How does this medication work? What will it do for me?
This medication belongs to a family of medications known as nicotine replacement therapies. It is used to help people over 18 years of age quit smoking. When a person stops smoking, they go through withdrawal from nicotine that causes symptoms such as irritability, mood swings, restlessness, trouble concentrating, and increased appetite. This medication helps reduce the symptoms of nicotine withdrawal by replacing some of the nicotine that the person no longer receives through cigarettes.
The nicotine patch when applied to the skin delivers a steady dose of nicotine over a 24-hour period. Gradually, the dose is reduced until the person no longer craves nicotine, and they can stop using the medication. This medication works best when used with a comprehensive program to quit smoking.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
NICORETTE Patch (Nicotine Transdermal System) is a multilayered, rectangular-shaped, laminated thin film containing nicotine as the active ingredient. Proceeding from the visible surface toward the surface attached to the skin, there are 3 distinct layers. These include (1) an outer backing layer composed of a laminated polyester film, (2) a middle layer which contains an adhesive, a structural non-woven material, and nicotine; the adhesive controls the rate of delivery of nicotine to the skin, and (3) a third layer comprised of a disposable liner that protects the systems; the liner is removed prior to use.
NICORETTE Patches are available in 3 strengths/sizes. The average amount of nicotine delivered to the patient from each NICORETTE Patch system is approximately proportional to the surface area of each system and results in systemic absorption of 5 mg (10 cm²),10 mg (20 cm²) and 15 mg (30 cm²), respectively, from each of the patches over a 16-hour period. Each patch contains nicotine at a concentration of 0.83 mg/cm². Other ingredients are polyester (non woven), polybutene, and polyisobutylene.
How should I use this medication?
Ask your doctor or pharmacist to teach you how to use the nicotine patch effectively and to give you tips on quitting smoking. Only one nicotine patch should be applied once a day to an area on the upper body or upper outer arm that is non-hairy, intact, non-irritated, clean, and dry.
The patch should be applied upon waking and removed at bedtime. After removing the patch at bedtime, the old patch should be discarded and a new patch applied upon waking the next day. The patch should not be worn for more than 16 hours in a day. Be sure that new and discarded patches are kept out of the reach of children.
It is very important to apply the patch to a new site on the body and avoid any unnecessary contact with the medicated part of the patch. If during handling you do come into contact with the medicated portion of the patch, quickly wash the affected area with water only. Do not use soap as it can increase the amount of nicotine absorbed into the body. Avoid contact with your eyes.
Your initial dose and duration of therapy can depend on a number of factors such as weight, number of cigarettes you smoke, and various medical conditions. Speak with your doctor or pharmacist before beginning a nicotine patch therapy.
Therapy for most people begins with the 15 mg/day patch and continues for 6 weeks. It is important to reassess your initial dose of nicotine after the first 2 weeks of therapy. The next stage of therapy will gradually reduce the dose of nicotine. After successful completion of the first 6-week stage, the 10 mg/day patch should be started for 2 weeks, immediately followed by the 5 mg/day patch for another 2 weeks. Treatment will generally take 6 to 10 weeks. You should not use this medication for more than 10 weeks. You must stop smoking completely when taking this medication.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
It is very important to use this medication on a regular schedule as prescribed by the doctor. If you miss a dose of this medication, take your next scheduled dose. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use nicotine patches if you:
- are allergic to nicotine or any ingredients of the patch
- are a non-smoker or an occasional smoker
- are under 18 years of age
- are pregnant or breast-feeding
- have just had a heart attack
- have life-threatening arrhythmias (abnormal heart rhythm)
- have severe or worsening angina (chest pain)
- have recently had a stroke
- have a generalized skin disorder
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- insomnia (difficulty sleeping)
- mild itching, burning, redness, or tingling in the area where the patch was applied
- upset stomach
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- chest pain
- feelings of dependence on the medication or difficulty stopping the medication after your treatment is done
- irregular heartbeat or heart palpitations
- leg pain
- severe stomach upset that does not go away
- skin rash or swollen skin
- skin redness caused by the patch that does not go away after 4 days
Stop taking the medication and seek immediate medical attention if any of the following occur:
- symptoms of a serious allergic reaction (such as hives, difficulty breathing, or swelling of the face and throat)
Symptoms of overdose
- abdominal or stomach pain
- cold sweat
- convulsions (seizures)
- disturbed hearing and vision
- extreme exhaustion
- pale skin
- rapid heartbeat
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Medical conditions: If you have thyroid conditions, diabetes, stomach ulcers, heart disease, blood vessel disease, kidney disease, or a skin disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Pregnancy: This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are using nicotine patches, they may affect your baby. Do not breast-feed while you are using this medication.
Children and adolescents: The safety and effectiveness of this medication have not been established for people under 18 years of age.
What other drugs could interact with this medication?
There may be an interaction between nicotine patches and any of the following:
- benzodiazepines (e.g., oxazepam)
- peginterferon alfa-2b
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.