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Nicotine Transdermal Patch
| Overview | Suggestions
for Use | Contraindications |
Dosages/Other info |
In the dental office, tobacco cessation can be offered as a
natural extension of the other routinely delivered preventive and
oral treatment procedures. If a patient has a desire to stop using
tobacco, dentists may want to consider
prescribing nicotine transdermal patches. Addicted patients
may include those who smoke more than 25 cigarettes per day (or a can
of snuff every 2 days); those who use tobacco within the first
one-half hour of arising; those who find it difficult to refrain from
smoking in nonsmoking areas; and those who have had withdrawal
symptoms in previous attempts to quit.
Nicotine patches were developed to help reduce or eliminate
withdrawal symptoms for heavy tobacco users. These patches may help
patients stop by allowing them to cope with the social and
psychological aspects of not using tobacco without also going through
It is important to note that patients seldom are successful in
stopping tobacco use when using nicotine patches in the absence of
appropriate advice, guidance, and follow-up. Dentists should have
office tobacco cessation plans that include these services.
Clinical trials assessing the nicotine patch have not turned up
any severe adverse reactions. Transdermal nicotine is well tolerated
systemically and topically. The most commonly reported side effects
are temporary itching, burning, and/or erythema at the application
Some symptoms (e.g., headaches, insomnia, dizziness) are found to
occur as a result of nicotine withdrawal and not as a reaction to the
medication. The dose-related adverse effects of transdermal nicotine
therapy are mild-to moderate sleep disturbances (e.g., insomnia and
abnormal, vivid dreams), dyspepsia, various myalgias and body aches,
and increases cough. The incidence of almost all side effects
decreases after a few days of treatment. Fewer than five percent of
tobacco users stop patches due to side effects.
The patch only provides nicotine at about half to two-thirds the
level a person obtains by smoking, and without the more than 4,000
chemicals and gases found in cigarette smoke.
- Stop using tobacco before use of patch.
- Patch is applied once every 24 hours to non-hairy, clean, dry
site on the upper body or arm. Skin site should not be reused for
a least one week.
- Different brands vary in nicotine dose and recommended length
- All brands recommend a higher dose (21-22 mg) for the first
4-6 weeks. Some then use lower dose patches.
- Lower initial dose may be used for patients with
cardiovascular disease or those weighing less than 100 lbs.
for Nicotine Patches
- Under age 18
- Women who are pregnant or nursing
- Immediate post-myocardial infarction period
- Patients with severe arrhythmia
- Patients with severe or worsening angina pectoris
- Use with CAUTION:
- insulin-dependent diabetes
- active peptic ulcers
- very high blood pressure
- severe skin conditions
- and kidney or liver disease
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Dosages and other types of nicotine replacements