Common Drug Interactions with Tobacco Smoke

Many interactions between tobacco smoke and medications have been identified. Tobacco smoke interacts with medications by influencing the absorption, distribution, metabolism, or elimination of other drugs, potentially causing an altered pharmacologic response.

• ALPRAZOLAM - Concurrent use of ALPRAZOLAM and TOBACCO may result in decreased alprazolam plasma concentrations and efficacy.

• BENDAMUSTINE - Concurrent use of BENDAMUSTINE and TOBACCO may result in decrease bendamustine concentrations.

• BENZODIAZEPINES (DIAZEPAM, CHLORDIAZEPOXIDE) - Concurrent use of BENZODIAZEPINES and TOBACCO may result in decrease therapeutic effect.

• BETA-BLOCKERS - Concurrent use of BETA-BLOCKERS and TOBACCO may result in decrease therapeutic effect.

• CAFFEINE - Concurrent use of CAFFEINE and TOBACCO may result in increased clearance (56%).

• CHLORPROMAZINE - Concurrent use of CHLORPROMAZINE and TOBACCO may result in decrease therapeutic effect.

• CLOPIDOGREL - Concurrent use of CLOPIDOGREL and TOBACCO may result in increased metabolism.

• CLOZAPINE - Concurrent use of CLOZAPINE and TOBACCO may result in increased metabolism and decrease plasma concentration.

• CONTRACEPTIVES, COMBINATION - Concurrent use of CONTRACEPTIVES, COMBINATION and TOBACCO may result in an increased risk of cardiovascular disease.

• ERLOTINIB - Concurrent use of ERLOTINIB and TOBACCO may result in increased erlotinib clearance and reduced serum concentrations.

• FLECAINIDE - Concurrent use of FLECAINIDE and TOBACCO may result in increased clearance and decrease serum concentration.

• FLUVOXAMINE - Concurrent use of FLUVOXAMINE and TOBACCO may result in increased fluvoxamine metabolism.

• HALOPERIDOL - Concurrent use of HALOPERIDOL and TOBACCO may result in increased clearance and decrease serum concentration.

• HEPARIN - Concurrent use of HEPARIN and TOBACCO may result in increased clearance and decrease half-life.

• IMIPRAMINE - Concurrent use of IMIPRAMINE and TOBACCO may result in decreased imipramine concentrations.

• INSULIN, SUBCUTANEOUS - Concurrent use of INSULIN, SUBCUTANEOUS and TOBACCO may result in decrease insulin absorption secondary to peripheral vasoconstriction.

• METHADONE – Concurrent use of METHADONE and TOBACCO may result in increased metabolism.

• MEXILETINE - Concurrent use of MEXILETINE and TOBACCO may result in increased clearance and decrease half-life.

• OLANZAPINE - Concurrent use of OLANZAPINE and TOBACCO may result in increased metabolism and clearance and serum concentrations.

• PENTAZOCINE - Concurrent use of PENTAZOCINE and TOBACCO may result in decreased pentazocine concentrations.

• PIRFENIDONE - Concurrent use of PIRFENIDONE and TOBACCO may result in increased metabolism and decrease Cmax.

• PROPRANOLOL - Concurrent use of PROPRANOLOL and TOBACCO may result in increased clearance.

• PROPOXYPHENE - Concurrent use of PROPOXYPHENE and TOBACCO may result in decreased propoxyphene concentrations.

• ROPINIROLE - Concurrent use of ROPINIROLE and TOBACCO may result in decreased ropinirole plasma concentrations and efficacy.

• THEOPHYLLINE - Concurrent use of THEOPHYLLINE and TOBACCO may result in decreased theophylline concentrations.

• TOLBUTAMIDE - Concurrent use of TOLBUTAMIDE and TOBACCO may result in decreased tolbutamide concentrations.

• TRICYCLIC ANTIDEPRESSANTS (e.g., IMIPRAMINE, NORTRIPTYLINE) - Concurrent use of TRICYCLIC ANTIDEPRESSANTS and TOBACCO may result in decrease blood concentration lavel.

• WARFARIN - Concurrent use of WARFARIN and TOBACCO may result in increased or decreased international normalized ratio (INR) or prothrombin time.

Read also: Common Drug Alcohol Interactions