I tried the nicotine gum, too, but found it hard to light.
January 13, 2010 9:57 PM   Subscribe

Can I cut my nicotine patch in half and receive half the dose?

I spent a month on 21mg patches, and about a month on 14mg patches (sometimes wearing a patch an extra day or two, or skipping a day or two). I now have a surplus of 14mg patches, and don't want to spend the extra money for a bunch of 7mg patches I may not use up entirely.

On each patch's envelope, where you're supposed to tear it open, it says, "Do not cut! Discard patch if cut!" On the internet, however, I have read about some people cutting theirs and saying, "I was fine," while others warn that the timing of the release of nicotine gets all out of whack when the patch is cut, and doing so can be dangerous.

So I'm left with these things in my brain:
- my obedience to authority telling me, "Don't cut the patch!!"
- my suspicion of authority telling me, "Of course they say don't cut them, so you have to buy more of their patches!"
- not really much info on what actually happens when you cut a patch in half.

So, got any advice backed up with solid links? I really want to finish weaning myself off these things. Thanks!

P.S. My lungs thank you too.
posted by not_on_display to Health & Fitness (17 answers total) 2 users marked this as a favorite
I don't have any science to back your lungs up, but really it's a sticker with some extra chemicals on it, the timing isn't rocket science. I used to cut mine and they still worked fine. And of course the company wants you to buy lesser dosages, they make bank on them.
posted by rhizome at 10:01 PM on January 13, 2010

It sound to me like you are practically "off" of nicotine.

I doubt cutting them will kill you, but you might get a bit more of a dose than you want. (you might like a kick of nicotine, sending you back to addiction)

My advice: Consider taking the patch off, and put it on only if you feel you need it.
posted by santogold at 10:05 PM on January 13, 2010

Like along the cut edge, the nicotine would leak out or something? Doesn't sound too likely, with how I understand drug patches to work. I agree with rhizome, the warning is probably economic in nature.
posted by telstar at 10:06 PM on January 13, 2010

If there's any chance the nicotine might leak out along the cut, you could cut off half the backing paper and stick it on so that half the patch is separated from your skin by the backing. Put a band-aid over it or something if it doesn't feel secure. The next day, peel the rest of the backing, stick that part down, and fold the used half (or put plastic under it or something to keep it from contacting your skin.
posted by pseudostrabismus at 10:16 PM on January 13, 2010 [1 favorite]

As far as I could ever tell the nicotine was contained in the adhesive. There was never any leakage.
posted by rhizome at 10:18 PM on January 13, 2010

The only thing I could figure regarding timing is that perhaps the nicotine is encased in a gel of some kind (uh, I've never seen a patch except on someone or in packaging, so this is a WAG) which breaks down in contact with skin or perspiration and that some is in more gel to delay the release, thus you get nicotine hits over the entire time you wear the patch -- but you don't know what part of the patch has more gel.

On the other hand this doesn't seem like a really risky thing to experiment with.
posted by dhartung at 10:36 PM on January 13, 2010

I think the key to the answer depends on what kind of patch you have. If its a patch where the nicotine is in the adhesive (usually clear, quite thin), you should be fine cutting the thing in half, as dosage is directly related to surface area.
posted by dantekgeek at 10:54 PM on January 13, 2010

Like along the cut edge, the nicotine would leak out or something?

Yes, exactly. The nicotine is delivered in a liquid form that contacts the skin through the part of the patch that adheres to the skin, where it is absorbed. By cutting it, you're going to either have it leak off into your clothing, where it won't won't be in contact with your skin and won't get absorbed, or a greater volume of liquid will leak over a larger volume of skin, resulting in absorbing too much nicotine too quickly.

Getting too much will give you nicotine toxicity, tachycardia, and "the shakes", getting too little will mean suffering nicotine withdrawal. Neither will give you the controlled amount you want to gradually quit.

Try this instead: block half the area of a 14mg patch, that is, half the sticky side that contacts the skin. Do this by just not removing the backing from half the patch. You'll still get a little "extra" sideways flow, but this might make the 14mg patch act more or less like a 7mg patch that delivers for about twice as long as an actual 7mg patch. When you're ready for your "next" "7mg" patch, remove the other half of the backing.
posted by orthogonality at 11:00 PM on January 13, 2010 [1 favorite]

Best answer: I would ask the pharmacist if not a doctor. I know that Lidoderm patches (lidocaine) are safe to cut but Duragesic and Scopolamine patches cannot. It destroys the time-release of the drugs and can be very serious in the case of Duragesic. (You can Google "Duragesic patch cut" and see a ton of links that say not to use one that's cut.)
posted by IndigoRain at 11:02 PM on January 13, 2010

According to my instructor in a college class about Drugs and Society, if the patch has a time-release element, cutting it will cause you to get the full dose all at once, which can be dangerous. She specifically told us to buy lower-dosage patches rather than cut them.
posted by brookedel at 11:43 PM on January 13, 2010

You're not "supposed to" for exactly the reasons stated - the physical delivery system of the patch is designed for the proper rate of release and cutting it can screw that up. I guarantee this is the only thing a pharmacist or doctor is going to tell you.

I did it before and stopped because I had a skin reaction on the border where I cut the patch (I always had skin reactions to the patch but this was worse). Which to me anyway lends creedence to the idea that you've got less controlled flow at the border. Nothing worse than a rash but it did give me pause for thought.

Listen: you're about to save roughly a billion dollars you were spending fucking killing yourself. Fuck it, toss them, buy the 7 mg. patch supply, do the rest of the program by the book, and throw those away when you're done with them too, would be my advice. Either way GlaxoSmithWellkline or whoever the fuck is going to romp through bounteous fields of all our cash, so that's not really much of an issue.
posted by nanojath at 11:45 PM on January 13, 2010 [2 favorites]

I think pseudostrabismus's idea - to avoid cutting the patch but still limit how much is in contact with your skin - is really sensible.
posted by aimedwander at 5:58 AM on January 14, 2010

"Some people cut patches in half, to get smaller doses. This is probably safe, but a cut patch may not provide a predictable dose, said Dr. Michael C. Fiore, director of the tobacco research and intervention center at the University of Wisconsin Medical School."
posted by stavx at 6:19 AM on January 14, 2010

If I am not mistaken, cutting the patch will also result in a "sharp" corner where the cut is made.
If you do try cutting it, round that out with a rounded cut or some craft tool.
Just so it won't dig into your skin.
posted by Drasher at 8:29 AM on January 14, 2010

Response by poster: Thanks, folks. I think I'm going to try the "taking off half of the backing" approach.

I agree, SmithKlineBeechamLillyGlaxo will swim in lots of moneys, but I like having my moneys for my own swimming purposes and would rather not spoon that cool swimwater into their polluted lake from my inflatable pool.

Thanks again for your advices!
posted by not_on_display at 8:36 AM on January 14, 2010

Response by poster: I asked a pharmacist; she talked to a rep, and then told me, "GlaxoSmithKline says: do not cut the patch because damaging the membrane may interfere with the rate of absorption."
posted by not_on_display at 11:35 AM on January 19, 2010

Response by poster: Anyway, I never cut the patches I had; I just wore them less regularly until I eventually didn't wear them at all. I haven't been "a smoker" for a few months now.* Hooray!

*I did have a few puffs off of others' cigs, though, but I'm not going to beat myself up over that. :)
posted by not_on_display at 10:23 AM on March 22, 2010

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