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nicotine and alprazolam

drylightning

Greenlighter
Joined
May 24, 2009
Messages
2
Hi,

I take alprazolam for panic disorder and I also chew tobacco (stupid, I know). I've read that cigarette smoking can reduce the effects of alprazolam. Is this due to the nicotine, or something in the cigarette smoke? In other words, does chewing tobacco also affect the strength of alprazolam?

Thanks in advance for the info...

Dan
 
smokeless tobacco shouldn't effect the metabolism of the alprazolam, the additive effect of the nicotine agonization and the benzo together might give you a nicer buzz. cigarettes are different though, the hydrocarbons from the cigarette smoke (not the nicotine!) induce the cytochrome enzymes 1A2 and 3A4, the latter being responsible for the breakdown of the alprazolam. inducing 3A4 will decrease the effect of the alprazolam and give you a lesser benzo buzz.

hope this was helpful.
 
smokeless tobacco shouldn't effect the metabolism of the alprazolam, the additive effect of the nicotine agonization and the benzo together might give you a nicer buzz. cigarettes are different though, the hydrocarbons from the cigarette smoke (not the nicotine!) induce the cytochrome enzymes 1A2 and 3A4, the latter being responsible for the breakdown of the alprazolam. inducing 3A4 will decrease the effect of the alprazolam and give you a lesser benzo buzz.

hope this was helpful.

Does this apply to valium as well...and does it affect the speed of the metabolism of the drug or does it just lessen the effects?
 
smokeless tobacco shouldn't effect the metabolism of the alprazolam, the additive effect of the nicotine agonization and the benzo together might give you a nicer buzz. cigarettes are different though, the hydrocarbons from the cigarette smoke (not the nicotine!) induce the cytochrome enzymes 1A2 and 3A4, the latter being responsible for the breakdown of the alprazolam. inducing 3A4 will decrease the effect of the alprazolam and give you a lesser benzo buzz.

hope this was helpful.

Very helpful - thanks!
 
How much weaker nicotine makes xanax feel?

I'm a daily tobacco smoker and I'm on xanax everyday for anxiety... I tried to quite smoking to get the full effetc from my alprazolam, but when I don't have my nicotine dose I'm getting anxious, so it's not really helpfull...

So does anybody have any idea on how bad tobacco makes xanax less potent? If it's something like -10%, it's fine, but if it's much more I would rather considering quitting smoking for good. =/
 
It doesn't make it less potent, but it will increase clearance. So in essence it won't last as long.
 
I've never noticed a difference when I smoked while on Xanax and when I did not.
 
I also use smokeless tobacco and Alprazolam, nightly, and I have never noticed the combo having a negative effect...

Still works GREAT for me...
 
Me neither... Well I always take my morning xanax (I usually take 2mg on the morning, and 0.5 at night) with a large glass of white grapefruit juice, to make it last longer... So maybe the juice and the tobacco concel each other, and at the end I just have the normal effects from my alprazolam. :)
 
thank god, I thought this was going to be another thread about smoking pills.
 
How much weaker nicotine makes xanax feel?

I'm a daily tobacco smoker and I'm on xanax everyday for anxiety... I tried to quite smoking to get the full effetc from my alprazolam, but when I don't have my nicotine dose I'm getting anxious, so it's not really helpfull...

So does anybody have any idea on how bad tobacco makes xanax less potent? If it's something like -10%, it's fine, but if it's much more I would rather considering quitting smoking for good. =/


in theory the interaction exists, but honestly i don't think the interaction is very significant...if you're smoking 1+ packs a day, it may be more noticeable, but a few cigarettes here and there i don't think will make a huge difference.
 
I knew smoking made my alprazolam weaker

So i've always thought that after i smoke, or if i smoke before taking xanax, the effects are weaker. i've always avoided smoking if i'm going to do it, for that reason.

today, i was at the pharm' filling up my suboxone when i picked up a pharmasuitical book. i was flipping through the book and stopped at alprazolam.
inside the "Drug Interactions" section it read,

"Smokers may need higher doses of Alprazolam because smoking may reduce up to 50% of Alprazolam in the blood steam."

I've read other threads before of people complaining about this also. everyone always said it's placebo because they work on different parts of the brain.

Must this be true>?
 
Last edited:
It is true.

If you're worried about getting the most out of your alprazolam, switch to chewing tobacco when you're on alprazolam. It's not an effect of the nicotine but an effect from a by-product of the tobacco smoke itself (hydrocarbons? someone posted an explanation around here that was much more detailed - I will see if I can find it).

http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Nonlinear mixed effects modeling of single dose and multiple dose data for an immediate release (IR) and a controlled release (CR) dosage form of alprazolam.
Hossain M, Wright E, Baweja R, Ludden T, Miller R.

Office of Clinical Pharmacology and Biopharmaceutics, Center for Drug Evaluation and Research, FDA, Rockville, Maryland 20857, USA.

PURPOSE: NONMEM was applied to single dose and multiple dose bioavailability data for an immediate release (IR) and a controlled release (CR) dosage form of alprazolam to acquire additional information from the data which are not easily obtainable by traditional means. METHODS: The objective function value (OBJ) and diagnostic plots were used as measures of goodness of fit of the model to the data. A change in the OBJ value of 7.9 was necessary to show statistical significance (p < 0.005) between two models when the two models differed by 1 parameter. RESULTS: A two-compartment linear model with first-order absorption and elimination best describes the data. Including a lag time, two different rates of absorption (KAIR and KACR), and bioavailability for the CR relative to the IR dosage form significantly improved the fit of the model to the data. Cigarette smoking was associated with a 100% increase in clearance of alprazolam as compared to non-smokers. The higher residual variability observed in this study, where interoccasion variability (IOV) was not initially modeled, could be explained to a large extent by the presence of significant interoccasion variability (IOV). CONCLUSIONS: Since alprazolam has been suggested to be mainly metabolized by the CYP3A4 isozyme in humans, it appears that tobacco could be an inducer of CYP3A4 and/or alprazolam may be metabolized by other isozyme(s) (specifically, CYP1A1/1A2) that are induced by cigarette smoke. The population pharmacokinetic model approach combined with exploratory graphical data analysis is capable of identifying important covariates from well-controlled "data rich" Phase I studies early in drug development.

http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Smoking in patients receiving psychotropic medications: a pharmacokinetic perspective.
Desai HD, Seabolt J, Jann MW.

Department of Pharmacy Practice and Pharmaceutical Sciences, Mercer University, Southern School of Pharmacy, Atlanta, Georgia 30341-4155, USA.

Many psychiatric patients smoke, and are believed to be heavier smokers than those without psychiatric disorders. Cigarette smoking is one of the environmental factors that contributes to interindividual variations in response to an administered drug. Polycyclic aromatic hydrocarbons (PAHs) present in cigarette smoke induce hepatic aryl hydrocarbon hydroxylases, thereby increasing metabolic clearance of drugs that are substrates for these enzymes. PAHs have been shown to induce 3 hepatic cytochrome P450 (CYP) isozymes, primarily CYP1A1, 1A2 and 2E1. Drug therapy can also be affected pharmacodynamically by nicotine. The most common effect of smoking on drug disposition in humans is an increase in biotransformation rate, consistent with induction of drug-metabolising enzymes. Induction of hepatic enzymes has been shown to increase the metabolism and to decrease the plasma concentrations of imipramine, clomipramine, fluvoxamine and trazodone. The effect of smoking on the plasma concentrations of amitriptyline and nortriptyline is variable. Amfebutamone (bupropion) does not appear to be affected by cigarette smoking. Smoking is associated with increased clearance of tiotixene, fluphenazine, haloperidol and olanzapine. Plasma concentrations of chlorpromazine and clozapine are reduced by cigarette smoking. Clinically, reduced drowsiness in smokers receiving chlorpromazine, and benzodiazepines, compared with nonsmokers has been reported. Increased clearance of the benzodiazepines alprazolam, lorazepam, oxazepam, diazepam and demethyl-diazepam is found in cigarette smokers, whereas chlordiazepoxide does not appear to be affected by smoking. Carbamazepine appears to be minimally affected by cigarette smoke, perhaps because hepatic enzymes are already stimulated by its own autoinductive properties. Cigarette smoking can affect the pharmacokinetic and pharmacodynamic properties of many psychotropic drugs. Clinicians should consider smoking as an important factor in the disposition of these drugs.


The above quotes were taken from: http://www.bluelight.ru/vb/showthread.php?t=446477
 
that is so interesting. i had no idea. i read another post about this a while back but no one ever pulled that out.
 
that is so interesting. i had no idea. i read another post about this a while back but no one ever pulled that out.

I don't smoke cigarettes at all so I don't have any personal experience IMO.

I would advise quitting tobacco if at all possible.
 
aha, the Captain beat me to it! to contribute at least slightly to this thread, subjectively, i definitely felt the alprazolam-cigarette interaction before i was aware of the research. i just didn't make the connection because smoking tobacco always made me jittery to an extent.

oh and yeah this is off-topic but congrats and bravo on the modship, Cap'n! i haven't been 'round here in a bit but it's definitely long overdue, there are very few in OD more deserving or just outright perfect for the position.

ok, enough ass-kissing i need a smoke ;)
 
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