nicotine [Transdermal]

Adult Dosing

Smoking cessation

<10 cigarettes/day habit

Stop cigarette use prior to starting therapy
Start 14 mg patch daily x 6 wks, then 7 mg daily x 2 wks

>10 cigarettes/day habit

Stop cigarette use prior to starting therapy
Start 21 mg patch daily x 6 wks, then 14 mg daily x 2 wks, then 7 mg daily x 2 wks

Pediatric Dosing

Safety and effectiveness in pediatric patients have not been established

[Outline]

Adult Dosing
Pediatric Dosing

Indications ⬆ ⬇

Contraindications ⬆ ⬇

Hypersensitivity to any of the ingredients of the product
Allergy to nicotine or to menthol
Severe arrhythmias
Acute MI within 2 wks
Worsening or severe angina

Black Box Warnings ⬆ ⬇

Dosing Adjustment ⬆ ⬇

Renal Dose Adjustment

Severe renal impairment: Dose adjustments not defined, caution advised

Hepatic Dose Adjustment

Hepatic impairment: Dose adjustments not defined, caution advised

Warnings/Precautions ⬆ ⬇

Use therapy on the advice of healthcare provider in case of pregnancy or breastfeeding
Concomitant use of smoking, chewing tobacco, using snuff or using a nicotine gum or other nicotine containing products is not recommended
Consult physician before use if suffering from heart disease, recent heart attack or irregular heart beat, high BP or an allergy to adhesive tape or have skin problems
Consult doctor before use if using a non-nicotine stop smoking drug or taking a prescription medicine for depression or asthma
When using this product do not smoke even when not wearing a patch. Remove patch on occurrence of vivid dreams or other sleep disturbances
Stop use and ask a doctor if irregular heartbeats or palpitations occur, skin redness caused by patch does not go away after four days or if skin swells or get a rash
Keep out of the reach of children and pets

Cautions: Use cautiously in

Severe renal impairment
Hepatic impairment
Cigarette use continues
Asthma or reactive airway disease
Pulmonary disease
Cardiovascular disease
Peripheral vascular disease
Hyperthyroidism
Pheochromocytoma

Interactions ⬆ ⬇

Habitrol, Nicoderm CQ interacts with :

	Clozapine
	Clozaril
	Fazaclo ODT
	Nicoderm
	Nicorette
	Nicotrol
	Olanzapine
	Versacloz
	Zyprexa
	Zyprexa Relprevv
	Zyprexa Zydis

Nicorette interacts with :

Pregnancy/Breast Feeding ⬆ ⬇

Pregnancy Category:D

Breastfeeding: Caution; lower patch strengths of 7 and 14 mg provide proportionately lower amounts of nicotine to the breastfed infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 17 February 2011). Manufacturer advises caution.

Adverse Reactions ⬆ ⬇

CNS: Headache, anxiety, depression, dizziness, drowsiness, fatigue
NEURO: Paresthesia
EENT: Mouth/throat irritation, rhinitis, sinusitis
RESP: Bronchospasm, cough, bronchitis
CV: Tachycardia, hypertension, chest discomfort
GI: Dyspepsia, abnormal taste, diarrhea, flatulence, hiccups, nausea
MUSC: Back pain, jaw pain, myalgia
ENDO: Dysmenorrhea
REPRODUCTIVE: Fetal harm risk
MISC: Nicotine dependence transference, allergy, fever, flu-like symptoms, pain tooth disorders

Clinical Pharmacology ⬆ ⬇

Alkaloid; provides a source of nicotine during controlled withdrawal from cigarette smoking by binding stereo-selectively to nicotinic-cholinergic receptors
50% of dose is systemically absorbed
Metabolized by liver, kidney, lung
10–20% excreted unchanged by the kidneys
Half-life: 1-2 hrs

Brands and Availability ⬆ ⬇

US Trade Name(s)

Nicoderm CQ
Habitrol

US Availability

nicotine (generic)

OTC ER TDP: 7 mg/24 hr
OTC ER TDP: 14 mg/24 hr
OTC ER TDP: 21 mg/24 hr

Nicoderm CQ

OTC ER TDP: 7 mg/24 hr
OTC ER TDP: 14 mg/24 hr
OTC ER TDP: 21 mg/24 hr

Habitrol

OTC ER TDP: 7 mg/24 hr
OTC ER TDP: 14 mg/24 hr
OTC ER TDP: 21 mg/24 hr

Canadian Trade Name(s)

Prostep

Canadian Availability

Prostep

TDP: 30 mg/7 sq cm

UK Trade Name(s)

Nicorette/Boots NicAssist
Nicorette invisi/NicAssist Translucent
Nicotinell TTS 20
Nicotinell TTS 30
NiQuitin
NiQuitin Clear

UK Availability

Nicorette/Boots NicAssist

TDP: 5 mg/16 hr
TDP: 10 mg/16 hr
TDP: 15 mg/16 hr

Nicorette invisi/NicAssist Translucent

TDP: 10 mg/16 hr
TDP: 15 mg/16 hr
TDP: 25 mg/16 hr

Nicotinell TTS 20

TDP: 14 mg/24 hr

Nicotinell TTS 30

TDP: 21 mg/24 hr

NiQuitin, NiQuitin Clear

TDP: 7 mg/24 hr
TDP: 14 mg/24 hr
TDP: 21 mg/24 hr

Australian Trade Name(s)

Nicabate
Nicabate Clear
Nicabate PreQuit
Nicorette
Nicotinell
QuitX

Australian Availability

nicotine (generic)

TDP: 7 mg/24 hr
TDP: 14 mg/24 hr
TDP: 21 mg/24 hr

Nicabate, Nicabate Clear, Nicotinell, QuitX

TDP: 7 mg/24 hr
TDP: 14 mg/24 hr
TDP: 21 mg/24 hr

Nicabate PreQuit

TDP: 21 mg/24 hr

Nicorette

TDP: 5 mg/16 hr (0.83 mg/cm ²)