Prescription Patches -- Better Than Pills?: Convenience

Convenience

It all started with a motion-sickness patch in 1981. Today, you can slap on a patch to avoid Pregnancy, stop smoking or treat pain. Soon, you may see patches for Alzheimer's, Depression, ADHD and Diabetes.

What's the point? "A patch is more convenient, so you're more likely to follow through on using it," says Larry S. Fields, MD, president of the American Academy of Family Physicians. Instead of remembering several pills a day, you can just stick a patch on your arm, belly or butt -- sometimes as infrequently as once a week -- and you're done. You get the same drug, through a different delivery system. And in certain cases, there are even fewer side effects.* Here's what's available now:

PAIN RELIEF
Patch: Duragesic (fentanyl), Lidoderm (lidocane)
What it does: Prescription-only Duragesic relieves constant pain, like that of cancer patients.
Prescription-only Lidoderm is for localized pain, such as shingles or osteoarthritis (OA).
How it compares to other options: A 72-hour Duragesic patch was as effective as IV morphine in one study. It causes less constipation and may be less sedating. Lidoderm can be as effective as certain NSAIDs for OA, without the increased heart risks.
Who should avoid? Those with a history of Depression or drug or alcohol abuse should avoid Duragesic. Lidoderm appears to be safe for most people.
Side effects: As with most patches, mild tingling, burning or redness may occur at the patch site, and if you're allergic to the pill form of a drug, you'll be allergic to the patch form too. The FDA is investigating reports of deaths related to Duragesic, possibly due to unintentional overdose.

BIRTH CONTROL
Patch: Ortho Evra (norelgestromin/ethinyl estradiol)
What it does: Prevents Pregnancy in 99% of cases when used correctly. It delivers the hormones estrogen and progestin, preventing ovulation.
How it compares to other options: It's as effective as the Pill, but its maker recently disclosed that the patch exposes women to 60% more estrogen than the Pill, increasing the risk of side effects. Both forms may cause blood clots and hypertension.
Who should avoid? Smokers, especially those over 35, and those with a history of blood clots, severe migraines or very high blood pressure.
Side effects: Skin irritation, headache, bloating, cramps. Talk to your MD if you're taking drugs for heart conditions or blood pressure. Antibiotics and herbs may interfere with effectiveness.

NICOTINE REPLACEMENT
Patch:NicoDerm CQ, Habitrol (nicotine)
What it does: Delivers nicotine to help reduce withdrawal symptoms when quitting smoking.
How it compares to other options: Since you may chew up to 24 pieces of NR gum per day, a patch is easier on your jaw -- and stomach. Zyban, a pill that's been proven helpful, has been linked to Depression and suicidal thoughts. The patch has not.
Who should avoid? Pregnant or breast-feeding women; people with heart disease (unless you have a doctor's okay).
Side effects: Smoking while on the patch can cause increased heart rate, irritability, nightmares, headaches, dizziness, upset stomach and more. Tell your MD if you use caffeine, acetaminophen or vitamins, or if you've had heart, thyroid or skin problems.

More Patches

CHEST PAIN
Patch: Nitro-Dur (nitroglycerin)
What it does: Relaxes blood vessels, increasing oxygen and blood flow to the heart.
How it compares to other options: It's as effective as a long-acting pill in preventing angina, but neither will help in an acute attack. Your MD may also prescribe short-acting pills to treat sudden attacks.
Who should avoid? People with low blood pressure; men on erectile dysfunction drugs; anyone taking long-acting nitroglycerin.
Side effects: Headache, lightheadedness. Inform your MD about any drugs you're taking, especially aspirin, beta blockers or calcium-channel blockers.

MENOPAUSE
Patch: Alora ETS, Climara, Estraderm, Vivelle (estradiol)
What it does: These estrogen-only patches relieve hot flashes. They may also prevent osteoporosis.
How it compares to other options: The patch is easier on the liver than the pill. A combination estrogen/progestin patch is also available, and is best for women who have not had a hysterectomy.
Who should avoid? Women with a history of Breast Cancer or blood clots. Those who have not had a hysterectomy should avoid estrogen-only patches, which can increase their risk of endometrial cancer.
Side effects: Breakthrough bleeding, breast tenderness, nausea, swelling, vision problems. Smokers over 35 are at increased risk of blood clots. Many drugs, alcohol, caffeine, vitamin C and herbal products can affect how the patch works, so tell your MD if you use them.

HIGH BLOOD PRESSURE
Patch: Catapres-TTS (clonidine)
What it does: Relaxes blood vessels so the heart doesn't need to work as hard to pump blood; may also help smokers fight cravings.
How it compares to other options: It seems to be as effective as the pill form, which is taken 2-3 times a day; the patch is applied once a week.
Who should avoid? People who are prone to sudden drops in blood pressure. Those on drugs that may affect blood pressure should talk to their MDs.
Side effects: Dry mouth, drowsiness, headache, decreased sexual ability, fatigue. Inform your doctor about your alcohol intake and any drugs you use, and tell her if you faint, have swollen feet or notice changes in heartbeat.

*Additional side effects may occur. Consult your doctor and the package insert for more information.Click here for this entire article and chart as a PDF.