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Nicotine PatchAka: Transdermal Nicotine, Nicoderm, Nicotrol

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  1. See Also
    1. Tobacco Abuse
    2. Nicotine Replacement
  2. Indications
    1. Tobacco Cessation
  3. Efficacy
    1. Six month quit rate: 26% (12% for Placebo)
    2. Best in white, non-obese with low nicotine dependence
      1. Lerman (2004) Ann Intern Med 140:426
  4. Procedure
    1. Stop Tobacco use first (>12 hours before first patch)
    2. Counsel not to use Tobacco with patch
      1. Excessive Nicotine Replacement is uncomfortable
      2. Concurrent Tobacco increases relapse rate to 100%
    3. Apply new patch daily to non-hairy skin
      1. Upper torso or arm
    4. Do not reuse skin sites for at least 1 week
    5. New patch applied each 24 hours
  5. Formulations
    1. Determining level of Nicotine Replacement
      1. See Fagerstrom Test for Nicotine Dependence
      2. Indications to reduce dosage
        1. Coronary Artery Disease
        2. Body weight <100 pounds
        3. Tobacco use less than 1/2 pack per day
    2. Dose based on Cigarette usage
      1. Smoking >10 Cigarettes per day
        1. 21 mg/day for 6-8 weeks
        2. 14 mg/day for 2-4 weeks
        3. 7 mg/day for 2-4 weeks
      2. Smoking <10 Cigarettes per day
        1. 15 mg/16-24 hours for 6 weeks
    3. Dose based on manufacturer schedules
      1. Nicoderm or Habitrol
        1. First 4 weeks: 21 mg patch per day
        2. Next 4 weeks: 14 mg patch per day
        3. Next 4 weeks: 7 mg patch per day
      2. Prostep
        1. First 6 weeks: 22 mg patch per day
        2. Optional taper: 11 mg patch per day
      3. Nicotrol
        1. First 6 weeks: 15 mg patch per day
  6. Adverse Effects
    1. Minor skin irritation (30-50%)
      1. Rotate patch application sites
      2. Symptoms: Erythema, Pruritus, Local burning sensation
    2. Sleep disturbance (consider removing patch at bedtime)
      1. Insomnia
      2. Abnormal dreams
    3. Diarrhea
    4. Dyspepsia
    5. Myalgia
    6. Nervousness
  7. Contraindications
    1. Pregnancy
    2. Unstable Angina or recent Myocardial Infarction
      1. Nicotine Replacement is safe in stable CAD
      2. Joseph (1996) N Engl J Med 335:1792
    3. Life threatening arrhythmia
    4. Active Peptic Ulcer Disease
  8. References
    1. Mallin (2002) Am Fam Physician 65:1107-17

Nicotine patches (C0358855)

Definition (NCI)A transepidermal patch designed to deliver nicotine, the addictive substance contained in cigarettes, directly through the skin and into the blood stream. Used for cessation of smoking.
ConceptsClinical Drug (T200)
EnglishNicotine m/r transdermal patch, nicotine patch, Nicotine patches, Nicotine Skin Patch
Spanishparche de nicotina
Parent Conceptsnicotine replacement system (C0813972), Transdermal Patch (C0991556), Nicotine (C0028040), Duplicate concept (C1274013)
SourcesAOD, CSP, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Nicoderm (C0701369)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishNicoderm
SourcesRXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Nicotrol (C0722099)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishNicotrol
SourcesRXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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