Nicotine patches to help quitting smoking(transdermal nicotine systems)

  Patches provide a measured dose of nicotine through the skin

Patches provide a measured dose of nicotine through the skin. As the nicotine doses are lowered by switching patches over a course of weeks, the tobacco user is weaned off nicotine. Patches can be purchased without a prescription. Several types and different strengths are available. Package inserts describe how to use the product as well as special considerations and possible side effects.

* The 16-hour patch works well for light-to-average tobacco users. It is less likely to cause side effects like skin irritation, racing heartbeat, sleep problems, and headache. But it does not deliver nicotine during the night, so it is not helpful for early morning withdrawal symptoms.

* The 24-hour patch provides a steady dose of nicotine, avoiding peaks and troughs. It helps with early morning withdrawal. However, there may be more side effects such as disrupted sleep patterns and skin irritation.

Depending on body size, most tobacco users should start using a full-strength patch (15-22 mg of nicotine) daily for 4 weeks, and then use a weaker patch (5-14 mg of nicotine) for another 4 weeks. The patch should be applied in the morning to a clean, dry area of the skin without much hair. It should be placed below the neck and above the waist - for example, on the arm. The FDA recommends using the patch for a total of 3 to 5 months. However, some studies have shown that using it for 8 weeks or less is just as effective as using it for longer.

Side effects are related to:

* the dose of nicotine
* the brand of patch
* your individual skin characteristics (such as the person’s tendency to have a skin reaction to the patch)
* how long you use the patch
* how it is applied

Some possible side effects of the nicotine patch include:

* skin irritation – redness and itching
* dizziness
* racing heartbeat
* sleep problems or unusual dreams
* headache
* nausea
* vomiting
* muscle aches and stiffness

What to do about side effects:

* Try a different brand of patch if skin irritation occurs.
* Reduce the amount of nicotine by using a lower dose patch.
* Sleep problems may be temporary and pass within 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 nicotine replacement.

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