punkftl
Bluelighter
i have read that smoking can decrease the amount of xanax in the body by 50% due to liver metabolism.
i have also heard the same thing goes for methadone...but i came across this and was wondering if smoking DOES NOT decrease methadone...
was checking on Cipro drug interactions for stomach virus..the paragraph i was talking about it the last one at the bottom
Coadministration with ciprofloxacin may increase the plasma concentrations and pharmacologic effects of methadone in some patients. The proposed mechanism is ciprofloxacin inhibition of methadone metabolism via CYP450 1A2, although methadone is primarily metabolized by CYP450 3A4 and also 2D6 in vivo. In one case report, a 42-year-old woman who had been receiving methadone 140 mg/day for pain became sedated and confused two days following the addition of ciprofloxacin 750 mg twice a day for urosepsis. Ciprofloxacin was replaced by sulfamethoxazole-trimethoprim during hospitalization, and the patient recovered within 48 hours. The interaction was suspected on three further occasions following reintroduction of ciprofloxacin by different prescribers. During each occasion, the patient regained her normal alertness after discontinuation of ciprofloxacin.
However, on the last occasion the patient developed profound sedation and respiratory depression and required treatment with naloxone (0.4 mg intramuscularly). This apparent increase in severity of interaction coincided with a replacement of venlafaxine with fluoxetine (a potent CYP450 2D6 inhibitor) in her concomitant drug regimen.
The patient was also a smoker, thus she may have had an induced CYP450 1A2 enzyme capacity that may have contributed to methadone metabolism to a greater extent than in nonsmokers.
i have also heard the same thing goes for methadone...but i came across this and was wondering if smoking DOES NOT decrease methadone...
was checking on Cipro drug interactions for stomach virus..the paragraph i was talking about it the last one at the bottom
Coadministration with ciprofloxacin may increase the plasma concentrations and pharmacologic effects of methadone in some patients. The proposed mechanism is ciprofloxacin inhibition of methadone metabolism via CYP450 1A2, although methadone is primarily metabolized by CYP450 3A4 and also 2D6 in vivo. In one case report, a 42-year-old woman who had been receiving methadone 140 mg/day for pain became sedated and confused two days following the addition of ciprofloxacin 750 mg twice a day for urosepsis. Ciprofloxacin was replaced by sulfamethoxazole-trimethoprim during hospitalization, and the patient recovered within 48 hours. The interaction was suspected on three further occasions following reintroduction of ciprofloxacin by different prescribers. During each occasion, the patient regained her normal alertness after discontinuation of ciprofloxacin.
However, on the last occasion the patient developed profound sedation and respiratory depression and required treatment with naloxone (0.4 mg intramuscularly). This apparent increase in severity of interaction coincided with a replacement of venlafaxine with fluoxetine (a potent CYP450 2D6 inhibitor) in her concomitant drug regimen.
The patient was also a smoker, thus she may have had an induced CYP450 1A2 enzyme capacity that may have contributed to methadone metabolism to a greater extent than in nonsmokers.
