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MEDICATION guide
Nicotine Replacement Therapy
Specifics on Transdermal Nicotine Therapy (The Patch)
Dosing:
- People who smoke 10-15 cigarettes or more per day may decide to start with the highest dose patch.
- For lighter smokers, using a lower-level dose patch may work best.
- Highly addicted smokers may opt for the 24-hour patch to avoid morning cravings.
- A patch is usually worn for 16 hrs or 24 hrs, depending on the brand.
- The patch is first applied upon awakening on the quit day.
- A new patch is applied daily.
- Do not smoke while using the patch.
Product Strengths:
Patches range in strength from 7 mg - 22 mg of nicotine, depending on the brand, and whether the product uses a single
dose regimen, or the 'step down' approach. The 'step down' approach gradually weans the user off therapy over a preset number of weeks.
Manufacturer's Recommended Treatment Duration:
Manufacturers recommend that the patch be used from a range of 4 weeks - 10 weeks, depending on the product. Treatment for 8 weeks is reasonable for most smokers; studies show 8 weeks is as effective as longer treatment. Tapering the dose after 4 weeks is generally recommended for most
smokers. Consult your physician to help you decide an appropriate strategy to meet your needs.
Adverse Reactions:
About half of patch users experience mild skin reactions. You can treat skin reactions by rotating patch sites and applying anti-itch creams. Less than 5% of patients have to stop using the patch because of skin reactions.
Some people report vivid dreams and sleep disturbances while using the 24-hour patch. If sleep disturbances occur, consider removing the patch at bedtime.
Unique Product Contraindications:
People who suffer from severe eczema, allergy to adhesive tape, or other skin diseases which may be exacerbated by the patch, should consider using an alternative therapy.
Cost:
Average retail price for over-the-counter transdermal nicotine patches (starter box) is approximately $4/day.
Adapted with permission from materials from the Center for Tobacco Prevention & Control, Massachusetts Tobacco Control Program, Department of Public Health.
Content author:
Alan S. Peters, CTTS-M
Reviewed by:
Andy Perez, MD, MBA, FACEP, February 2009
View Sources
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