Nicabate CQ and Nicabate CQ Clear

Generic Name: Nicotine
Product Name: Nicabate CQ and Nicobate CQ Clear

Indication

Nicabate CQ and Nicabate CQ Clear are patches used to stop smoking. They help you give up smoking by replacing some of the nicotine you are used to getting from cigarettes. The treatment is called Nicotine Replacement Therapy (NRT). Nicabate CQ and Nicabate CQ Clear Patches release nicotine over a period of time at a constant rate. This will help easing unpleasant symptoms such as feeling ill or irritable that smokers often feel when they try to give up. The nicotine can also reduce your cravings for a cigarette and help you to resist the urge to smoke.

Action

Nicabate patches maintain a low, steady amount of nicotine in your body to reduce your cravings for a cigarette and help you resist the urge to smoke. The nicotine relieves some of the unpleasant symptoms such as feeling ill or irritable while you are attemptng to give up.

Dose advice

Use in Pregnancy (Category D)

Smoking during pregnancy is associated with birth defect risks. There are clear benefits from stopping smoking. If you are unable to quit on your own, NRT may be used as early as possible and it should be used for 2 to 3 months only. As the effects of sustained low level nicotine exposure upon the human fetus are unclear, short acting products such as lozenges and soft gums are preferred. However, if patches are chosen, you should remove them before going to bed at night.

If you are breastfeeding

You should avoid using Nicabate patches. Instead, soft gums or lozenges should be considered if you need to use NRT to help you quit.

NICABATE CQ and Nicabate CQ Clear Patches are not suitable for use if you

• are a non-smoker or an occasional smoker
• are under 12 years of age
• have a skin condition or disease such as eczema or dermatitis

Caution should be exercised if you:

1. have a heart attack recently
2. have severe irregular heart rates
3. have a stroke
4. have diabetes
5. are pregnant or breastfeeding
6. have serious liver or kidney problems

Use of NRT should be in consultation with your doctor if you belong to any of the above categories.

Tell your doctor if you are using any of the following medicines as they may be affected by or affect how well Nicabate CQ and Nicabate CQ patches work:

• Caffeine
• Theophylline
• Some medicines used to treat depression
• Dextropropoxyphene and pentazocine (medicines that may be used for pain relief)
• Insulin
• Some medicines used to treat mental disorders
• Frusemide (fluid tablet)
• Medicines used to treat ulcers
• Blood pressure medicines

How to use Nicabate CQ and Nicabate CQ Clear Patches:

1. Remove the stiff, transparent protective cover (one half at a time) and apply the sticky surface to the skin.
2. Apply Nicabate patch on a hairless area of your upper trunk or outer arm. Press the patch firmly onto the skin with palm and hold in place for 10 seconds.
3. Replace Nicabate patch after 24 hours. Do not apply to previously used skin site for approximately one week.
4. Do not wear more than one patch at a time.
5. After 24 hours, remove patch, fold in two, sticky side inside, replace in its pouch and discard well away from children or pets. Do not flush down the toilet.
6. If the patch gets wet, water does not harm the Nicabate patch, so you can swim, bathe and shower with it on. Avoid using soap on the patch or skin immediately surrounding the patch.
7. The patch is effective as long as it is against your skin. If the patch comes off, you may use a strip of adhesive tape to secure it.
8. Remove patch before going to bed if you experience weird dreams.

How long to use it

Nicabate patches are designed to be used as part of a 10 week “weaning off” nicotine programme. This consists of the 6-2-2 Programme:

• 6 weeks on a patch delivering 21 mg of nicotine over 24 hours
• 2 weeks on a smaller patch delivering 14 mg of nicotine over 24 hours
• 2-4 weeks on a very small patch delivering 7 mg of nicotine over 24 hours

Using Nicabate combination therapy

Combination therapy can be used if patches alone are not sufficient to help quiting. You may use Nicabate 2 mg Soft Gum or 2 mg Lozenges. Do not use more than 12 pieces of gum or lozenges a day. The use of the 4 mg soft gum or lozenges together with the patches is not recommended.

If you are using Nicabae patches together with soft gum or lozenges, the combination treatment should be used for 12 weeks. After this time, you may taper the dose as below:

• Use the 14 mg patch for 2 weeks and then the 7 mg patch for 2 weeks while continuing to take the same number of lozenges or pieces of gum you routinely use. Once you are not using any patches, you can gradually reduce the number of lozenges or pieces of gum until you are not using any; OR
• Stop using the 21 mg patch and then gradually reduce the number of lozenges or pieces of gum you are using.

Schedule

Nicabate CQ and Nicabate CQ Clear Patches are unscheduled

Common side effects

Stop smoking itself can cause some symptoms such as dizziness, headache, sleep disturbance, cough and cold-like symptoms. Symptoms such as depression, irritability, anxiety and insomnia may also be related to withdrawal symptoms associated with giving up smoking. You may also get more mouth ulcers than usual.

All medicines can have side effects. Sometimes they are serious, most of the time they are not. Do not be alarmed by the reported side effects. You may not experience any of them. Tell your doctor as soon as possible if you feel unwell while you are using Nicabate CQ or Nicabate CQ Clear Patches.

These patches are well tolerated in most people but it may have unwanted side effects in a few people. Tell your doctor if you notice any of the following and they worry you:

• Nausea and vomiting
• Dizziness
• Headache
• Slight redness and itching at the application site
• Nightmares

These are common (>1% occurrence) side effects of Nicabate patches and are usually mild and short-lived. You may experience these side effects as you decrease the strength of the patches that you use.

Uncommon side effects

Stop using Nicabate patches and tell your doctor immediately if you notice any of the following:

• Fast or very irregular heartbeat
• Swelling of the face, lips, mouth or throat which may cause difficulty in swallowing or breathing.

These are very serious side effects but they are rare (occurrence < 1%).

References

1. Australian Medicines Handbook, Adelaide, Pharmaceutical Society of Australia, 2007.
2. MIMS Online [online]. 2003 [cited 2008 April 28]. Available from: [URL Link] 

For further information talk to your doctor.