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Nicotine Replacement Therapy (NRT)

Specifics on Transdermal Nicotine Therapy (The Patch)

What are the product strengths?
Patches range in strength from 7 mg - 21 mg of nicotine. A "step down" approach over 8-10 weeks gradually weans the user off therapy.

What is the recommended treatment duration?
Manufacturers recommend that the patch be used from a range of 8 weeks - 10 weeks, depending on your tobacco use history. Consult your physician if you think you might benefit from using a patch longer than 8 to 10 weeks.

What are the adverse reactions and cautionary messages?
People who suffer from severe eczema, allergy to adhesive tape, or other skin conditions, should consider using an alternative therapy. About half of all patch users experience mild skin itchiness or rashes, but less than 5% have to stop using the patch because of them. The rash is generally caused by a reaction to either the adhesive on the patch, or to the nicotine in the patch. You can help avoid skin irritation by rotating patch sites. Use a topical cream (such as hydrocortisone) to relieve some of the discomfort. Check with your doctor if you take prescription medicine for depression, asthma, diabetes or other conditions; your medications may need to be adjusted as you quit. Also, consult your doctor if you are pregnant or breastfeeding.

Since your mind is unaccustomed to receiving nicotine while asleep, sleep disturbances almost always occur when the patch is used for twenty-four hours. The patch can cause vivid, colorful dreams, too. Taking the patch off after 16 hours may help avoid this problem, but it can leave you craving a cigarette in the morning.

It is advised to start using the nicotine patch on your quit day. If you happen to have a brief lapse and smoke a cigarette or briefly use another type of tobacco, do not stop your nicotine therapy program. It is important to quickly get back to your quit plan and try to avoid relapse to your previous smoking or tobacco use. If you resume your previous pattern of tobacco use, discontinue patch use and re-examine your quit plan with your doctor or coach. Using tobacco at significant levels and the patch as directed might cause you to have an excessive amount of nicotine in your blood. While the patch eliminates most of health risks associated with tobacco use, nicotine itself can cause serious medical problems if abused. Keep out of reach of children and animals.

If you are considering patches, first read this information from the National Institutes of Health and see your doctor:

Content author: Alan S. Peters, CTTS-M
Reviewed by: Ann Wendling, MD, MPH, April 2013

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