Indications 

Nicoderm is a transdermal patch used to relieve withdrawal symptoms and nicotine cravings during smoking cessation. It should be used within a comprehensive stop-smoking program involving behavior modification, counseling, and encouragement. 

As a smoking cessation aid, Nicoderm functions by substituting the nicotine derived from cigarettes. 

Each patch incorporates a unique nicotine rate-controlling membrane, regulating the release of nicotine into the bloodstream via the skin. The nicotine absorption level is lower than that of cigarettes, and the program is specifically designed to facilitate a gradual adjustment to reduced nicotine intake until it is no longer necessary. 

Uses and Dosage 

Before using Nicoderm, and every time you get a refill, carefully review its medication guide and patient information leaflet. Consult your doctor or pharmacist if you have questions or uncertainties. 

Nicoderm is initiated on the designated quit day and is usually applied to the skin once daily, at a consistent time each day. 

Follow the instructions on the prescription label or adhere to your doctor’s guidance precisely. Avoid using a higher or lower dosage than prescribed or exceeding the recommended frequency and duration of use. 

For individuals smoking more than 10 cigarettes per day, the recommended 10-week schedule for Nicoderm usage is as follows: 

• STEP 1: Use one 21 mg patch daily during weeks 1-6. 
• STEP 2: Transition to one 14 mg patch daily during weeks 7-8. 
• STEP 3: Further reduce to one 7 mg patch daily during weeks 9-10. 

For individuals smoking 10 or fewer cigarettes daily, omit STEP 1 (21 mg) and begin with STEP 2 (14 mg) for 6 weeks. Afterward, proceed to STEP 3 (7 mg) for an additional 2 weeks before discontinuing use. 

The purpose of steps 2 and 3 is to decrease nicotine intake gradually. Completing the entire program will enhance the likelihood of a successful smoking cessation outcome. 

To properly apply Nicoderm, follow these steps: 

1. Keep the patch inside its sealed protective pouch until ready for use to prevent nicotine loss. Select a clean, dry area of non-hairy skin.  
   • Avoid applying the patch on irritated, burned, cut, or broken skin. 
   • Ensure the skin is free from lotion or soap residue. 
2. Get the patch from the pouch and remove the protective liner by pulling it apart starting from the middle slit.  
   • Hold the patch by the outer edges (minimizing contact with the sticky side), and peel off the remaining half of the liner.  
   • Place the liner back in the pouch for disposal after use. 
3. Immediately apply the sticky side of the patch firmly onto the skin. 
   • Press it down with the heel of your hand for at least 10 seconds, ensuring secure adhesion, particularly around the edges. 
4. After applying the patch, wash your hands thoroughly. Nicotine residue on your hands may cause discomfort or more severe issues if it comes into contact with your eyes or nose. 
5. Wear the patch for 16 hours; or 24 hours if you crave cigarettes upon waking up. 
   • The patch may be removed at bedtime if you experience vivid dreams or sleep disturbances. 
6. After wearing the patch for 16 or 24 hours, remove it by folding the sticky ends together.  
   • Place the used patch in its pouch and dispose of it in a location inaccessible to children and pets. Even used patches contain enough nicotine to be harmful. Remember to wash your hands. 
7. When applying the next patch, select a different skin area and repeat Steps 1 to 6. Avoid using the same patch site for at least one week. 

Consult your doctor before discontinuing Nicoderm, as withdrawal symptoms may arise, such as tobacco cravings, nervousness, irritability, and headaches. To mitigate withdrawal, your doctor may gradually reduce your dosage.  

Notify your physician if smoking cessation is not achieved within 4 weeks of Nicoderm usage. Initial attempts to quit may be unsuccessful for some smokers. Cease product use and attempt cessation again at a later time if necessary. Subsequent attempts have proven successful for many individuals who were unsuccessful initially. 

Side Effects 

Listed below are the potential adverse effects of Nicoderm. Inform your doctor right away if any of them lasts or worsens. 

Common Side Effects 

• Difficulty sleeping 
• Disturbing dreams 
• Increased nervousness and excitability 
• Headaches 
• Joint and back pain 
• Irritation at the application site of the patch 
• Flu-like symptoms 
• Gas 

Serious Side Effects 

• Symptoms of high blood pressure: 
  • Severe headaches 
  • Dizziness 
  • Fainting 
  • Changes in eyesight 
• Mood changes 
• Confusion 
• Chest pain or pressure, rapid or irregular heartbeat 
• Unusual burning, numbness, or tingling sensations 
• Dizziness 
• Upset stomach or vomiting 
• Diarrhea 
• Excessive drooling 
• Tremors or shakiness 
• Fatigue or weakness 
• Cold sweats 
• Blurred vision 
• Changes in hearing 

If you experience any of the severe side effects mentioned above, promptly seek medical assistance or inform your physician. 

Allergic Reactions 

Although rare, a severe allergic reaction to Nicoderm may occur. Seek immediate medical attention if you notice any of the following symptoms: 

• Rash 
• Hives 
• Itching 
• Red, swollen, blistered, or peeling skin (with or without fever) 
• Wheezing 
• Tightness in the chest or throat 
• Difficulty breathing, swallowing, or talking 
• Unusual hoarseness 
• Swelling (mouth, face, lips, tongue, or throat) 

Not all side effects of Nicoderm are included in this list. In case any unlisted effects occur, tell your doctor immediately. 

Cautions 

Before starting treatment with Nicoderm, inform your doctor and pharmacist of any known allergies, particularly to: 

• Nicotine 
• Adhesive tape 
• Other drugs 
• Any of the components of Nicoderm patches 

To ensure Nicoderm is safe for you, disclose to your physician your medical background, especially if you have a history of: 

• Blood vessel disease (e.g., Raynaud’s disease, stroke) 
• Diabetes 
• Heart disease (e.g., chest pain, heart attack, irregular heartbeat) 
• High blood pressure 
• Liver disease 
• Kidney disease 
• Esophagus problems (e.g., esophagitis) 
• Stomach/intestinal sores (peptic ulcers) 
• Certain adrenal problems (pheochromocytoma) 
• Overactive thyroid (hyperthyroidism) 
• Seizures 
• Skin problems (e.g., eczema, contact dermatitis) 

Inform your doctor and pharmacist of all prescription and non-prescription drugs, vitamins, and herbal supplements you are taking to reduce the risk of drug interaction with Nicoderm. 

Some products that may interact with Nicoderm include: 

• Medications for high blood pressure, including beta blockers like labetalol and prazosin 
• Bronchodilators/decongestants like isoproterenol and phenylephrine 

Inform all healthcare providers and pharmacists of your decision to quit smoking, for it can alter the liver’s drug elimination process for specific medications, like: 

• Acetaminophen 
• Caffeine 
• Insulin 
• Oxazepam 
• Pentazocine 
• Propoxyphene 
• Propranolol 
• Theophylline  
• Tricyclic antidepressants (e.g., amitriptyline and imipramine) 
• Diuretics (e.g., furosemide) 

Remove Nicoderm before undergoing any MRI (magnetic resonance imaging) procedures to prevent potential burns. 

While wearing Nicoderm, refrain from exposing the skin beneath it to direct heat sources such as electric blankets, heating pads, saunas, hot tubs, heated water beds, or prolonged direct sunlight. Such heat sources may lead to increased drug release into the body, thereby elevating the risk of side effects. 

Intense physical activity can elevate skin temperature and enhance nicotine absorption through the skin. Consult with your physician regarding the impact of exercise on this medication. 

Refrain from driving or performing tasks that require alertness until you have gauged the impact of Nicoderm on your system. 

The use of Nicoderm during pregnancy may harm the unborn baby. Promptly inform your doctor if you become pregnant while using Nicoderm or are already pregnant. 

Prior to using Nicoderm, inform your physician if you are currently breastfeeding and discuss any potential hazards to your infant.