Nicotine patch side effects may include dizziness, skin irritation, and headaches. Doctors may recommend switching to a lower dose patch if someone experiences side effects.

Nicotine patches are a type of nicotine replacement therapy (NRT) that delivers a steady dose of nicotine. NRTs can help people stop smoking by reducing withdrawal symptoms and cravings.

Patches come in different nicotine doses. The correct dose will depend on how many cigarettes a person smokes daily. Side effects may indicate that someone needs a lower dose.

This article examines the most common side effects of nicotine patches, nicotine withdrawal symptoms, other NRT options, and when to contact a doctor about side effects.

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According to a 2020 article, nicotine patches may cause insomnia and irritation at the application site.

The American Cancer Society (ACS) also lists the following potential side effects:

Not everyone will experience all symptoms. People should speak with a doctor if they experience side effects, as they may occur due to the wrong patch dose.

As well as experiencing side effects if a patch dose is too high, individuals can experience symptoms of nicotine withdrawal if their patch dose is too low.

Nicotine withdrawal symptoms may include:

Getting the right dose

Nicotine patches are available in a variety of dose strengths. People can typically wear patches for 24 hours.

However, if someone experiences side effects such as sleep disturbances or vivid dreams, doctors may recommend wearing it for 16 hours and removing the patch before they go to bed.

The right patch dose will depend on how many cigarettes a person smokes per day. People can speak with a healthcare professional to determine which patch they need and follow instructions on the packaging to reduce the risk of side effects.

People will typically reduce the patch strength over 8–10 weeks to wean themselves off nicotine.

Using a nicotine patch appropriately will reduce the risk of unwanted side effects that can occur if the medication releases too quickly.

People should apply the patch onto clean, dry, hair-free skin on the upper body, such as the following areas:

  • upper chest
  • shoulder
  • back
  • upper or inner arm

People should not cut the patch, as this can affect how quickly nicotine releases and absorbs into the body. It is also advisable to avoid applying heat to the pad or using heat near the pad, as this may also increase absorption.

Nicotine may interact with the following drugs:

  • adenosine — this interaction may affect the heart rate
  • cimetidine (Tagamet) — interaction with nicotine may cause toxicity
  • varenicline (Chantix, Champix) — this interaction can worsen nicotine-related side effects, such as nausea, sleep disturbances, and skin reactions

People should speak with a doctor about any medications they are currently taking before using nicotine patches.

If people experience side effects from nicotine patches, doctors may recommend an alternative NRT option. Other therapies include:

  • gum
  • nasal spray
  • lozenges
  • inhalers

The most suitable option for an individual may depend on their lifestyle and the urgency of their cravings.

Some doctors may also recommend combining the nicotine patch with another NRT to relieve periods of intense craving. This is typically for people who smoke a pack a day or more. People should only combine NRTs under a doctor’s guidance.

Long-term dependence

According to the ACS, nicotine patches and other forms of NRT are not long-term replacements for nicotine use. They help wean the body off nicotine dependence entirely.

However, they state that using patches for longer periods is better than returning to smoking.

The National Cancer Institute suggests research does not associate long-term use of NRTs with serious harmful effects. Long-term use of nicotine patches may increase the rate of quitting smoking.

People can work with a healthcare professional to create a plan for weaning themselves off nicotine patches.

People should speak with a doctor if they experience nicotine patch side effects. They may need to adjust the dose they are using.

People should seek immediate medical help if they suspect they or someone else is experiencing a nicotine overdose. Symptoms include:

  • nausea and vomiting
  • headaches
  • stomach pain
  • diarrhea
  • irregular or fast heart rate
  • pale skin and mouth
  • cold sweat
  • shaking
  • weakness
  • confusion or agitation
  • restlessness
  • dizziness or faintness
  • fast breathing
  • seizures

People should dispose of nicotine patches safely to ensure other people, children, or animals do not come into contact with them.

Smoking or using tobacco creates a physical dependence on nicotine. Trying to stop can cause physical symptoms of withdrawal. Nicotine patches are one option for treating withdrawal symptoms and weaning off nicotine.

The right nicotine patch will depend on a person’s lifestyle and how many cigarettes they typically smoke. Side effects from nicotine patches may indicate an incorrect dose strength, drug interactions, or inappropriate administration or use.

If someone experiences side effects, they should speak with a doctor. Symptoms of a nicotine overdose, such as a cold sweat, tremors, and vomiting, may require urgent medical attention.