title: Semipermeable membrane dressings can be used with the nicotine transdermal system and do not interfere with nicotine absorption.
abstract: OBJECTIVE
  Adverse skin reactions as a local side effect of nicotine patches sometimes interfere with smoking cessation therapy. We studied the effects of semipermeable membrane dressings (SMD) used under nicotine patches (NP) on nicotine absorption, as assessed according to the urinary cotinine levels, and skin symptoms.
  
  
  METHODS
  First, the urinary cotinine levels were compared in eight nonsmokers that applied NP over SMD and NP without SMD (Study 1). The urinary cotinine levels were measured using a highly sensitive competitive enzyme immunoassay. Second, 28 subjects undergoing NP therapy for diagnosed nicotine dependence were randomly assigned into two groups in a crossover design to receive NP over SMD and NP without SMD. The urinary cotinine levels and skin symptoms were compared between the two treatment groups. During the follow-up period of 48 weeks, the smoking cessation rate was evaluated (Study 2).
  
  
  RESULTS
  No statistical differences were observed in the urinary cotinine levels between the NP over SMD and NP without SMD groups. In Study 2, the skin symptoms improved with the use of SMD in 42.8% (6/14) of the patients and worsened in 28.5% (4/14) of the patients. No serious skin disorders were reported. The subjects followed in Study 2 exhibited smoking cessation rates of 92.8%, 78.5% and 64.2% at 12, 24 and 48 weeks, respectively.
  
  
  CONCLUSIONS
  The use of NP over SMD is a safe and effective alternative application to NP treatment for preventing the skin symptoms caused by NP without interfering with nicotine absorption.
authors: Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Hospital, Japan.
authors: Nobuko
authors: N
authors: Hazeki
authors: Kazuyuki
authors: K
authors: Kobayashi
authors: Haruko
authors: H
authors: Shinke
authors: Masatsugu
authors: M
authors: Yamamoto
authors: Mitsuhiro
authors: M
authors: Ohta
authors: Yoshihiro
authors: Y
authors: Nishimura
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D001458:Bandages; D002463:Cell Membrane Permeability / Q000187:drug effects*; D003367:Cotinine / Q000652:urine; D018592:Cross-Over Studies; D004337:Drug Carriers / Q000008:administration & dosage / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage* / Q000378:metabolism*; D012869:Skin Absorption / Q000187:drug effects / Q000502:physiology*; D016540:Smoking Cessation / Q000379:methods; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder
chemical_list: D004337:Drug Carriers; D009538:Nicotine; D003367:Cotinine