the consistency of it must remain the same, thereby allowing only a specific amount of nicotine through. Yet all the patches regardless of size seem to have the same costs. Buying the strongest patches and cutting them into smaller (weaker) patches is a cost cutting method which the manufacturers warn may lead to nicotine leaking and an unstable delivery, there is no evidence to support or disprove this claim.

Issues

Efficacy

There have been some doubts expressed as to the efficacy of Nicotine Patches, in trials, the success rates of the control groups was significantly lower than would be expected, the presumption being that the low dose control patches made it harder to quit than normal.

Nicotine replacement products (including patches) result in 7% of quitters quitting for at least six months. Alternative such as high intensity counseling increase quitting rates 300% to 22% (see Table 12)

The very government report that states the 22% figure above actually encourages use of nicotine patches, stating the following. "Numerous effective pharmacotherapies for smoking cessation now exist. Except in the presence of contraindications, these should be used with all patients attempting to quit smoking."

Side effects

Death

There are a few recorded cases in which tobacco users died from heart failure after applying multiple patches and then smoking and consuming alcohol at the same time, against doctor's orders. Lawsuits by survivors of such decedents against the decedent's physician and the manufacturers of nicotine patches, cigarettes, and alcohol have generally all been unsuccessful.

Nightmares

Patches are intended to be worn for 24 hours at a time, and then be replaced at the same time every day. However, some individuals wearing the patch while they sleep experience abnormally vivid, erotic, or possibly violent dreams. Within this group, some people become acclimated and are not bothered; others find them completely intolerable. Other people actually enjoy the intense vivid dreaming, experiencing no nightmares or unpleasant dreams, just pleasant dreams of unusual intensity.

For some smokers the solution is simply to wear the patch for approximately 17 hours only, and remove it before bed. There are also several brands which offer sixteen hour patches. However, because the patches take between two and four hours to achieve peak concentration in the body, this can leave the wearer vulnerable to cravings in the morning, particularly if they don't put on the patch immediately when they wake up. For heavier smokers, or smokers whose prior smoking habits included a smoke first thing in the morning or when getting home from work, the twenty-four hour patches can help avoid times of the day where the patch is not delivering enough nicotine and cravings start.

Itching

The nicotine and the adhesive can cause swelling, itching and discomfort in the area covered by the patch. Instructions for using the patch indicate it should be placed at a different location every day. Usually the feeling of itching and mild burning subsides in 30-60 minutes, and is only slightly uncomfortable.

See also

• Smoking cessation
• Transdermal patch
• Nicoderm CQ