Medications

Nicoderm® patches   

This product is manufactured by McNeil Consumer Healthcare using the ingredient nicotine.

This product is taken via transdermal system.

Why is it prescribed?

As an aid to smoking cessation for partial relief of nicotine withdrawal symptoms. This treatment should be used as part of a comprehensive behavioural smoking-cessation program.


Nicoderm® is a multilayered rectangular film containing nicotine as the active ingredient. It provides 24 hour rate controlled delivery of nicotine following its application to intact skin. Nicoderm® reduces the withdrawal symptoms associated with smoking cessation and thus increases the success rate of smoking cessation programs. The patient should be urged to stop smoking completely when initiating Nicoderm® therapy. Patients should be informed that if they continue to smoke while using Nicoderm® systems, they may experience adverse effects due to high nicotine levels.

How to use Nicoderm® patches:
1.Do not remove the Nicoderm patch from its sealed protective pouch until you are ready to use it. Nicoderm patches will lose nicotine to the air if you store them out of the pouch. Use scissors to cut the protective pouch on the dotted line. 
2.Choose a nonhairy, clean, dry area of your front or back above the waist or the upper outer area of your arm. Do not put Nicoderm patches on skin that is burned, broken out, cut, or irritated in any way. Make sure your skin is free of lotion and soap before applying a patch. 
3.A clear protective liner covers the sticky side of the Nicoderm patch, which is the side that will be put on your skin. The liner has a slit down the middle to help you remove it from the patch. With the sticky side facing you, pull one half of the liner away from the Nicoderm patch starting at the middle slit. Hold the Nicoderm patch at one of the outside edges (touch the sticky side as little as possible), and pull off the other half of the protective liner. Throw away this liner. 
4.Immediately apply the sticky side of the Nicoderm patch to your skin. Press the patch firmly on your skin with the heel of your hand for at least 10 seconds. Make sure it sticks well to your skin, especially around the edges. 
5.Rinse your hands with water when you have finished applying the Nicoderm patch. Do not use soap as it may increase the absorption of nicotine by your skin. Nicotine on your hands could get into your eyes and nose, and cause stinging, redness or more serious problems. 
6.After 24 hours, remove the Nicoderm patch you have been wearing. Choose a different place on your skin to apply the next patch and repeat steps 1 to 5. Do not return to a previously used skin site for at least 1 week. Do not leave the patch on for more than 24 hours, as it may irritate your skin and because it loses strength after 24 hours. 

When you first put on a Nicoderm® patch, mild itching, burning or tingling is normal and should go away within 1 hour. After you remove the patch, the skin under the patch might be somewhat red. Your skin should not stay red for more than 1 day. If you get a skin rash after using a patch, or if the skin under the patch becomes swollen or very red, remove the patch, wash the area with water (do not use soap). Do not put on a new patch. Call your doctor or pharmacist. You may be allergic to one of the components of the patch.

Water will not usually affect the patch if it is applied correctly. You may bathe, swim, shower, or exercise while wearing the patch. It should be removed 2 hours before engaging in prolonged strenuous exercise. 
If a patch does fall off, dispose of it and put on a new patch as soon as possible. Be sure the area is non-hairy, clean (not oily), dry, and free of creams, lotions, oils or powder. You should remove this replacement patch at the time you regularly change the patch (the time you would have replaced the other patch if it had not fallen off). 

You cannot adjust your dose by cutting a patch, even though the smallest patch contains half the nicotine contained in the next size up. Cutting a patch will cause the nicotine to evaporate rapidly, making all the pieces useless. 

Store at room temperature, between 15 and 30 degrees C. Apply immediately upon removal from pouch, and do not store after the pouch has been opened.


Alternatives

Other products that have the same ingredient as Nicoderm® patches are •Habitrol® patches •Nicorette® gum •Nicorette® inhaler •Nicorette® Lozenges •Nicorette® Quick Mist •Nicotine Gum •Nicotine Patch •Thrive® gum •Thrive® lozenges •

See other products used in the treatment of •nicotine withdrawal symptoms •

Patients must be motivated to stop smoking and should be instructed to stop smoking immediately as they begin using Nicoderm® therapy. For the first 6 weeks you will use the highest strength, step 1 (21mg/day) because at first your body's cravings will be strongest. Weeks 7 and 8 you will use step 2 (14mg/day). For weeks 9 and 10 you will use step 3 (7mg/day). However, if you smoke less than 10 cigarettes a day, weigh less than 45 kilograms or have heart disease and your doctor recommended Nicoderm® you should start with step 2 (14mg/day). For the first 6 weeks you will use step 2 (14mg/day) then for weeks 7 and 8 you will use step 3 (7mg/day). If you need to, use step 3 (7mg/day) for an additional 2 weeks (weeks 9 and 10). If you do not understand how to use the patch or the dosing schedule ask your pharmacist.


Nicotine replacement therapy provides a lower level of nicotine to your blood than cigarettes, and allows the body's need for nicotine to gradually go away. It works as a temporary aid to help with smoking cessation by reducing nicotine cravings and nicotine withdrawal symptoms.


Along with its needed effects, nicotine replacement may cause some unwanted or undesirable effects. Generally, nicotine replacement is well tolerated and many people will not experience unwanted effects. The frequency and severity of these effects is dependant on many factors including dose, duration of therapy and individual susceptibility. Possible unwanted effects include:

  • belching
  • increased appetite
  • injury or irritation to mouth, teeth or dental work (chewing gum only)
  • trouble sleeping
  • unusual dreams

Rare:

  • fast or irregular heartbeat
  • high blood pressure
  • hives
  • rash
  • stomach pain
  • coughing
  • irritability

 


Do not continue to smoke while using nicotine replacement products.(If using nicotine gum to cut back, do not smoke at the same time as chewing gum.) If you smoke or use other nicotine-containing products while using nicotine replacement you may get a nicotine overdose. Signs of an overdose include headaches, dizziness, nausea, abdominal pain, drooling, vomiting, diarrhea, cold sweat, blurred vision, difficulty with hearing, mental confusion, weakness and fainting, rapid heartbeat and difficulty breathing. If you experience any of these symptoms contact your doctor or Poison Control Centre at once.

Do not use nicotine replacement therapy if you have:

  • certain heart conditions (e.g. heart attacks, heart beat irregularities)is contraindicated.
  • recent stroke
  • skin diseases
  • known allergy to the patches or to nicotine

Consult your doctor first if you have ever had any of the following:

  • irregular heart beat (arrhythmia)
  • high blood pressure
  • overactive thyroid (hyperthyroidism)
  • stomach ulcers
  • kidney or liver disease
  • diabetes requiring insulin
  • treatment for poor circulation
  • rashes from adhesive tape or bandages

Drug Interactions: It is important to tell your doctor and pharmacist of any prescription or over-the-counter medications you are taking. In some cases the dose of one or both drugs may need to be altered or another drug may be prescribed. The concentration of medication in the body may be altered by smoking cessation with or without nicotine replacement. The dosage of certain medications may require adjustment. Drugs whose concentrations may be affected by smoking cessation include:

  • acetaminophen
  • imipramine
  • oxazepam
  • propranolol
  • theophylline
  • insulin
  • prazosin
  • labetalol

Use in pregnancy: Consult your doctor or pharmacist if you suspect you are pregnant.
Use while breastfeeding: Consult your doctor or pharmacist before use.


Page Last Updated: 05/10/2016