Please how the dosages on nicotine patches are calculated on a per hour basis, per day basis and total nicotine content.
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Standard nicotine patches are dosed by the amount of nicotine **delivered** over 24 hours. So, a 21 mg patch gives just under a milligram of nicotine per hour, which is close to smoking a pack of cigarettes. (The label usually tells you to wear it for 24 hours, but most professionals recommend removing it at night as they can cause notably vivid dreams.)
The thing about transdermal patches is that you can’t just put 21mg in a patch and assume it will all trickle into the body over 24 hours. You actually need a lot MORE of the drug you’re trying to deliver, to push a steady and predictable flow. So, in this case, the 21mg patch happens to have more like 115 milligrams of nicotine in it. That number doesn’t relate to the dose you get in a relevant way, so don’t bother doing math–just know that about a sixth of what’s in the patch will cross the skin on day 1.
Similarly, a fentanyl patch that delivers 0.025 mg per hour for three days actually has about 5 mg of fentanyl in it, which is 2-3 times what we’re trying to deliver across the skin. This can be a real problem if the patch is misused or not disposed of safely.
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