Nicotine patch: Difference between revisions
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{{short description|Transdermal patch that releases nicotine into the body}} |
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[[Image:Nicoderm.JPG|thumb|right|A 21 mg dose patch applied to the left arm]] |
[[Image:Nicoderm.JPG|300px|thumb|right|A 21 mg dose patch applied to the left arm]] |
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A '''nicotine patch''' is a [[transdermal patch]] that releases [[nicotine]] into the body through the skin. It is used in [[nicotine replacement therapy]] (NRT), a process for [[smoking cessation]]. Endorsed and approved by the [[Food and Drug Administration]] (FDA), it is considered one of the safer NRTs available. |
A '''nicotine patch''' is a [[transdermal patch]] that releases [[nicotine]] into the body through the skin. It is used in [[nicotine replacement therapy]] (NRT), a process for [[smoking cessation]]. Endorsed and approved by the U.S. [[Food and Drug Administration]] (FDA), it is considered one of the safer NRTs available for the treatment of [[tobacco use disorder]]. |
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Nicotine replacement products including gum and transdermal patches are on the [[WHO Model List of Essential Medicines|World Health Organization's List of Essential Medicines]].<ref name="WHO21st">{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}</ref> |
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| ⚫ | A meta-analysis found that fewer than 20% of people treated with nicotine replacement therapy remain abstinent from smoking at one year.<ref>{{cite journal |
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=== Effectiveness === |
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| ⚫ | A meta-analysis found that fewer than 20% of people treated with nicotine replacement therapy remain abstinent from smoking at one year.<ref name=":2">{{cite journal|vauthors=Rosen LJ, Galili T, Kott J, Goodman M, Freedman LS|date=2018|title=Diminishing benefit of smoking cessation medications during the first year: a meta-analysis of randomized controlled trials|journal=Addiction|volume=113|issue=5|pages=805–816|doi=10.1111/add.14134|pmc=5947828|pmid=29377409}}</ref> |
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==History== |
==History== |
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The first study of the [[pharmacokinetics]] of a transdermal nicotine patch in humans was published in 1984<ref>{{ |
The first study of the [[pharmacokinetics]] of a transdermal nicotine patch in humans was published in 1984<ref>{{cite journal | vauthors = Rose JE, Jarvik ME, Rose KD | title = Transdermal administration of nicotine | journal = Drug and Alcohol Dependence | volume = 13 | issue = 3 | pages = 209–13 | date = May 1984 | pmid = 6734425 | doi = 10.1016/0376-8716(84)90061-9 }}</ref> by [[Jed Rose (scientist)|Jed Rose]], [[Murray Jarvik]], and Daniel Rose, and was followed by publication by Rose et al. (1985) of results of a study of smokers showing that a transdermal nicotine patch reduced craving for cigarettes.<ref>{{cite journal | vauthors = Rose JE, Herskovic JE, Trilling Y, Jarvik ME | title = Transdermal nicotine reduces cigarette craving and nicotine preference | journal = Clinical Pharmacology and Therapeutics | volume = 38 | issue = 4 | pages = 450–6 | date = October 1985 | pmid = 4042528 | doi = 10.1038/clpt.1985.203 | s2cid = 19915646 }}</ref> Frank Etscorn filed a patent in the [[United States]] on January the 23rd 1985 and was issued the patent on July 1, 1986.<ref>{{ cite patent | country = US | number = 4597961 | status = | title = | pubdate = | gdate = | fdate = | pridate = | inventor =Etscorn, FT | invent1 = | invent2 = | assign1 = | assign2 = | class = }}</ref> The University of California filed a competing patent application nearly three years after Etscorn's filing on February 19, 1988, which was granted on May 1, 1990.<ref>{{cite patent | country = US | number = 4920989 }}</ref> Subsequently, the U.S. Patent Office declared an interference action and, after a thorough review of conception, reduction to practice and patent filing dates, issued on September 29, 1993, a priority decision in favor of the Rose et al. patent.<ref>{{cite web|title=Adverse Decisions in Interference|url=http://www.uspto.gov/web/offices/com/sol/og/1995/week08/patadve.htm|access-date=25 November 2013|date=21 February 1995|publisher= Board of Patent Appeals & Interferences|author=OLIVIA M. DUVALL}}</ref> |
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==Research== |
==Research== |
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Research has shown that NRT in combination with [[Cognitive Behavioral Therapy]] (CBT) can improve the rates of smoking cessation in pregnant women.<ref name=":2" /> CBT counseling includes motivational interviewing,<ref>{{Cite journal|last1=Miller|first1=William|last2=Rollnick|first2=Stephen | name-list-style = vanc |date=May 2003|title=Motivational Interviewing: Preparing People for Change, 2nd ed.|journal=Journal for Healthcare Quality|volume=25|issue=3|pages=46|doi=10.1097/01445442-200305000-00013|issn=1062-2551}}</ref> Transtheoretical Model of Behavior Change,<ref>{{cite journal | vauthors = Prochaska JO, DiClemente CC | title = Stages and processes of self-change of smoking: toward an integrative model of change | journal = Journal of Consulting and Clinical Psychology | volume = 51 | issue = 3 | pages = 390–5 | date = June 1983 | pmid = 6863699 | doi = 10.1037/0022-006x.51.3.390 }}</ref> and Social Cognitive Theory.<ref>{{Cite journal|last=Webb|first=Mark C. | name-list-style = vanc |date=1993|title=Neurobiology of learning, emotion, and affect. John Madden, ed. Raven Press, Ltd., New York City, New York, 1991. 354 pp. $126.00|journal=Depression|volume=1|issue=2|pages=116–117|doi=10.1002/depr.3050010211|issn=1062-6417}}</ref> |
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| ⚫ | Nicotine patches are under study to help relieve the symptoms of [[postoperative pain]]<ref>{{cite web|title=Nicotine Patch Decreases Post Surgical Pain|url=http://www.medicalnewstoday.com/releases/85508.php|publisher=MediLexicon International Ltd, Bexhill-on-Sea, UK| |
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| ⚫ | Nicotine patches are under study to help relieve the symptoms of [[postoperative pain]]<ref>{{cite web|title=Nicotine Patch Decreases Post Surgical Pain|url=http://www.medicalnewstoday.com/releases/85508.php|publisher=MediLexicon International Ltd, Bexhill-on-Sea, UK|access-date=25 November 2013|date=15 October 2007}}</ref> and to treat early [[dementia]].<ref>{{cite web|title=Nicotine Patches Up Early Memory Loss In Study|website=[[NPR]] |url=https://www.npr.org/blogs/health/2012/01/09/144906236/nicotine-patches-up-early-memory-loss-in-study|access-date=3 February 2014|date=9 January 2013}}</ref> |
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| ⚫ | Studies are being conducted about the use of transdermal nicotine patches to treat anxiety, depression, and inattentiveness in subjects with [[ADHD]]<ref>{{cite journal| |
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| ⚫ | Studies are being conducted about the use of transdermal nicotine patches to treat anxiety, depression, and inattentiveness in subjects with [[ADHD]]<ref>{{cite journal | vauthors = Cocores JA | title = Transdermal nicotine in adult ADHD with depression and anxiety | journal = Primary Care Companion to the Journal of Clinical Psychiatry | volume = 10 | issue = 3 | pages = 253–4 | year = 2008 | pmid = 18615164 | pmc = 2446482 | doi = 10.4088/pcc.v10n0312f }}</ref> {{vs|date=August 2013}} and to treat late-life depression.<ref>{{cite web|title=Nicotine Patch May Help Late-Life Depression|url=https://www.medscape.com/viewarticle/894298|publisher=Medscape|access-date=24 March 2018|date=21 March 2018}}</ref> |
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| ⚫ | Two small studies have shown that transdermal nicotine patches improve some symptoms of [[ulcerative colitis]].<ref>Cheah |
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| ⚫ | Two small studies have shown that transdermal nicotine patches improve some symptoms of [[ulcerative colitis]].<ref>{{cite book | last1 = Cheah | first1 = Matthew | first2 = Reena | last2 = Khanna | name-list-style = vanc | chapter = Current Medical Therapies for Ulcerative Colitis. | title = Pouchitis and Ileal Pouch Disorders | pages = 1–15 | publisher = Academic Press | date = 2019 }}</ref> However, this is not the case with [[Crohn's disease]], a similar health condition, where smoking and nicotine intake in general worsen the disease's effects. |
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== Application == |
== Application == |
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The patch is typically worn for 16 to 24 hours.<ref>{{Cite web|url=https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking/nicotine-replacement-therapy.html|title=Nicotine Replacement Therapy for Quitting Tobacco|website=www.cancer.org|access-date=2019-10-23}}</ref> Patches can be removed at night prior to bed if vivid dreams are experienced and undesirable.<ref name="medlineplus.gov">{{Cite web|url=https://medlineplus.gov/ency/article/007438.htm|title=Nicotine replacement therapy: MedlinePlus Medical Encyclopedia|website=medlineplus.gov|access-date=2019-10-23}}</ref> |
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Nicotine patches should be placed on a clean, dry, and hairless part of the skin. <ref name=":0">{{Cite book|url=https://www.ncbi.nlm.nih.gov/books/NBK279221/|title=Smoking: Nicotine replacement therapy|last=Information|first=National Center for Biotechnology|last2=Pike|first2=U. S. National Library of Medicine 8600 Rockville|last3=MD|first3=Bethesda|last4=Usa|first4=20894|date=2017-08-24|publisher=Institute for Quality and Efficiency in Health Care (IQWiG)|language=en}}</ref> The patch can be placed on the upper body, such as on the inside or outside part of the arm or the shoulder, or it can be placed on the hip area. <ref name=":0" /> When applying the patch, the sticky adhesive part of the patch should make contact with the skin, and the remaining protective covering should be removed.<ref name=":1">{{Cite journal|date=2000-09-15|title=The Nicotine Patch|url=https://www.aafp.org/afp/2000/0915/p1421.html|journal=American Family Physician|language=en|volume=62|issue=6|pages=1421|issn=0002-838X}}</ref>Then, the patch should be pressed into place for at least 10 seconds to ensure that the patch will stick. <ref name=":1" />After application, hands should be washed since nicotine from the patch could linger on the hands, and this could cause further irritation if left alone. <ref>{{Cite web|url=https://medlineplus.gov/ency/article/007438.htm|title=Nicotine replacement therapy: MedlinePlus Medical Encyclopedia|website=medlineplus.gov|language=en|access-date=2019-10-23}}</ref> |
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== Side effects == |
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A study published in the medical journal JAMA Internal Medicine in 2015 found that the most common side effects experienced when using a nicotine patch include: cough, headache, nausea, light-headedness, insomnia, disturbing dreams, sweating, watery eyes, shortness of breath, and skin irritation at the application site. The same study found that the following side effects were reported by patch wearers less frequently: diarrhea, dizziness, coldness in limbs, vomiting, and fast or pounding heart beat.<ref>{{cite journal | vauthors = Schnoll RA, Goelz PM, Veluz-Wilkins A, Blazekovic S, Powers L, Leone FT, Gariti P, Wileyto EP, Hitsman B | display-authors = 6 | title = Long-term nicotine replacement therapy: a randomized clinical trial | journal = JAMA Internal Medicine | volume = 175 | issue = 4 | pages = 504–11 | date = April 2015 | pmid = 25705872 | pmc = 4410859 | doi = 10.1001/jamainternmed.2014.8313 }}</ref> |
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== Availability == |
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Nicotine patches are available for purchase over-the-counter from various manufacturers, without a prescription.<ref name=":3">{{Cite journal| author = Commissioner Office |date=2019-03-22|title=Want to Quit Smoking? FDA-Approved Products Can Help|url=https://www.fda.gov/consumers/consumer-updates/want-quit-smoking-fda-approved-products-can-help|journal=FDA}}</ref> |
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{| class="wikitable" |
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|+Example of Nicotine Patch Regimen (NicoDerm CQ<ref>{{Cite web|url=https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020165|title=Drugs@FDA: FDA Approved Drug Products|website=www.accessdata.fda.gov|access-date=2019-10-23}}</ref>) |
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!NicoDerm CQ patch strength |
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!For a person who smokes 10 or fewer cigarettes per day |
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!For a person who smokes more than 10 cigarettes per day |
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|- |
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|21 mg |
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|Do '''not''' use this patch strength. |
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|Step 1: Apply 1 patch per day for 6 weeks |
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|- |
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|14 mg |
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|Step 1: Apply 1 patch per day for 6 weeks |
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|Step 2: Apply 1 patch per day for 2 weeks |
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|- |
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|7 mg |
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|Step 2: Apply 1 patch per day for 2 weeks |
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|Step 3: Apply 1 patch per day for 2 weeks |
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|- |
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| |
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|Total Patch Treatment Period: 8 weeks |
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|Total Patch Treatment Period: 10 weeks |
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|} |
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==See also== |
== See also == |
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* [[Smoking cessation]] |
* [[Smoking cessation]] |
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* [[Nicotine replacement therapy]] |
* [[Nicotine replacement therapy]] |
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* [[Transdermal patch]] |
* [[Transdermal patch]] |
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==References== |
== References == |
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{{reflist}} |
{{reflist}} |
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{{Dependence treatment}} |
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{{Dosage forms|state=expanded}} |
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{{DEFAULTSORT:Nicotine Patch}} |
{{DEFAULTSORT:Nicotine Patch}} |
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Latest revision as of 16:52, 7 February 2023
A nicotine patch is a transdermal patch that releases nicotine into the body through the skin. It is used in nicotine replacement therapy (NRT), a process for smoking cessation. Endorsed and approved by the U.S. Food and Drug Administration (FDA), it is considered one of the safer NRTs available for the treatment of tobacco use disorder.
Nicotine replacement products including gum and transdermal patches are on the World Health Organization's List of Essential Medicines.[1]
Medical uses
[edit]Effectiveness
[edit]A meta-analysis found that fewer than 20% of people treated with nicotine replacement therapy remain abstinent from smoking at one year.[2]
History
[edit]The first study of the pharmacokinetics of a transdermal nicotine patch in humans was published in 1984[3] by Jed Rose, Murray Jarvik, and Daniel Rose, and was followed by publication by Rose et al. (1985) of results of a study of smokers showing that a transdermal nicotine patch reduced craving for cigarettes.[4] Frank Etscorn filed a patent in the United States on January the 23rd 1985 and was issued the patent on July 1, 1986.[5] The University of California filed a competing patent application nearly three years after Etscorn's filing on February 19, 1988, which was granted on May 1, 1990.[6] Subsequently, the U.S. Patent Office declared an interference action and, after a thorough review of conception, reduction to practice and patent filing dates, issued on September 29, 1993, a priority decision in favor of the Rose et al. patent.[7]
Research
[edit]Research has shown that NRT in combination with Cognitive Behavioral Therapy (CBT) can improve the rates of smoking cessation in pregnant women.[2] CBT counseling includes motivational interviewing,[8] Transtheoretical Model of Behavior Change,[9] and Social Cognitive Theory.[10]
Nicotine patches are under study to help relieve the symptoms of postoperative pain[11] and to treat early dementia.[12]
Studies are being conducted about the use of transdermal nicotine patches to treat anxiety, depression, and inattentiveness in subjects with ADHD[13] [verification needed] and to treat late-life depression.[14]
Two small studies have shown that transdermal nicotine patches improve some symptoms of ulcerative colitis.[15] However, this is not the case with Crohn's disease, a similar health condition, where smoking and nicotine intake in general worsen the disease's effects.
Application
[edit]The patch is typically worn for 16 to 24 hours.[16] Patches can be removed at night prior to bed if vivid dreams are experienced and undesirable.[17]
Side effects
[edit]A study published in the medical journal JAMA Internal Medicine in 2015 found that the most common side effects experienced when using a nicotine patch include: cough, headache, nausea, light-headedness, insomnia, disturbing dreams, sweating, watery eyes, shortness of breath, and skin irritation at the application site. The same study found that the following side effects were reported by patch wearers less frequently: diarrhea, dizziness, coldness in limbs, vomiting, and fast or pounding heart beat.[18]
Availability
[edit]Nicotine patches are available for purchase over-the-counter from various manufacturers, without a prescription.[19]
| NicoDerm CQ patch strength | For a person who smokes 10 or fewer cigarettes per day | For a person who smokes more than 10 cigarettes per day |
|---|---|---|
| 21 mg | Do not use this patch strength. | Step 1: Apply 1 patch per day for 6 weeks |
| 14 mg | Step 1: Apply 1 patch per day for 6 weeks | Step 2: Apply 1 patch per day for 2 weeks |
| 7 mg | Step 2: Apply 1 patch per day for 2 weeks | Step 3: Apply 1 patch per day for 2 weeks |
| Total Patch Treatment Period: 8 weeks | Total Patch Treatment Period: 10 weeks |
See also
[edit]References
[edit]- ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ^ a b Rosen LJ, Galili T, Kott J, Goodman M, Freedman LS (2018). "Diminishing benefit of smoking cessation medications during the first year: a meta-analysis of randomized controlled trials". Addiction. 113 (5): 805–816. doi:10.1111/add.14134. PMC 5947828. PMID 29377409.
- ^ Rose JE, Jarvik ME, Rose KD (May 1984). "Transdermal administration of nicotine". Drug and Alcohol Dependence. 13 (3): 209–13. doi:10.1016/0376-8716(84)90061-9. PMID 6734425.
- ^ Rose JE, Herskovic JE, Trilling Y, Jarvik ME (October 1985). "Transdermal nicotine reduces cigarette craving and nicotine preference". Clinical Pharmacology and Therapeutics. 38 (4): 450–6. doi:10.1038/clpt.1985.203. PMID 4042528. S2CID 19915646.
- ^ US 4597961, Etscorn, FT
- ^ US 4920989
- ^ OLIVIA M. DUVALL (21 February 1995). "Adverse Decisions in Interference". Board of Patent Appeals & Interferences. Retrieved 25 November 2013.
- ^ Miller W, Rollnick S (May 2003). "Motivational Interviewing: Preparing People for Change, 2nd ed". Journal for Healthcare Quality. 25 (3): 46. doi:10.1097/01445442-200305000-00013. ISSN 1062-2551.
- ^ Prochaska JO, DiClemente CC (June 1983). "Stages and processes of self-change of smoking: toward an integrative model of change". Journal of Consulting and Clinical Psychology. 51 (3): 390–5. doi:10.1037/0022-006x.51.3.390. PMID 6863699.
- ^ Webb MC (1993). "Neurobiology of learning, emotion, and affect. John Madden, ed. Raven Press, Ltd., New York City, New York, 1991. 354 pp. $126.00". Depression. 1 (2): 116–117. doi:10.1002/depr.3050010211. ISSN 1062-6417.
- ^ "Nicotine Patch Decreases Post Surgical Pain". MediLexicon International Ltd, Bexhill-on-Sea, UK. 15 October 2007. Retrieved 25 November 2013.
- ^ "Nicotine Patches Up Early Memory Loss In Study". NPR. 9 January 2013. Retrieved 3 February 2014.
- ^ Cocores JA (2008). "Transdermal nicotine in adult ADHD with depression and anxiety". Primary Care Companion to the Journal of Clinical Psychiatry. 10 (3): 253–4. doi:10.4088/pcc.v10n0312f. PMC 2446482. PMID 18615164.
- ^ "Nicotine Patch May Help Late-Life Depression". Medscape. 21 March 2018. Retrieved 24 March 2018.
- ^ Cheah M, Khanna R (2019). "Current Medical Therapies for Ulcerative Colitis.". Pouchitis and Ileal Pouch Disorders. Academic Press. pp. 1–15.
- ^ "Nicotine Replacement Therapy for Quitting Tobacco". www.cancer.org. Retrieved 2019-10-23.
- ^ "Nicotine replacement therapy: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 2019-10-23.
- ^ Schnoll RA, Goelz PM, Veluz-Wilkins A, Blazekovic S, Powers L, Leone FT, et al. (April 2015). "Long-term nicotine replacement therapy: a randomized clinical trial". JAMA Internal Medicine. 175 (4): 504–11. doi:10.1001/jamainternmed.2014.8313. PMC 4410859. PMID 25705872.
- ^ Commissioner Office (2019-03-22). "Want to Quit Smoking? FDA-Approved Products Can Help". FDA.
- ^ "Drugs@FDA: FDA Approved Drug Products". www.accessdata.fda.gov. Retrieved 2019-10-23.