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Nicotine Patches

Brand names: Habitrol, NicoDerm CQ, Nicotrol


Why is this drug prescribed: Nicotine patches, which are available under several brand names, are designed to help you quit smoking by reducing your craving for tobacco. Each adhesive patch contains a specific amount of nicotine embedded in a pad or gel. Nicotine, the habit-forming ingredient in tobacco, is a stimulant and a mood lifter. When you give up smoking, lack of nicotine makes you crave cigarettes and may also cause anger, anxiety, concentration problems, irritability, frustration, or restlessness. When you wear a nicotine patch, a specific amount of nicotine steadily travels out of the patch, through your skin, and into your bloodstream, keeping a constant low level of nicotine in your body. Although the resulting level of nicotine is less than you would get from smoking, it may be enough to keep you from craving cigarettes or experiencing other withdrawal symptoms. Habitrol patches are round and come in three strengths: 21, 14, or 7 milligrams of nicotine per patch. You wear a Habitrol patch 24 hours a day. NicoDerm CQ patches are rectangular and come in three strengths: 21, 14, or 7 milligrams of nicotine per patch. You wear a NicoDerm CQ patch 24 hours a day. Nicotrol patches are rectangular and deliver 15 milligrams of nicotine per patch. You put on a Nicotrol patch in the morning, wear it all day, and remove it at bedtime. You do not use it when you sleep. Nicotrol is available over-the-counter.

Most important fact about this drug: Nicotine patch therapy should be part of an overall stop-smoking program that also includes behavior modification, counseling, and support. The goal of the therapy should be complete cessation of smoking, not just "cutting down."

How should you take this medication: Use nicotine patches exactly as prescribed. The general procedure is as follows: Take a fresh patch out of its packaging and remove the protective liner from the adhesive. Save the wrapper for later disposal of the used patch. Stick the patch onto your outer upper arm or any clean, dry, non-hairy part of your trunk. Press the patch firmly onto your skin for about 10 seconds, making sure that the edges are sticking well. Wash your hands. Any nicotine sticking to your hands could get into your eyes or nose, causing irritation. After 16 or 24 hours (depending on the brand), remove that patch and apply a fresh patch to a different spot on your body. To reduce the chances of irritation, do not return to a previously used spot for at least a week. Fold the used patch in half, place it back in its own wrapper, and throw it in a trash container that cannot be reached by children or pets. Water will not harm the nicotine patch. You may keep wearing your patch while bathing, showering, swimming, or using a hot tub. If your patch does fall off, dispose of it carefully and apply a new patch. As a memory aid, pick a specific time of day and always apply a fresh patch at that time. You may change the schedule if you need to. Just remember not to wear any single patch for more than the recommended time (16 or 24 hours), since after that time the patch will begin to lose strength and may begin to irritate your skin. Do not change brands without consulting your doctor, and do not attempt to adjust your dosage by cutting a patch in pieces. If you are unable to stop smoking after 4 to 10 weeks of wearing nicotine patches, it is likely that patch treatment will not work for you. --If you miss a dose... Apply the patch as soon as you remember. Never use 2 patches at once. --Storage instructions... Do not remove a patch from its wrapping until you are ready to use it. Store your supply of patches at temperatures no higher than 86 degrees Fahrenheit; remember that in warm weather the inside of a car can get much hotter than this.

What side effects may occur: Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue using nicotine patches. Most common side effects may include: Dizziness, high blood pressure, itching and burning at the application site, nausea, redness of the skin Less common side effects may include: Abnormal dreaming, allergic reactions, back pain, chest pain, constipation, cough, diarrhea, drowsiness, dry mouth, headache, impaired concentration, indigestion, inflammation of sinuses, menstrual irregularities, numb­ness, pain, pins and needles sensation, rash, sleeplessness, sore throat, stomach pain, sweating, taste changes, tingling, vomiting, weakness

Why should this drug not be prescribed: Do not take this medication if you are sensitive to or have ever had an allergic reaction to nicotine. Be cautious if you have ever had a bad reaction to a different brand of nicotine patch or to adhesive tape or other adhesive material.

Special warnings about this medication: Do not smoke, chew, or sniff any form of tobacco while wearing a patch; doing so could give you an overdose of nicotine. Be aware that for several hours after you remove a patch, nicotine from the patch is still in your skin and passing into your bloodstream, so you should not smoke even when the patch is off. The use of nicotine patches may aggravate certain medical conditions. Before you use any brand of nicotine patch, make sure your doctor knows if you have, or have ever had, any of the following conditions: Allergies to drugs, adhesive tape, or bandages Chest pain from a heart condition (angina) Diabetes requiring insulin injections Heart attack or heart disease High blood pressure (severe) Irregular heartbeat (heart arrhythmia) Kidney disease Liver disease Overactive thyroid Skin disease Stomach ulcer Nicotine, from any source, can be toxic and addictive. Do not use nicotine patches any longer than your doctor prescribes or the product instructions recommend. Thoroughly discuss with your doctor the benefits and risks of nicotine replacement therapy. If your heartbeat becomes irregular or you have heart palpitations, stop using the patch and call your doctor. Do the same if redness caused by the patch doesn't go away in 4 days or if your skin swells or develops a rash. Nicotine patches sometimes can cause vivid dreams or other sleep disturbances. If this happens, take the patch off at bedtime. Do not use a patch if its pouch is unsealed. The safety and effectiveness of nicotine patches have not been tested in children. Over-the-counter Nicotrol is not for use by children under age 18. Because a used nicotine patch still contains enough nicotine to poison a child or a pet, you must dispose of used patches with special care. Wrap each patch in the opened pouch or aluminum foil in which it came and throw it in a trash receptacle that is out of the reach of youngsters and animals.

Possible food and drug interactions when taking this medication: If nicotine patches are used with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining nicotine patches with the following: Acetaminophen-containing drugs such as Tylenol Caffeine-containing drugs such as No Doz Certain airway-opening drugs such as Isuprel, Dristan, and Neo-Synephrine Certain blood pressure medicines such as Minipress, Trandate, and Normodyne Cimetidine (Tagamet) Haloperidol (Haldol) Imipramine (Tofranil) Insulin Lithium (Eskalith, Lithobid) Non-nicotine quit-smoking drugs such as Zyban Oxazepam Pentazocine (Talwin) Propranolol (Inderal) Theophylline (Theo-Dur)

Special information if you are pregnant or breastfeeding: If you are pregnant or plan to become pregnant, inform your doctor immediately. Ideally, a pregnant woman should not take nicotine in any form. Do your best to quit smoking with the aid of counseling and support and without drug therapy. If you are unable to quit, you and your doctor should discuss which is more likely to harm your unborn baby: continued smoking or use of nicotine patches to help you quit smoking. Because nicotine passes very readily into breast milk, ideally it should not be taken in any form during breastfeeding. If you are breastfeeding and are unable to quit smoking, discuss with your doctor the pros and cons of using nicotine patches. Remember that if you smoke while wearing a patch, you are giving your body a "double dose" of nicotine; if you are pregnant or breastfeeding, your baby will get the "double dose", too.

Recommended dosage: Nicotine patches come in one, two, or three strengths, depending on the brand; larger patches contain higher doses of nicotine. The usual starting dose is 1 high-strength patch per day. If you weigh less than 100 pounds, however, or if you smoke less than half a pack of cigarettes a day or have heart disease, your doctor may start you on a lower-dose patch. Your doctor will work closely with you to determine the best product and the most effective cessation program.

Overdosage: Any medication used in excess, including nicotine patches, can have serious consequences. If you suspect symptoms of an overdose of nicotine, either from a patch or from smoking while wearing a patch, seek medical attention immediately. Symptoms of nicotine overdose may include: Abdominal pain, blurred vision, breathing abnormalities, cold sweat, confusion, diarrhea, dizziness, drooling, fainting, hearing difficulties, heart palpitations, low blood pressure, nausea, pallor, rapid heartbeat, salivation, severe headaches, sweating, tremor, upset stomach, vision problems, vomiting, weakness




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