Nicotine (NiQuitin patches)

How does it work?

NiQuitin patches contain nicotine. They are a type of medicine known as nicotine replacement therapy (NRT) and are used to help smokers give up the habit.

Nicotine is the addictive substance present in tobacco. Smokers who try to give up often experience unpleasant withdrawal symptoms and cravings for cigarettes, because they are dependent on the nicotine in tobacco. Withdrawal symptoms can include irritability, headaches, restlessness, insomnia and difficulty concentrating. These, combined with cigarette cravings, are why it is difficult for some people to give up smoking.

Nicotine replacement therapies work by giving you a small amount of nicotine, but without the dangerous effects of inhaling tobacco smoke. This helps relieve the withdrawal symptoms and cravings for a cigarette that you get when you stop smoking, and allows you to get on with breaking the psychological habit of smoking. If you are physically addicted to nicotine, using NRT has been shown to almost double your chances of successfully quitting smoking.

NiQuitin patches are worn continuously for 24 hours. The nicotine in the patches is absorbed continuously through the skin into the bloodstream. This produces a lower amount of nicotine in the blood than smoking, but the continuous level is enough to help prevent the withdrawal symptoms and cravings that you get after you stop smoking. Wearing the patch for 24 hours can be helpful if you usually get a strong craving for a cigarette when you wake up.

NRT comes in many forms. There are factsheets on all these linked at the end of this page. Nicotine patches are used to help prevent cravings for cigarettes, while nasal sprays, inhalators, chewing gum, tablets that dissolve under the tongue, and lozenges, are all forms that can be used instead of smoking when you get a cigarette craving.

As well as breaking the physical addiction, you also need to break the smoking habits you used to have. Try to avoid situations where you will be tempted to smoke, and remember to seek help and support whenever you feel like giving in to your cravings.

What is it used for?

  • Relief of withdrawal symptoms associated with giving up smoking.

NiQuitin patches can be used to help relieve or prevent withdrawal symptoms once you have completely stopped smoking.

If you are not yet ready to stop smoking completely, NiQuitin patches are also licensed to help you to cut down the number of cigarettes you smoke each day, by using the patches daily to prevent cravings for a cigarette. The patches can also be used to prevent cravings on occasions when you can’t or don’t want to smoke for long periods of time, for example on long-haul flights or while at work.

How do I use it?

  • Follow the instructions in the leaflet provided with your patches carefully.
  • The patches come in three different strengths: 21mg, 14mg and 7mg. Most smokers should start with the 21mg strength. If you have managed not to smoke after six weeks of using the 21mg patches, you should then drop down to the 14mg strength patches for two weeks, and finally the 7mg patches for two weeks. People who smoke less than ten cigarettes a day should start with the 14mg patches. Reducing the patch strength in this way gradually weans you off the nicotine, allowing you to focus on breaking the smoking habit. By the time you stop using the patches your psychological urge to smoke should be reduced.
  • One patch should be applied at the same time every day, usually in the morning and replaced after 24 hours. (You can remove the patch before going to bed, but leaving it on overnight will reduce your morning cravings.) Only one patch should be applied at a time.
  • The patch should be applied to clean, dry, hairless, healthy skin on the trunk, hip or upper arm. Don’t apply oils or talcum powder to the skin before applying the patch, as they will prevent it sticking properly. The patches must not be cut.
  • NiQuitin patches come in individual child resistant sachets, which need to be opened by cutting along the edge. The patch is applied to the chosen area by peeling off a clear backing film from the patch and pressing the patch firmly on to the skin with the finger tips and palm.
  • Change the patch after 24 hours and apply the new patch to a different area of skin. Avoid using the same skin site for at least seven days, so as to avoid irritating the same area of the skin.

Warning!

  • Do not apply the patches to broken, red or irritated skin.
  • If you exercise while wearing a nicotine patch the amount of nicotine absorbed into your bloodstream may increase, which could increase the side effects of nicotine.
  • If you get a severe or persistent skin reaction, such as severe redness, itching, rash, hives or swelling after using these patches, you should stop using them and consult your doctor for advice.
  • Make sure you do not leave unused or used NiQuitin patches where children can reach them. Doses of nicotine that are tolerated by adult smokers during treatment can produce severe symptoms of poisoning in small children and may prove fatal. Fold used patches in half so the sticky side is inside and put them inside the opened sachet, or in a piece of tinfoil. Dispose of used patches carefully, away from children and animals, as they will still contain some nicotine.

Use with caution in

  • Adolescents aged 12 to 18 years old. (If you are in this age group you should not use NRT for longer than 12 weeks without consulting a doctor, pharmacist or nurse for advice.)
  • Disease involving the heart and blood vessels (cardiovascular disease). (Using NRT is much less hazardous than continuing to smoke. However, if you are in hospital because you have recently had a heart attack or stroke or you have severe irregular heart beats, you should ideally try to stop smoking without using NRT. Seek advice from your doctor.)
  • Diabetes. (Monitor your blood sugar more closely when starting NRT.)
  • Overactive thyroid gland (hyperthyroidism).
  • Tumour of the adrenal gland (phaeochromocytoma).
  • Severely decreased kidney function.
  • Moderate to severely decreased liver function.
  • Eczema or other skin diseases.

Not to be used in

  • Non-smokers.
  • Occasional smokers.
  • Children under 12 years of age.

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • Nicotine in any form should ideally not be used during pregnancy, as it has been shown to adversely affect the development of the baby, both in the womb and after birth. However, for pregnant women who are unable to give up smoking without a smoking cessation aid, NRT may deliver less nicotine (and none of the other potentially disease-causing agents) than would be obtained from cigarettes. As a result, it is considered that NRT poses less of a risk to the baby than continuing to smoke. Pregnant women who smoke should discuss the risks and benefits of NRT with their doctor as early as possible in their pregnancy and only use this medicine on their advice.
  • If NRT is used during pregnancy, forms such as gum, lozenges, microtabs, inhalators or nasal sprays are preferable to patches, although your doctor may suggest a patch if you suffer from morning sickness. If you do use patches, you should remove them before going to bed at night. The aim should be to stop using NRT as soon as possible, preferably after two to three months.
  • Nicotine taken in any form passes into breast milk and is harmful to the nursing infant. However, for women who are unable to give up smoking without a smoking cessation aid, NRT may deliver less nicotine (and none of the other potentially disease-causing agents) than would be obtained from cigarettes. It is also less hazardous than the second-hand smoke that the infant would be exposed to if the mother continued to smoke.
  • However, if possible, nicotine patches should be avoided during breastfeeding because they provide a continuous stream of nicotine into the breast milk. It is better to use intermittent forms such as gum, lozenges, microtabs, inhalators or nasal sprays, because these can be more easily adjusted around breastfeeding times to minimise the amount of nicotine that the infant is exposed to via the breast milk. Seek advice from your doctor or pharmacist.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Very common (affect more than 1 in 10 people)

  • Rash, itching, burning, tingling, numbness, swelling, pain or hives at patch application site.
  • Nausea.
  • Vomiting.
  • Headache.
  • Dizziness.
  • Sleep disturbances, such as difficulty in sleeping, abnormal dreams.

Common (affect between 1 in 10 and 1 in 100 people)

  • Nervousness.
  • Tremor.
  • Awareness of your heartbeat (palpitations).
  • Difficulty breathing. (dyspnoea).
  • Sore throat.
  • Cough.
  • Disturbances of the gut such as indigestion, abdominal pain, dry mouth, constipation.
  • Increased sweating.
  • Joint and muscle pain.
  • Chest pain.
  • Fatigue.
  • Redness at patch application site.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

  • Faster than normal heart beat (tachycardia).
  • Allergic reaction.
  • Flu-like symptoms.

Very rare (affect less than 1 in 10,000 people)

  • Allergic skin reactions including photosensitivity.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

Nicotine replacement itself does not affect other medicines. However, the components of tobacco smoke can cause certain medicines to be removed from the body faster than normal. This means that when you stop smoking, they could be removed slower and so their blood levels may increase. You should tell your doctor that you are giving up smoking if you are taking the following medicines, as when you stop smoking your doses may need to be changed:

  • aminophylline
  • chlorpromazine
  • cinacalcet
  • clozapine
  • dextropropoxyphene
  • flecainide
  • fluphenazine
  • haloperidol
  • olanzapine
  • pentazocine
  • ropinirole
  • tacrine
  • theophylline.

People with diabetes who smoke normally need more insulin, as smoking reduces the amount of insulin that is absorbed into the blood from an injection under the skin. Therefore if people with diabetes give up smoking, they may subsequently need a reduction in their insulin dose. People with diabetes should monitor their blood sugar levels more closely when stopping smoking. Discuss this with your doctor.

Using nicotine replacement therapy in combination with bupropion (Zyban) or varenicline (Champix) is not currently recommended. You can, however, use a combination of different NRT products if you find this is helpful. Ask your pharmacist for advice.

Other medicines containing the same active ingredient

Nicopass lozengesNicopatchNicorette gumNicorette inhalator
Nicorette microtab Nicorette nasal spray Nicorette patchesNicorette quickmist
Nicotinell gum Nicotinell lozenges Nicotinell patches NiQuitin gum
NiQuitin lozenges