How much nicotine is in the patch. Nicotine Patch: Dosage, Usage, and Safety Guidelines for Smoking Cessation
How much nicotine is in a patch. What are the effects of nicotine patches on pregnant smokers. How to use nicotine patches correctly for smoking cessation. What are the potential side effects and precautions when using nicotine patches.
Understanding Nicotine Patch Strengths and Dosages
Nicotine patches are a popular smoking cessation aid designed to deliver controlled amounts of nicotine through the skin. The patches come in three different strengths:
- Step 1: 21mg nicotine delivered over 24 hours
- Step 2: 14mg nicotine delivered over 24 hours
- Step 3: 7mg nicotine delivered over 24 hours
The choice of patch strength depends on the individual’s smoking habits. For those who smoke more than 10 cigarettes per day, a 10-week program is recommended:
- Weeks 1-6: Use one 21mg patch per day
- Weeks 7-8: Use one 14mg patch per day
- Weeks 9-10: Use one 7mg patch per day
For smokers who consume 10 or fewer cigarettes daily, the program starts with Step 2 (14mg) for 6 weeks, followed by Step 3 (7mg) for 2 weeks.
Proper Application and Usage of Nicotine Patches
To maximize the effectiveness of nicotine patches, it’s crucial to follow the correct application and usage guidelines:
- Apply one new patch every 24 hours on clean, dry, and hairless skin
- Press the patch firmly onto the skin for 10 seconds after removing the backing
- Wash hands after applying or removing the patch
- Wear the patch for 16 or 24 hours, depending on individual needs
- Remove the used patch and apply a new one to a different skin site at the same time each day
- Do not wear more than one patch at a time or cut patches into smaller pieces
Is it necessary to wear the patch for the full 24 hours? If you experience cigarette cravings upon waking, it’s recommended to wear the patch for the full 24-hour period. However, if you experience vivid dreams or sleep disturbances, you may remove the patch at bedtime and apply a new one in the morning.
Safety Precautions and Warnings for Nicotine Patch Users
While nicotine patches are generally considered safe for most adults, there are important precautions to keep in mind:
- Consult a healthcare provider before use if pregnant or breastfeeding
- Do not use patches if continuing to smoke or use other nicotine-containing products
- Seek medical advice before use if you have heart disease, recent heart attack, irregular heartbeat, or uncontrolled high blood pressure
- Inform your doctor or pharmacist if you’re using non-nicotine stop-smoking drugs or taking prescription medications for depression or asthma
- Discontinue use and consult a doctor if you experience persistent skin irritation, irregular heartbeat, or symptoms of nicotine overdose
Can nicotine patches be used safely by individuals with certain medical conditions? While nicotine patches can be an effective tool for smoking cessation, individuals with heart conditions, high blood pressure, or skin sensitivities should consult their healthcare provider before starting treatment to ensure safety and adjust dosages if necessary.
Potential Side Effects and Management Strategies
Users of nicotine patches may experience some side effects, which are often manageable:
- Skin irritation or redness at the patch site
- Vivid dreams or sleep disturbances
- Nausea, vomiting, dizziness, or weakness
- Rapid heartbeat or palpitations
How can users minimize skin irritation from nicotine patches? To reduce the risk of skin irritation, rotate the patch application site daily, avoid using lotions or oils on the skin before applying the patch, and ensure the skin is clean and dry. If irritation persists for more than four days, consult a healthcare provider.
Nicotine Patches and Pregnancy: Considerations and Risks
The use of nicotine patches during pregnancy is a complex issue that requires careful consideration:
- Pregnant women should attempt to quit smoking without nicotine replacement therapy if possible
- Nicotine patches are believed to be safer than smoking during pregnancy, but risks are not fully known
- Consultation with a healthcare provider is essential before using nicotine patches while pregnant or breastfeeding
What are the potential effects of nicotine patches on pregnant smokers? While nicotine patches may help reduce exposure to harmful chemicals found in cigarette smoke, nicotine itself can still pose risks to fetal development. Studies have shown that nicotine and cotinine concentrations in pregnant smokers using patches or nasal sprays may differ from those who continue to smoke, but the long-term implications for fetal health are not fully understood.
Combining Nicotine Patches with Other Smoking Cessation Methods
Nicotine patches can be used in conjunction with other smoking cessation strategies to improve quit rates:
- Behavioral counseling and support groups
- Nicotine gum or lozenges for breakthrough cravings
- Prescription medications like bupropion or varenicline
- Mindfulness and stress-reduction techniques
Is it safe to use nicotine patches alongside other nicotine replacement products? While combining nicotine patches with short-acting forms of nicotine replacement (such as gum or lozenges) can be effective for some individuals, it’s crucial to consult a healthcare provider before doing so to avoid nicotine overdose and ensure proper usage.
Proper Disposal and Storage of Nicotine Patches
Correct handling and disposal of nicotine patches are important for safety reasons:
- Store patches at room temperature (20-25°C or 68-77°F)
- Keep patches out of reach of children and pets
- Dispose of used patches by folding sticky ends together and placing them back in the original pouch
- Discard used patches in a secure trash container, away from children and pets
Why is proper disposal of nicotine patches crucial? Used nicotine patches still contain significant amounts of nicotine, which can be toxic if ingested by children or pets. Proper disposal helps prevent accidental exposure and potential poisoning incidents.
Long-term Success and Relapse Prevention
While nicotine patches can be an effective tool for quitting smoking, long-term success often requires additional strategies:
- Completing the full recommended program duration
- Developing coping mechanisms for stress and triggers
- Establishing a support network of friends, family, or support groups
- Incorporating lifestyle changes that promote overall health and well-being
How can individuals maintain their quit status after completing the nicotine patch program? Ongoing support, continued use of coping strategies, and regular physical activity can help maintain smoking cessation. Some individuals may benefit from extended use of nicotine replacement therapy or other medications under medical supervision to prevent relapse.
Cost Considerations and Insurance Coverage
The cost of nicotine patches can vary depending on several factors:
- Brand name vs. generic options
- Dosage strength and duration of treatment
- Insurance coverage and pharmacy discounts
- Over-the-counter availability in some regions
Are nicotine patches covered by health insurance? Many health insurance plans now cover smoking cessation treatments, including nicotine patches, as preventive care. Check with your insurance provider to understand your coverage options and potential out-of-pocket costs.
Nicotine Patches vs. Other Nicotine Replacement Therapies
While nicotine patches are a popular choice, other nicotine replacement therapies (NRTs) are available:
- Nicotine gum
- Nicotine lozenges
- Nicotine nasal spray
- Nicotine inhalers
How do nicotine patches compare to other forms of NRT? Nicotine patches provide a steady, controlled release of nicotine throughout the day, which can be beneficial for managing background cravings. Other forms of NRT, such as gum or lozenges, offer more immediate relief for acute cravings but require more frequent use. The choice between different NRT options depends on individual preferences, smoking habits, and medical considerations.
Impact of Nicotine Patches on Weight Management During Smoking Cessation
Weight gain is a common concern for individuals quitting smoking. Nicotine patches may help address this issue:
- Nicotine can act as an appetite suppressant
- Patches may help manage food cravings associated with smoking cessation
- Gradual reduction of nicotine intake can help mitigate potential weight gain
Can nicotine patches help prevent weight gain when quitting smoking? While nicotine patches may help reduce weight gain in the short term, they are not a long-term solution for weight management. Combining nicotine replacement therapy with a healthy diet and regular exercise is the most effective approach for managing weight during and after smoking cessation.
Nicotine Patches and Cardiovascular Health
The use of nicotine patches can have implications for cardiovascular health:
- Nicotine can increase heart rate and blood pressure
- Patches deliver nicotine more slowly and steadily than cigarettes
- Overall cardiovascular risk is generally lower with patches compared to smoking
Are nicotine patches safe for individuals with pre-existing heart conditions? While nicotine patches are generally considered safer than continued smoking, individuals with heart disease, recent heart attacks, or uncontrolled high blood pressure should consult their healthcare provider before using nicotine patches. Close monitoring and potential dosage adjustments may be necessary to ensure safety.
Psychological Aspects of Using Nicotine Patches
The psychological component of using nicotine patches for smoking cessation is significant:
- Patches can help break the hand-to-mouth habit associated with smoking
- They provide a sense of control over nicotine intake
- Using patches can serve as a visible reminder of the commitment to quit
How do nicotine patches address the psychological aspects of smoking addiction? By providing a controlled source of nicotine, patches help manage physical cravings, allowing individuals to focus on breaking the behavioral and emotional aspects of smoking addiction. This separation of physical and psychological dependence can be crucial for long-term success in quitting smoking.
Nicotine Patches and Sleep Quality
The impact of nicotine patches on sleep is an important consideration:
- 24-hour patches may cause sleep disturbances or vivid dreams
- Removing the patch before bedtime can help mitigate sleep issues
- Individual responses to nighttime patch use can vary
How can users optimize their sleep while using nicotine patches? If experiencing sleep disturbances, users can try removing the patch 3-4 hours before bedtime and applying a new one upon waking. It’s also helpful to practice good sleep hygiene, such as maintaining a consistent sleep schedule and avoiding caffeine in the evening.
Long-term Health Benefits of Quitting Smoking with Nicotine Patches
Successfully quitting smoking using nicotine patches can lead to numerous health benefits:
- Reduced risk of heart disease and stroke
- Improved lung function and reduced risk of respiratory diseases
- Decreased risk of various cancers
- Enhanced overall quality of life and life expectancy
How quickly do health improvements occur after quitting smoking? Some health benefits, such as improved circulation and lung function, can begin within weeks of quitting. Other benefits, like reduced risk of heart disease and cancer, continue to accrue over months and years of remaining smoke-free.
In conclusion, nicotine patches are a valuable tool in the smoking cessation arsenal, offering a controlled and steady delivery of nicotine to help manage cravings and withdrawal symptoms. When used correctly and in conjunction with other supportive strategies, they can significantly increase the chances of successfully quitting smoking. However, it’s crucial to follow proper usage guidelines, be aware of potential side effects, and consult healthcare providers when necessary, especially for individuals with pre-existing health conditions or during pregnancy. The journey to becoming smoke-free is challenging, but with the right approach and support, it’s an achievable goal that can lead to substantial improvements in health and quality of life.
Nicotine Patch: Package Insert – Drugs.com
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Package insert / product label
Dosage form: patch, extended release
Drug class: Smoking cessation agents
Medically reviewed by Drugs.com. Last updated on Jan 23, 2023.
On This Page
- Indications and Usage
- Warnings
- Dosage and Administration
Active ingredient Step 1 (in each patch)
Nicotine, 21mg delivered over 24 hours
Active ingredient Step 2 (in each patch)
Nicotine, 14mg delivered over 24 hours
Active ingredient Step 3 (in each patch)
Nicotine, 7mg delivered over 24 hours
Purpose
Stop smoking aid
Use
reduces withdrawal symptoms, including nicotine craving, associated with quitting smoking
Warnings
If you are pregnant or breast-feeding, only use this medicine on the advice of your health care provider. Smoking can seriously harm your child. Try to stop smoking without using any nicotine replacement medicine. This medicine is believed to be safer than smoking. However, the risks to your child from this medicine are not fully known.
Do not use
- If you continue to smoke, chew tobacco, use snuff, or use a nicotine gum or other nicotine containing products
Ask a doctor before use if you have
- heart disease, recent heart attack, or irregular heartbeat. Nicotine can increase your heart rate.
- high blood pressure not controlled with medication. Nicotine can increase your blood pressure.
- an allergy to adhesive tape or have skin problems because you are more likely to get rashes
Ask a doctor or pharmacist before use if you are
- using a non-nicotine stop smoking drug
- taking a prescription medicine for depression or asthma. Your prescription dose may need to be adjusted.
When using this product
- do not smoke even when not wearing the patch. The nicotine in your skin will still be entering your blood stream for several hours after you take off the patch.
- If you have vivid dreams or other sleep disturbances remove this patch at bedtime
Stop use and ask a doctor if
- skin redness caused by the patch does not go away after four days, or if your skin swells, or you get a rash
- irregular heartbeat or palpitations occur
- you get symptoms of nicotine overdose such as nausea, vomiting, dizziness, weakness, and rapid heartbeat
Keep out of reach of children and pets.
Used patches have enough nicotine to poison children and pets. If swallowed, get medical help or contact a Poison Control Center right away. Dispose of the used patches by folding sticky ends together. Replace in pouch and discard.
Directions
- if you are under 18 years of age, ask a doctor before use
- before using this product, read the enclosed User’s Guide for complete directions and other information
- stop smoking completely when you begin using the patch
- if you smoke more than 10 cigarettes per day, use according to the following 10-week schedule:
STEP 1 STEP 2 STEP 3 Use one 21mg patch/day Use one 14mg patch/day Use one 7mg patch/day Weeks 1-6 Weeks 7-8 Weeks 9-10
- if you smoke 10 or less cigarettes per day, do not use STEP 1 (21mg). Start with STEP 2 (14mg) for 6 weeks, then STEP 3 (7mg) for 2 weeks and then stop.
- steps 2 and 3 allow you to gradually reduce your level of nicotine. Completing the full program will increase your chances of quitting successfully.
- apply one new patch every 24 hours on skin that is dry, clean and hairless. Save pouch for disposing of the patch after use.
- remove backing from patch and immediately press onto skin. Hold for 10 seconds.
- wash hands after applying or removing patch. Throw away the patch by folding sticky ends together. Replace in its pouch and discard. See enclosed User’s Guide for safety and handling.
- you may wear the patch for 16 or 24 hours.
- if you crave cigarettes when you wake up, wear the patch for 24 hours.
- if you have vivid dreams or other sleep disturbances, you may remove the patch at bedtime and apply a new one in the morning
- the used patch should be removed and a new one applied to a different skin site at the same time each day
- do not wear more than one patch at a time
- do not cut patch in half or into smaller pieces
- do not leave patch on for more than 24 hours because it may irritate your skin and loses strength after 24 hours
- stop using the patch at the end of 10 weeks. If you started with STEP 2, stop using the patch at the end of 8 weeks. If you still feel the need to use the patch, talk to your doctor.
Inactive ingredients
ethylene vinyl acetate-copolymer, polyisobutylene and high density polyethylene between clear polyester backings
Other information
store at 20 – 25oC (68 – 77oF)
Made in Switzerland
See top panel for lot number and expiration date.
*NICODERM is a licensed trademark of the GlaxoSmithKline group of companies.
Questions and comments?
call toll-free 1-877-306-0019
(English/Spanish) weekdays (9:00 a.m. – 4:30 p.m. ET)
Principal Display Panel
NDC 0363-0194-02
CLEAR Nicotine Transdermal System Patch
Walgreens
STEP 1
21mg delivered over 24 hours
14 Clear Patches
2 WEEK KIT
STOP SMOKING AID
with Behavior Support Program
If you smoke more than 10 cigarettes per day: start with Step 1
If you smoke 10 or less cigarettes per day: start with Step 2
Compare to NicoDerm® CQ®*
Principal Display Panel
NDC 0363-0195-02
CLEAR Nicotine Transdermal System Patch
Walgreens
STEP 2
14mg delivered over 24 hours
14 Clear Patches
2 WEEK KIT
STOP SMOKING AID
with Behavior Support Program
If you smoke more than 10 cigarettes per day: start with Step 1
If you smoke 10 or less cigarettes per day: start with Step 2
Compare to NicoDerm® CQ®*
Principal Display Panel
NDC 0363-0196-02
CLEAR Nicotine Transdermal System Patch
Walgreens
STEP 3
7mg delivered over 24 hours
14 Clear Patches
2 WEEK KIT
STOP SMOKING AID
with Behavior Support Program
For use after completing Step 2
Compare to NicoDerm® CQ®*
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Labeler – Walgreens (008965063) |
Walgreens
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Medical Disclaimer
Nicotine Replacement Therapy to Help You Quit Tobacco
Nicotine is the main addictive substance in tobacco. When a person uses tobacco, many parts of the body get used to having nicotine in them. When a person quits tobacco, they also quit nicotine and will likely have withdrawal symptoms from it. This is because the body has to get used to not having nicotine.
The nicotine in tobacco leads to actual physical dependence. This can cause unpleasant withdrawal symptoms when a person tries to quit. Nicotine replacement therapy (NRT) gives you nicotine – in the form of gum, patches, sprays, inhalers, or lozenges – but not the other harmful chemicals in tobacco. NRT can help relieve some of the physical withdrawal symptoms so that you can focus on the psychological (emotional) aspects of quitting.
Many studies have shown using NRT can nearly double the chances of quitting smoking. It hasn’t been studied as much for quitting smokeless tobacco, but the NRT lozenges may help.
People who smoke and are significantly dependent on nicotine should consider nicotine replacement or drug therapy to help them quit. Signs of severe nicotine dependence include:
- Smoking more than 1 pack a day
- Smoking within 5 minutes of waking up
- Smoking even while sick
- Waking up at night to smoke
- Smoking to ease symptoms of withdrawal
The more of these that apply, the more serious the nicotine dependence.
How does nicotine replacement therapy work?
Nicotine replacement therapy (NRT) can help with the difficult withdrawal symptoms and cravings that most people say is their only reason for not giving up tobacco. Using NRT reduces those symptoms.
Many people can quit tobacco without using NRT, but most of those who attempt quitting do not succeed on the first try. In fact, people trying to quit usually need many tries before they’re able to quit for good. Most people who try to quit on their own go back to smoking within the first month of quitting – often because of the withdrawal symptoms. But the good news is that many do succeed. In fact, there are now more people who formerly smoked than people who currently smoke!
Together with counseling or other support, NRT may help increase the number of smokeless tobacco users who quit, too.
You can start using nicotine replacement therapy (NRT) as soon as you throw away your tobacco. You don’t need to wait a certain length of time to put on the patch or start using the gum, lozenge, nasal spray, or inhaler. Double-check this information with the instructions on your chosen method of nicotine replacement, but in general there’s no need to wait to start using NRT.
Getting the most from nicotine replacement therapy
Nicotine replacement therapy (NRT) only deals with the physical dependence. It’s not meant to be the only thing you use to help you quit smoking. You’ll need other methods that help with the psychological (emotional and mental) part of tobacco, such as a quit program. Use these support systems during treatment with NRT and for at least a few months after you quit. Studies have shown that this approach – pairing NRT with a program that helps to change behavior – can improve your chances of quitting and staying quit compared to approaches that use only one method.
The best time to start NRT is when you first quit. Often people first try to quit tobacco on their own then decide to try NRT a day or more into quitting. This does not give you the greatest chance of success, but don’t let this discourage you. There are many options for quitting and staying quit. Just remember that it often takes many tries.
The Food and Drug Administration (FDA) has approved the NRT products discussed here as effective aids for helping people quit smoking. None of these products has been FDA-approved specifically to help people quit smokeless tobacco. Still, studies are being done, and some have shown the lozenge form may help.
Who should not use nicotine replacement therapy?
The US Agency for Healthcare Research and Quality states that nicotine replacement therapy (NRT) is safe for all adults who want to quit smoking except pregnant women and teens. Still, it’s best to discuss NRT use with your health care provider before starting it. You may have medical problems that should be considered. When deciding whether to use NRT, the benefits of quitting tobacco must outweigh the potential health risks of NRT for each person.
People who are still smoking or using any other form of tobacco should not use NRT. The companies that make NRT products warn that you should not use them if you’re still using tobacco, and the FDA has not approved them to be used in this way. Get the advice of a health care provider if you want to use NRT while continuing to smoke or chew.
NRT has not yet been proven to help people who smoke fewer than 10 cigarettes a day. But many tobacco treatment centers do use NRT for people who are “light smokers.” Talk with your health care provider about a lower dose of NRT if you smoke less than that but feel you need nicotine replacement.
Types of nicotine replacement therapy
The US Food and Drug Administration (FDA) has approved 5 forms of nicotine replacement therapy (NRT):
- Patch
- Gum
- Nasal spray
- Inhalers
- Lozenges
Note that the patch, gum, and lozenge can be purchased over the counter, while the nasal spray and inhaler require a prescription.
The most important thing to do with any form of NRT is read and follow the package instructions very carefully.
Nicotine patches (transdermal nicotine systems)
Patches can be bought with or without a prescription.
Patches give a measured dose of nicotine through the skin. You’re weaned off nicotine by switching to lower-dose patches over a course of weeks.
Many different types and strengths of patches are available, including 16-hour and 24-hour patches. Which patch you should use depends on how many cigarettes you smoke each day. Package instructions tell you how to use them, and list special considerations and possible side effects.
How to use nicotine patches: Depending on body size and smoking habits, most people who smoke should start using a full-strength patch (15-22 mg of nicotine) daily for several weeks, and then use a weaker patch (5-14 mg of nicotine) for another several weeks. The patch is changed every day. It should be put on in the morning on a clean, dry area of the skin without much hair. It should be placed below the neck and above the waist – for instance, on the upper arm or chest. The FDA has approved using the patch for a total of 3 to 5 months, but using it longer is better than going back to smoking.
Possible side effects of the nicotine patch include:
- Skin irritation (redness and itching)
- Dizziness
- Racing heartbeat
- Sleep problems or unusual dreams (more common with the 24-hour patch)
- Headache
- Nausea
- Muscle aches and stiffness
No one has all of the side effects, and some people have none. Some side effects, such as racing heart, may mean the dose of nicotine is too high for you. Stop using the patch and talk to your health care provider if this happens. You could also have nicotine withdrawal symptoms if your NRT dose is too low.
What to do about side effects
- Try a different brand of patch if your skin becomes irritated.
- Reduce the amount of nicotine by using a lower-dose patch.
- Sleep problems may go away in 3 or 4 days. If not, and you’re using a 24-hour patch, try switching to a 16-hour patch.
- Stop using the patch and try a different form of NRT.
Nicotine gum (nicotine polacrilex)
Nicotine gum can be bought without a prescription.
Nicotine gum is a fast-acting form of replacement. Nicotine is taken in through the mucous membrane of the mouth. You can buy it over the counter (without a prescription). It comes in 2 mg and 4 mg strengths.
In choosing your dose, think about whether you
- Smoke 25 or more cigarettes per day
- Smoke within 30 minutes of waking up
- Have trouble not smoking in restricted areas
If any of these describe you, you may need to start with the higher 4mg gum dose.
How to use nicotine gum
For best results, follow the instructions in the package. Nicotine gum is not meant to be used like regular gum. Chew the gum slowly until you get a peppery taste or tingle. Then tuck it inside your cheek until the taste fades. Chew it to get the peppery taste back, and hold it again. Do this off and on for 20 to 30 minutes. Food and drink can affect how well the nicotine is absorbed, so don’t eat or drink for at least 15 minutes before and during gum use. This is important because many people misuse the nicotine gum and chew it like regular gum instead of how it should be used.
An advantage of nicotine gum is that it allows you to control the amount of nicotine you get. The gum can be used as needed or on a fixed schedule during the day. The most recent research has shown that scheduled dosing works better. A schedule of 1 to 2 pieces per hour is common. On the other hand, with an as-needed schedule, you can use it when you need it most – when you have cravings.
Chew no more than 24 pieces of gum in one day. Nicotine gum is usually recommended for 6 to 12 weeks, with the maximum being 6 months. Tapering down the amount of gum you use as you approach 3 months may help you stop using it. But it is better to keep using the gum rather than starting to smoke again.
Possible side effects of nicotine gum include:
- Bad taste
- Throat irritation
- Mouth sores
- Hiccups
- Nausea
- Jaw discomfort
- Racing heartbeat
The gum can also stick to and damage dentures and dental work.
Stomach and jaw discomfort are usually caused by improper use of the gum, such as swallowing the nicotine or chewing too fast. No one has all of the side effects, and some people have none. If your heart is racing or beating irregularly, stop using the gum and talk to your health care provider. You could also have nicotine withdrawal symptoms if your NRT dose is too low.
Nicotine nasal spray
Nicotine nasal spray is only available by prescription.
The nasal spray delivers nicotine to the bloodstream rapidly because it’s absorbed through the nose. It relieves withdrawal symptoms very quickly and lets you control your nicotine cravings.
How to use nicotine nasal spray
Most people are told to use 1 to 2 doses per hour. (1 dose = 2 sprays, 1 in each nostril.) At least 8 doses (16 sprays) each day may be needed when you first start, but use as directed by your health care provider. You should not use more than 40 doses (80 sprays) per day. Instructions can vary. Talk to your provider about the plan that’s best for you.
The FDA recommends that the spray be prescribed for 3-month periods and that it not be used for longer than 6 months.
Possible side effects of nicotine spray
The most common side effects of the spray get better in about 1 to 2 weeks and can include:
- Nasal irritation
- Runny nose
- Watery eyes
- Sneezing
- Throat irritation
- Coughing
Other side effects are related to nicotine:
- Racing heart
- Nervousness
- Headache
No one has all of the side effects, and some people have none. Some side effects, such as racing heart, may occur because you’ve gotten too much nicotine. Stop using the spray to see if the feelings get better and talk to your health care provider if this happens. You may need to use it less often. You could also have nicotine withdrawal symptoms if your NRT dose is too low.
If you have asthma, allergies, nasal polyps, or sinus problems, your provider may suggest another form of NRT.
Special note: This form of NRT poses a more serious risk to small children and pets because the empty bottles of nasal spray contain enough nicotine to harm them. Do not get the liquid on your skin. If there’s any skin contact, rinse thoroughly with plain water right away. If a bottle breaks or liquid leaks out, put on plastic or rubber gloves to clean it up. Call Poison Control and get emergency help if there’s any question of overdose.
Nicotine inhalers
Inhalers are available only by prescription.
The nicotine inhaler is a thin plastic tube with a nicotine cartridge inside. Unlike other inhalers, which deliver most of the medicine to the lungs, the nicotine inhaler delivers most of the nicotine vapor to the mouth and throat where it’s absorbed into the bloodstream.
Nicotine inhalers are the FDA-approved nicotine replacement method that’s most like smoking a cigarette, which some people trying to quit find helpful. They are not the same as electronic cigarettes, which are not approved by the FDA to help people quit smoking. At this time, inhalers are the most expensive form of NRT available.
How to use the nicotine oral inhaler
You puff on the inhaler and the cartridge sends a pure nicotine vapor into your mouth. You may use up the cartridge all at once over about 20 minutes, or puff on it only a few minutes at a time. The recommended dose is between 4 and 20 cartridges a day, slowly tapering off over 6 months.
Possible side effects of the nicotine inhaler
The most common side effects, especially when first using the inhaler, include:
- Coughing
- Mouth and/or throat irritation
- Runny nose
- Upset stomach
Other side effects are related to nicotine:
- Racing heart
- Nervousness
- Headache
No one has all of the side effects, and some people have none. Some side effects, such as racing heart, may occur because you’ve gotten too much nicotine. Stop using the inhaler to see if the feelings get better and talk to your health care provider if this happens. You may need to use it less often. You could also have nicotine withdrawal symptoms if your NRT dose is too low.
Special note: This form of NRT poses an extra risk to small children and pets because the used cartridges still have enough nicotine in them to cause harm if it gets on skin or mucous membranes (for instance, if licked or touched to the eyes, mouth, or other mucous membrane). Be sure to store and dispose of the cartridges away from children and pets. Call Poison Control and get emergency help if there’s any question of overdose.
Nicotine lozenges
Nicotine lozenges can be bought without a prescription.
The lozenge is available in 2 strengths: 2 mg and 4 mg. The needed dose should be based on how long after waking up a person normally has their first cigarette. So, if you smoke your first cigarette within 30 minutes of waking up, use 4 mg nicotine lozenges. If you smoke your first cigarette more than 30 minutes after waking up, use 2 mg-nicotine lozenges. Some people who are using NRT prefer the lozenge to the gum because its use is less conspicuous.
How to use nicotine lozenges
The recommended dose is 1 lozenge every 1 to 2 hours for 6 weeks, then 1 lozenge every 2 to 4 hours for weeks 7 to 9, and finally, 1 lozenge every 4 to 8 hours for weeks 10 to 12. The lozenge makers also recommend:
- Do not eat or drink for at least 15 minutes before using a lozenge or while using a lozenge. (Some drinks can reduce how well the lozenge works.)
- Do not use more than 1 lozenge at a time and do not use one right after another.
- Suck on the lozenge until it is fully dissolved, about 20 to 30 minutes. Move it from side to side in your mouth. Do not bite or chew it like a hard candy, and don’t swallow it. The nicotine absorbs through the mucous membranes of the mouth.
- Do not use more than 5 lozenges in 6 hours, or more than 20 lozenges per day.
- Stop using the lozenge after 12 weeks. If you still feel you need to use the lozenge, talk to your doctor.
Possible side effects of the nicotine lozenge
- Nausea
- Hiccups
- Sore throat
- Coughing
- Heartburn
- Headache
- Gas
- Trouble sleeping
- Racing heart
Choosing and using the right nicotine replacement therapy for you
No one type of nicotine replacement therapy (NRT) – by itself or in combination – is necessarily any better than another. When choosing the type of NRT you will use, think about which method will best fit your lifestyle and pattern of smoking or using smokeless tobacco. For example, do you want/need something in your mouth or something to keep your hands busy? Are you looking for once-a-day convenience? How urgent are your cravings for nicotine?
Here are some important points to think about as you decide:
- Nicotine gums, lozenges, and inhalers are substitutes you can put into your mouth that let you control your dosage to help keep cravings under better control.
- Nicotine gums and lozenges are generally sugar-free, but if you are diabetic and have any doubts, check with the manufacturer.
- Nicotine nasal spray works very quickly when you need it.
- Nicotine inhalers allow you to mimic the use of cigarettes by puffing and holding the inhaler. It also works very quickly.
- Nicotine patches are convenient and only have to be put on once a day.
- Both inhalers and nasal sprays require a doctor’s prescription.
- Some people may not be able to use patches, inhalers, or nasal sprays because of allergies or other conditions.
- Nicotine gum may stick to dentures or dental work making it hard to chew before “parking.”
Whatever type you use, take your NRT at the recommended dose. NRT is not recommended for long-term use, but if it’s needed to prevent relapse, continuing to use NRT is preferable than returning to smoking.
If you use a different dose or stop taking it too soon, NRT can’t be expected to work like it should. If you smoke very heavily very lightly, or are a smokeless tobacco user, talk with your health care provider about how to get the NRT dose that best fits your needs.
What is light, average, and heavy smoking?
Most nicotine replacement therapy (NRT) products recommendations are based on how much you smoke. But there’s no formal category in any textbook or group that defines how much smoking is considered light, average, or heavy smoking.
These are general guidelines:
- Light smoking: Fewer than 10 cigarettes per day
- Heavy smoking: A pack a day or more
- Average smoking falls in between.
How do I know what NRT dose to use based on my smokeless tobacco use?
NRT products are supposed to roughly match the amount of nicotine you typically took in through tobacco. It can be more of a challenge to get the dose right for smokeless tobacco users, since NRT products are labeled for people who smoke.
Certain types of NRT may help more than others. If you look at the way the tobacco is used, nicotine gum and lozenges are most like using smokeless tobacco. They also let you control your dose to help keep nicotine cravings down. To avoid withdrawal symptoms, you want to aim for a nicotine dose fairly close to what you got from snuff or tobacco use.
These are general guidelines:
- A heavy user is a person who uses more than 3 cans of snuff or 3 pouches of tobacco a week, and would typically use the higher doses of NRT (the dose for people who smoke heavily).
- Those who use 2 to 3 cans or pouches per week would usually try the moderate doses.
- Those who use less than 2 would start with the lowest doses of NRT.
If you’ve decided to try NRT, discuss your dose with a health care provider before you quit tobacco.
Combining the patch and other nicotine replacement products
Using the nicotine patch along with shorter-acting products, like the gum, lozenge, nasal spray, or inhaler, is another method of NRT. The idea is to get a steady dose of nicotine with the patch and then use one of the shorter-acting products when you have strong cravings. In general, people who have smoked heavily do better with this combination approach. If you’re thinking about using more than one NRT product, be sure to talk to your health care provider first.
High-dose nicotine replacement therapy for people who smoke heavily
For people who have been smoking heavily, Another option is to use NRT at a higher than usual dose based on the amount of nicotine that they’ve been getting from cigarettes. At this time, not much is known about this option. High-dose NRT should be considered only with a health care provider’s guidance and close supervision.
Can you get too much nicotine from NRT?
Nicotine overdose is rare, but possible. Nicotine replacement therapy (NRT) products are labeled to match the amount of nicotine you get from NRT to the amount you got from tobacco. If used this way, you should get a nicotine dose fairly close to what you’ve been getting. You don’t want to get more than that, because higher doses of nicotine can cause harm. To avoid this, follow dosing instructions carefully. Also, don’t use heat (like a heating pad or heat lamp) on the skin near your nicotine patch – you could absorb more nicotine due to the increased blood supply.
Nicotine absorbs through the skin and mucous membranes, so you must store and dispose of your NRT safely. Nicotine overdose can be fatal, but this is rare and requires taking in very high doses of nicotine. Overdose is more of a problem in children and pets because of their smaller size. Keep NRT and used gum, patches, empty cartridges, bottles, etc., safely away from children and pets. Never drop them on the street or in open trash cans where kids and animals can reach them.
Symptoms of nicotine overdose
Here are some symptoms of too much nicotine:
- Headache
- Nausea and vomiting
- Belly pain
- Diarrhea
- Agitation, restlessness
- Fast or irregular heartbeat
- Cold sweat
- Pale skin and mouth
- Weakness
- Tremors (shaking)
- Confusion
- Disturbed vision and hearing
- Weakness
- High blood pressure, which then drops
- Dizziness or faintness due to low blood pressure
- Seizures
- Fast breathing in early poisoning, breathing may stop later
Call Poison Control and get emergency help if you suspect an overdose. If you’re taking NRT as prescribed and are still having mild symptoms such as headache, vomiting, diarrhea, or sweating, lower your dose and talk to your health care provider.
Does nicotine cause cancer?
No, nicotine has not been found to cause cancer. While nicotine is the addictive substance in tobacco, it is other compounds in tobacco that can cause cancer. Using NRT to quit tobacco does not increase your risk of cancer – in fact, it can help lower your risk if it helps you stop using tobacco.
Stopping nicotine replacement therapy
Nicotine replacement therapy (NRT) is meant to be used for a limited period of time. Use should be tapered down before NRT is stopped. Studies to date have not shown that extending NRT use longer than the recommended time greatly impacts quit success. However, long-term NRT use is still preferable to smoking.
Research is still being done to refine the use of NRT. If you feel that you need NRT for a different length of time than is recommended, it’s best to discuss this with your health care provider.
Long-term nicotine replacement therapy dependence
Nicotine replacement therapy (NRT) has the potential for long-term dependence. Nicotine is addictive, and people can transfer their dependence from tobacco to the NRT.
Use NRT only as long as you need it, as prescribed by your health care provider. Talk to your provider if you’re having trouble stopping NRT.
I quit smoking! Which is better – nicotine spray, patch or gum?
Smoking is the most common bad habit in the world. It affects over one billion people on the planet, who annually smoke trillions of cigarettes worth hundreds of billions of dollars.
Agree, this is an impressive amount, and many people would quickly give up smoking. Unfortunately, the number of smokers not only does not decrease, but also increases, as a result of which more and more new ways to quit smoking .
Products containing nicotine will not make you forget about cigarettes forever, nor will they completely discourage you from smoking. They will only slightly dampen that desire and alleviate the symptoms of nicotine withdrawal, giving you more opportunities to exercise willpower.
Products containing nicotine include products containing nicotine:
– chewing gums,
– patches,
– nasal sprays.
These products usually contain less nicotine than cigarettes and absorb it more slowly, so the addictive effect is less.
However, many smokers who use nicotine-containing drugs do not use them correctly or do not last long enough to show the expected effect.
The best effect is achieved if you start wearing a nicotine patch two weeks before the day of quitting smoking, and then add, say, nicotine-containing chewing gum, lozenge or inhalation. And use them for at least six weeks.
Nicotine Gum
This was the first mass-produced nicotine gum and is still the most popular of its kind.
The dose of nicotine in chewing gum is different – up to four milligrams.
Most importantly: don’t chew it like regular gum! When you have sweet chewing gum in your mouth, it is very difficult to resist the temptation to clench it with your teeth again and again. But if you chew such chewing gum without stopping, then the nicotine will quickly stand out, you will swallow it, and everything will go down the drain.
For nicotine from gum to have any effect, it must be absorbed by the oral mucosa. From the stomach, nicotine travels to the liver, where it is broken down before it reaches the brain. Therefore, you need to chew the gum a couple of times, and then just hold it in your mouth for ten seconds. Then chew again a couple of times, stop, and so on. This is how you get the most benefit. Use at least ten gummies a day for at least six weeks.
And now one more piece of advice: To use chewing gum, do not wait for an acute desire to smoke. It takes 15-20 minutes for nicotine from chewing gum to have any effect on the body. So by the time you really want to smoke, it will be too late!
And the last important tip: do not limit yourself to chewing gum, combine it with a nicotine patch. There is evidence that the use of both of these products significantly reduces the desire to smoke and reduces the severity of abstinence symptoms, which is very important for complete smoking cessation.
Nicotine patch
This is a modern day remedy for tobacco dependence and withdrawal symptoms .
The patch creates optimal conditions for a constant intake of purified nicotine, which helps to meet the daily need for it and achieve a more effective treatment.
The drug acts for 16 hours, supporting the body during wakefulness and provides it with a night’s rest from nicotine.
The patch does not need to be changed during the day.
The translucent structure makes the patch invisible on the skin – you can quit smoking with this product completely unnoticed by others.
It is believed that the success of the nicotine patch confirms one very important fact related to smoking, namely that the need for nicotine plays a big role for the smoker.
For patch selection, you can start with the “standard dose”:
- 15 milligrams for a 16 hour patch to be removed at night;
- 21 milligrams for a 24-hour patch left on overnight.
The 24-hour patch was developed for those who light their first cigarette as soon as they wake up.
It takes several hours for nicotine to penetrate the body, so if you put on the patch at night, you will have the necessary concentration of nicotine in your body by morning.
There are also patches with a high nicotine content (25 milligrams). If you are using a standard patch and another nicotine product, but still have difficulty with abstinence from cigarettes, you can use a patch with increased nicotine content.
Nicotine Nasal Spray
This is one of the fastest acting nicotine products. True, the spray is not to everyone’s taste – for some it seems unpleasant and at first irritates the nasal mucosa. But thanks to him, nicotine quickly enters the body, and its effect is noticeable after a few minutes.
The idea of consuming nicotine through the nose may sound strange, but it’s actually nothing new – once upon a time people sniffed tobacco regularly.
A nasal spray bottle is a bottle containing a nicotine solution with a spray device similar to perfume or cologne. The only thing that can be noted is that you should continue to use the spray only in cases where other products are ineffective.
However, when choosing a way to fight smoking, consult a doctor!
Your health is in your hands!!!!
Nicorette patches 25mg, 16h, 7pcs
Nicorette patch is discreet and convenient, it is used once a day for smoking cessation to reduce cravings for nicotine and symptoms caused by its absence. This is the best way to quit smoking if you smoke regularly throughout the day.
More about the product
Before using the medicine, read the instructions for use or the relevant information on the package. Talk to your doctor or pharmacist about taking the medicine.
IRREGULAR USE OF DRUGS HARMFUL FOR HEALTH
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