Usage patterns of transdermal nicotine when purchased as a non- prescription medicine from pharmacies - - Shaw et al. Tobacco Control. Usage patterns of transdermal nicotine when purchased as a non- prescription medicine from pharmacies. John P Shawa. Donald G Ferrya. Damian Pethicab. Daniel Brennerc. Ian G Tuckeraa. School of Pharmacy, University of Otago, Dunedin, New Zealand, b. Ciba- Geigy New Zealand Ltd (now Novartis New Zealand Ltd), Auckland, c. Ciba- Geigy AG, Basle, Switzerland (now Swiss Federal Office of Public Health, Bern, Switzerland)Corresponence to: Dr JP Shaw, School of Pharmacy, University of Otago, PO Box 9. Dunedin, New Zealand. Approximately 6. 0% of purchasers were first- time users. For those continuing a course of treatment, there. Twenty- eight per cent of respondents. OBJECTIVE: To assess nicotine patch use in smokers who purchased the product as a non-prescription medicine from pharmacies. DESIGN: A questionnaire administered at the time of purchase. SETTING: Community pharmacies. Side effects were reported by 2. It is supplied as a course of treatment with the intent of “weaning” the user off nicotine dependence by. The length of treatment recommended by various manufacturers varies between eight and 1. Other nicotine replacement products include nicotine gum, which has been widely used since the early 1. Are Nicotine Patches OTC? Nicotine patches are available without a prescription and are commonly used to help people quit smoking. OBJECTIVE To assess nicotine patch use in smokers who purchased the product as a non-prescription medicine from pharmacies. DESIGN A questionnaire administered at the time of purchase. Easy to read patient leaflet for nicotine patch. Includes indications, proper use, special instructions, precautions, and possible side effects. Nicotine Patch and Prescription Drugs Help With Quitting Smoking, Study Finds. Photographic rights remain the property of Join Together and the Partnership for Drug-Free Kids. DIN (Drug Identification Number) 02065754 NICORETTE PATCH 10MG/16 HOURS 02065762 NICORETTE PATCH 15MG/16 HOURS 02065738 NICORETTE PATCH 5MG/16 HOURS. The nicotine patch has been available worldwide since about the early 1. In the United States it was released as a prescription. In some countries, it has been available as a non- prescription medicine for several years and recently the Food and Drug. Administration approved over- the- counter (OTC) use of this product in the United States. In New Zealand, the product Nicotinell TTS (known as Habitrol in the United States) was launched as a pharmacy- only medicine. Real-world efficacy of prescription and over-the-counter nicotine replacement therapy. To assess smoking cessation rates achieved with nicotine gum and patch in simulated over-the. A nicotine patch is a transdermal patch that releases nicotine into the body through the skin. It is used as an aid in nicotine replacement therapy (NRT), a process for smoking cessation. The nicotine patch is a quit medication that you can get from your local pharmacy without a. It is a non-prescription (over-the-counter) nicotine replacement therapy product you can get from your. The nicotine patch is a quit medication that you can get from your local pharmacy without a prescription. The patch only contains clean nicotine which means it has none of the other toxins that are in tobacco. OTC sale only in a registered pharmacy) in 1. There are three patch sizes: Nicotinell TTS 1. The usual pack size of the product is seven patches. This presents the opportunity for pharmacists to provide repeated counselling. The effectiveness of the nicotine patch for smoking cessation has been evaluated in a variety of settings, and a meta- analysis. The authors of the meta- analysis pointed out that there were still many unanswered questions in the use of the nicotine patch. This study emphasised the need for further research on the “real- world”. Nicotine is the. addictive component of tobacco, and rapidity of onset and frequency of use have been suggested as determinants of dependence. This being the case, nicotine sprays and aerosols should have dependence potential, but not nicotine patches. Surveys. of transdermal nicotine usage and studies of subject effects are consistent with this notion. Physical dependence on nicotine gum has been reported in some users, and a substantial percentage of smokers who quit may. It must be noted, however, that this is not a clearcut issue. These studies involved. In such instances its use may be quite appropriate. One method to investigate the dependence potential of transdermal nicotine would be to document the duration of usage when. We took this approach in our study to determine if any. The objectives of the study were (a) to establish the present use and previous usage of this product by purchasers. Pharmacies were identified using the Pharmacy Guild of New Zealand Directory of Retail Pharmacies. New Zealand . The study was conducted in accordance with Good Drug Monitoring Practice guidelines, and in compliance. Declaration of Helsinki. The study was administered from the country’s single School of Pharmacy. Dunedin. Copies of the questionnaire. The. letter advised pharmacists of the proposed period of sampling. Their role was. to recruit purchasers of Nicotinell TTS into the study and to administer a short questionnaire on behalf of the researchers. In this study, purchasers were. Nicotinell TTS. The. The pharmacist then explained the nature of the study using the information sheet, which. This sheet outlined the aims of the study and emphasised the voluntary nature of participation and. It also outlined the exclusion criteria—namely, consumers who had already participated in the study. If the consumer gave verbal consent. These investigated age and smoking history; descriptions. Nicotinell TTS with regard to strength of patch used, duration. Nicotinell TTS. In addition, side. Nicotinell TTS use and pre- existing medical conditions were recorded. The questionnaire was specifically designed. It took about two or three minutes on average to complete the questionnaire. No record was kept regarding the number of purchasers who did not participate in the study. To identify covariates of selected process and outcome. A minimum of 8. 00 responses was set as a reasonable target for the. At the time of commencement, Nicotinell TTS had been available for purchase through pharmacies. New Zealand for approximately 1. The total number of questionnaires. Men and women were almost equally represented. Sixteen years is the minimum age. New Zealand. The average duration of smoking was 1. Cigarette consumption was the main method of smoking (9. The average number of cigarettes smoked per day was 2. Of the 6. 34 purchasers who had made previous attempts to quit smoking, 3. This represents 4. Analysis of the relationship between the use of nicotine- containing products, gender, and each of the number. The. main products used were Nicotinell TTS, used by 1. Nicorette gum,2. 8 used by 1. Some respondents reported the use of more than one product previously. At the time of the study Nicotinell. TTS had been available for purchase through pharmacy in New Zealand for about 1. Nicorette gum had been available. The products Nicabate. One previous attempt using Nicotinell TTS had been made by 1. For the first attempt the mean duration of. The maximum duration of use of any one patch strength. The mean total duration of patch use involving all strengths for the first attempt was 4. The mean total duration. The interval between the present attempt and the most recent past attempt is shown in table 3. For 1. 51 (7. 7. 4%) of these respondents this interval was greater than six months. Only 1. 6 (8. 2%) of purchasers who had made. Nicotinell TTS had done so within the last three months. When duration of use was recorded. Nicotinell TTS were combined for these participants (which may well be inappropriate. The mean duration of use overall for the previous. The mean total duration of use of. Only 1. 0% of these respondents had used Nicotinell TTS for six weeks or more in the present attempt at the time. Of the 3. 14 who gave information about concurrent smoking while using Nicotinell TTS during the present. Of those who. were still smoking, 8. Analysis of the relationship between. Nicotinell, gender, and each of the number of years smoking, the number of cigarettes each day. Of the 3. 01 who reported on side effects caused by Nicotinell TTS during their present quit attempt, 2. There were reports of side effects by 7. Of the total reports on. There was no statistically significant relationship. Nicotinell TTS. Pharmacists are expected to ask appropriate questions. The pharmaceutical companies that market the products in New Zealand (Nicotinell TTS—Ciba- Geigy Pharmaceuticals; Nicabate—Marion. Merrell Dow Pharmaceuticals) also provide support to pharmacists and consumers in the form of written material (starter packs). The products are priced OTC to correspond approximately with the cost of continuing to smoke at the. Marketing was by direct advertising to the public in print. At the time of the launch of. Nicotinell TTS, the company (Ciba- Geigy New Zealand) provided extensive educational programmes to pharmacists on the use of. The total number of pharmacies generating. It is difficult to say whether this was. We were actually quite pleased with this response. Given the. busy and complex nature of community pharmacy practice, it was encouraging that a large number of pharmacists took the time. It was not the intention of. The focus was on how transdermal. For this reason the design was deliberately non- interventional. There was no attempt. Anecdotally, pharmacists reported. There was no attempt to establish efficacy and the study was not a clinical trial. It might rather be viewed as a form. The methods. employed were exploratory, there being relatively few reports of similar studies in the literature. The study has demonstrated that useful data can be obtained in this fashion. In some countries a proportion of the population. OTC setting, avoiding the expense and inconvenience of a physician’s visit. It could be argued that the effectiveness of transdermal nicotine. On the other hand, a number of studies have demonstrated that less intensive or minimal intervention is still associated. In the context of this study we have assumed minimal intervention (routine initial questioning and counselling on first purchase). The opportunity then exists for identification and referral of treatment failures to. There are case reports of the onset of angina, myocardial infarction, and cerebral. Continuing to smoke is inconsistent with the use of transdermal nicotine as an aid to quit, but little is known of the way. There are a number of reports of this occurring with nicotine gum, and some commentators predict that. The release characteristics and pharmacokinetic profile of transdermal nicotine would appear to minimise the risk of addiction. One of the aims of this study was to assess the potential for the development of “transfer of addiction” in the OTC use of. For those reporting. Nicotinell TTS within the previous three months. The maximum duration of use for the previous course was recorded as 1. Accordingly, we could find no evidence. Nicotinell TTS for longer than the manufacturer’s recommended maximum of 1. These data suggest that there. It has to be acknowledged that these are not conclusive. Pharmacists reported that the usual purchase was for one week’s supply at a time, with relatively few purchases. Perhaps this pattern of purchase could be exploited more effectively by pharmacists. This purchase pattern suggests that encouraging compliance. The manufacturer’s instructions clearly. Transdermal Nicotine Patch - Uses, Side Effects, Interactions. How does this medication work? What will it do for me? This medication belongs to a family of medications known as nicotine replacement therapies. It is used to help people over 1. When a person stops smoking, they go through withdrawal from nicotine that causes symptoms such as irritability, mood swings, restlessness, trouble concentrating, and increased appetite. This medication helps reduce the symptoms of nicotine withdrawal by replacing some of the nicotine that the person no longer receives through cigarettes. The nicotine patch when applied to the skin delivers a steady dose of nicotine over a 2. Gradually, the dose is reduced until the person no longer craves nicotine, and they can stop using the medication. This medication works best when used with a comprehensive program to quit smoking. Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor. Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it. What form(s) does this medication come in? This medication is available as 7mg/day, 1. How should I use this medication? Ask your doctor or pharmacist to teach you how to use the nicotine patch effectively and to give you tips on quitting smoking. Only one nicotine patch should be applied once a day to an area on the upper body or upper outer arm that is non- hairy, intact, non- irritated, clean, and dry. After 2. 4 hours, the old patch should be removed and discarded and a new patch applied. Be sure that new and discarded patches are kept out of the reach of children. It is very important to apply the patch to a new site on the body and avoid any unnecessary contact with the medicated part of the patch. If during handling you do come into contact with the medicated portion of the patch, quickly wash the affected area with water only. Do not use soap as it can increase the amount of nicotine absorbed into the body. Avoid contact with your eyes. Your initial dose and duration of therapy can depend on a number of factors such as weight, number of cigarettes you smoke, and various medical conditions. Speak with your doctor or pharmacist before beginning a nicotine patch therapy. Therapy for most people begins with the 2. It is important to reassess your initial dose of nicotine after the first 2 weeks of therapy. The next stage of therapy will gradually reduce the dose of nicotine. After successful completion of the first 6- week stage, the 1. Treatment will generally take 8 to 1. You should not use this medication for more than 3 months. You must stop smoking completely when taking this medication. Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. It is important to use this medication on a regular schedule as prescribed by the doctor. If you miss a dose of this medication, take your next scheduled dose. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice. Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children. Do not dispose of medications in wastewater (e. Ask your pharmacist how to dispose of medications that are no longer needed or have expired. Who should NOT take this medication? Do not use nicotine patches if you: are allergic to nicotine or any ingredients of the patchare a non- smoker or an occasional smokerare under 1. What side effects are possible with this medication? Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time. Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects. Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention. Check with your doctor as soon as possible if any of the following side effects occur: chest painfeelings of dependence on the medication or difficulty stopping the medication after your treatment is doneirregular heartbeat or heart palpitationsleg painsevere stomach upset that does not go awayskin rash or swollen skinskin redness caused by the patch that does not go away after 4 days. Stop taking the medication and seek immediate medical attention if any of the following occur: symptoms of a serious allergic reaction (such as hives, difficulty breathing, or swelling of the face and throat)Symptoms of overdoseabdominal or stomach paincold sweatconfusionconvulsions (seizures)disturbed hearing and visiondroolingextreme exhaustionpale skinrapid heartbeattremors. Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication. Are there any other precautions or warnings for this medication? Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast- feeding, and any other significant facts about your health. These factors may affect how you should use this medication. Medical conditions: If you have thyroid conditions, diabetes, stomach ulcers, heart disease, blood vessel disease, kidney disease, or a skin disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Pregnancy: This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately. Breast- feeding: This medication passes into breast milk. If you are a breast- feeding mother and are using nicotine patches, they may affect your baby. Do not breast- feed while you are using this medication. Children and adolescents: The safety and effectiveness of this medication have not been established for people under 1. What other drugs could interact with this medication? There may be an interaction between nicotine patches and any of the following: acetaminophenadenosinebenzodiazepines (e. If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to: stop taking one of the medications,change one of the medications to another,change how you are taking one or both of the medications, orleave everything as is. An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed. Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over- the- counter (non- prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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