Guidelines for Nicotine Replacement Therapy: Nicotine Patch

These instructions are for Children’s Hospital of Philadelphia patients who are beginning nicotine replacement therapy.

Patient instructions: nicotine patch

Congratulations on taking the next step to become tobacco free!

Applying the patch:

• Make sure your skin is clean, dry and hairless. Then peel off the backing from the patch.

• Apply sticky side of the patch to your skin and press firmly for 10 seconds. Make sure the patch sticks well to the skin and around the edges.

• Apply the patch to your upper arm, upper chest or your back.

• Wash your hands after touching the patch. Nicotine can get into your eyes or nose and cause stinging or redness.

• Replace patch every 24 hours with a new one. Do not use the same area again for at least one week.

• Keep the patch on, even if you use nicotine.

Patch strengths:

Patches come in 21mg, 14mg, and 7mg doses. Reduce your dose every 4 to 6 weeks if your symptoms are well controlled.

• For example, if you started on a 21mg patch, go down to 14mg after 4 to 6 weeks if symptoms are well controlled.

• Go down from 14mg to 7mg after 4 to 6 weeks of symptoms being well controlled.

• After 4-6 weeks on a 7mg patch, try to go without a patch.

Removing the patch:

• Remove the patch before showering.

• Throw away the used patch by folding it in half, so that you do not get any nicotine on your fingers.

• Immediately dry skin and place a new patch on a different area of skin.

Temporary side effects of nicotine patches can include:

• Dizziness

• Nausea, vomiting, diarrhea

• Redness or swelling at patch site

• Headache

Reviewed November 2023, by Leighann Sweeney, RRT-NPS, CTTS, AE-C