Nicotine Patch Dosages for Adults: Your GoodRx Guide

Quitting smoking can be hard to do, but medications can increase your chance of success. The nicotine patch (Nicoderm CQ, Habitrol) is part of a drug class called nicotine replacement therapy (NRT). Using a combination of NRT products, such as the patch combined with nicotine gum or lozenges (Nicorette), is one of the most effective ways to quit smoking.

If you’re using NRT, it’s a good idea to work with a healthcare professional to find the right dosage. In this article, we’ll focus on nicotine patch dosages. Using the right dosage can help you minimize discomfort while you transition away from cigarettes.

What’s the typical nicotine patch dosage for adults?

The typical nicotine patch dosage is one patch applied once a day. But which patch you’ll use depends on how many cigarettes you smoke each day. In some cases, you may use more than one patch per day if your healthcare professional recommends it.

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There’s no clear-cut answer as to how many cigarettes are equivalent to one nicotine patch. But the manufacturer's recommendations for which patch dosage to use depends on how much you smoke per day. The available patch products come in 21 mg, 14 mg, and 7 mg doses. If you smoke more than 10 cigarettes a day, the recommended dosage schedule is below:

• Weeks 1 through 4: 21 mg patch

• Weeks 5 and 6: 14 mg patch

• Weeks 7 and 8: 7 mg patch

If you smoke 10 cigarettes or less per day, the recommended dosage schedule is:

• Weeks 1 through 6: 14 mg patch

• Weeks 7 and 8: 7 mg patch

Based on the manufacturer recommendations, someone who smokes 11 cigarettes a day and someone who smokes 30 cigarettes a day would both start with the 21 mg patch. However, these two people may have a very different dependency on nicotine, so in real life these recommendations aren’t always effective. We’ll discuss more below.

Keep in mind: The nicotine patch isn’t approved for use in children because there’s not enough research on NRT in people younger than 18. But the American Academy of Pediatrics recommends that healthcare professionals consider NRT to help adolescents quit smoking, since it’s safe and effective in adults.

Nicotine patch dosing: How do you know if you need a higher dose?

Typical nicotine patch dosage recommendations may not work for everyone. For example, usual doses may not work well for people who are highly dependent on nicotine. This includes people who smoke a lot (about a pack a day or more), smoke first thing in the morning, or who have trouble avoiding cigarettes in situations where it isn’t allowed. If this sounds like you, it’s possible that you’ll need a higher nicotine patch dosage.

Additionally, a “fixed” dosing schedule may not work for everyone. This is where you follow an exact schedule for decreasing your patch dose over time. Some people may want to remain on a higher nicotine patch dose if they haven’t quit smoking completely yet. Others may have quit smoking, but still wish to remain on a higher patch dose until they feel confident they won’t return to cigarette use.

If you feel like the manufacturer recommendations for nicotine patch dosing won’t work for you, enlist the help of a healthcare professional. When talking about your nicotine patch dosage, they’ll want to know if you’ve been able to decrease or stop smoking. They’ll also want to know if you’re experiencing side effects of too much nicotine, including nausea, a fast heartbeat, and headache.

Good to know: Some research shows that higher nicotine patch dosages can work for people using smokeless tobacco (including chewing tobacco and snuff). But NRT products aren’t FDA-approved for helping people quit smokeless tobacco. So talk to a healthcare professional first. They can help you decide if it’s a good idea to try these products and what the best dosage is.

Where do you put a nicotine patch?

The nicotine patch is a transdermal patch, meaning it’s placed on the skin. It should be placed on an area of the body that’s clean and dry with no hair. Options include your:

• Upper chest

• Upper arm

• Inner arm

• Shoulder

• Back

How do you use the nicotine patch?

When placing the patch, hold down on the adhesive (sticky side down) for at least 10 seconds to make sure it sticks, then wash your hands. A new nicotine patch should be applied every 24 hours, at the same time each day. Rotate where you place the patch with each application, and don’t apply the patch to the same site more than once a week.

EXPERT PICKS: WHAT TO READ NEXT

• Can the nicotine patch cause side effects? It’s possible that the nicotine patch will cause skin irritation, sleep disruptions, and nausea. But usually, these side effects are mild.

• Comparing NRT products: Each NRT product is used in a unique way and might have some different side effects. But the best way to use NRT products is to combine them.

• What’s the best way to quit smoking? Doctors discuss several methods for quitting smoking and how they can help you.

Cutting nicotine patches isn’t recommended. This can change how the medication is delivered to your body, increasing the risk of side effects.

One side effect of the nicotine patch is having vivid dreams. If this occurs and it’s bothersome, you can take the patch off right before you go to bed. But remember to replace it each morning.

When should you start wearing your nicotine patch?

The manufacturers of the nicotine patch recommend starting to use it on your “quit day.” This is the day you plan to quit smoking. However, some research shows that starting the nicotine patch 2 weeks or more weeks before you plan to quit smoking may lead to greater success. This means that instead of starting on your “quit day,” you would start a few weeks in advance.

Talk to your healthcare professional about the best time to start using the nicotine patch. One risk of starting the nicotine patch in advance is that it increases the amount of nicotine your body gets (since you’ll likely continue smoking until your quit day). This can lead to side effects in some people, including nausea and a fast heartbeat. However, the benefits may outweigh the risks if starting the patch early helps you quit in the long run.

Can the nicotine patch help you quit vaping?

Possibly. But there isn’t much research on this. We don’t have any large studies looking at how successful the nicotine patch is at helping people quit vaping. But given the health risks of vaping, it’s worth talking to your healthcare professional about using NRT products to help you quit.

Can the nicotine patch help you quit smokeless tobacco?

Most likely. Similar to vaping, there aren't many studies on using NRT products to help people quit smokeless tobacco. But we would expect that NRT products are more effective at helping people quit smokeless tobacco compared to quitting cold turkey. And some research shows that nicotine lozenges may help.

Additionally, as discussed above, there’s some evidence that higher nicotine patch dosages helped people who used smokeless tobacco. So it’s worth talking to your healthcare professional about using NRT products to help you quit smokeless tobacco.

What happens if you miss a dose of the nicotine patch?

If you forget to replace your nicotine patch, put one on as soon as you remember. Then, the next day, replace your patch at your usual time (even if it’s been less than 24 hours since you replaced your patch).

Don’t put on more patches at one time than what has been recommended by your healthcare professional. This can lead to side effects of too much nicotine, including nausea and a fast heartbeat.

If you realize you’ve left your nicotine patch on for longer than 24 hours, or you’ve accidentally placed more patches than you intended to, let your healthcare professional know (especially if you’re feeling side effects).

Tips for getting the most benefit out of your nicotine patch

There are a few tips you can follow to get the most out of your nicotine patch. This helps you have the greatest chance at quitting smoking.

• If your patch falls off, put a new one on. Just place it on a different area of the skin. Replacing your patch after it falls off ensures that you always have a consistent amount of nicotine working in your body.

• Don’t take your patch off to shower. Getting your nicotine patch wet shouldn’t cause it to fall off or be less effective. If you’re worried, you can put two pieces of medical or sports tape over the patch (in the shape of an “X”).

• If you smoke while using the nicotine patch, don’t stop using it without talking to a healthcare professional. In most cases, smoking while wearing the nicotine patch won’t cause dangerous side effects. So if you slip up and smoke, and you’re not experiencing side effects, talk to your healthcare professional before taking the nicotine patch off. Interrupting your treatment could cause you to smoke even more. However, if you’re experiencing symptoms of too much nicotine, such as a fast heartbeat, let your healthcare professional know immediately.

• Enroll in a smoking cessation program to help you quit. People who use programs to help them quit smoking experience more success. These may involve counseling, support groups, and education. You can check out another GoodRx Health article for tips on how to find a smoking cessation program.

• Consider also using nicotine lozenges or nicotine gum to help you quit smoking. Combining these fast-acting NRT products with the long-acting nicotine patch is more effective than using the patch alone.

• Don’t cut your nicotine patch. As mentioned, cutting your nicotine patch can increase your risk of side effects because nicotine may enter the body more quickly.

• Complete the full treatment course. Even if you’ve quit smoking, don’t stop using the nicotine patch prematurely. Talk to your healthcare professional about how long they recommend using the patch. Many people may need treatment for a longer amount of time than the manufacturer recommends. Long-term nicotine patch use (up to a year) has been shown to be safe.

How to save on the nicotine patch

As part of the Affordable Care Act (ACA), many commercial plans must cover some amount of smoking cessation medications. So it’s possible the nicotine patch may be partially or fully covered by your insurance.

But if the nicotine patch isn’t fully covered, having a prescription for it can help you receive a GoodRx coupon. GoodRx may be able to help you up get a monthly supply of nicotine patches at certain pharmacies for as low as $23.73 with a free GoodRx coupon.

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Written by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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