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  • BDD Moderators: Keif’ Richards

what drugs have a decreased effect due to smoking?

A

Anon54

Ex-Bluelighter
Joined
Jun 11, 2010
Messages
861
Cytochrome P450 Drug Interactions
http://www.ildcare.eu/Downloads/artseninfo/CYP450_drug_interactions.pdf

If Im reading this chart properly Valium, Caffeine, Zyprexa (Olanzapine) Mirtazapine & APAP are included in drugs that are reduced in effect due by smoking.
I take valium sometimes which I get hardly any effect from even with doses over 100mg.
So if I switch to Temazepam, k-pins or Xanax they wont have a decreased effect due to smoking?
Am I reading this chart correctly?
It also only listed Diphenhydramine as a potentiator to Oxy, Codeine, Morphine & also Meth which is interesting. So what about the other antihistamines?
Is DPH the only true potentiator?

I take Zyprexa & Im trying to quit smoking. would be interesting if i could lower the dose because it's effected by smoking. although i could just change to Seroquel which it doesnt state as being effected by smoking.
If I quit smoking should I need a lower dose of Zyprexa?

What else is effected by smoking do u think?
Ive got a feeling that alcohol is also effected by smoking
 
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You are reading the chart correctly, however all it does is make them get metabolized slightly faster and completely ignores the psychoactive effects of nicotine. Furthermore you have to better understand the metabolism of each drug and can't just make a blanket statement that it is bad. There may be active metabolites that it would be beneficial to induce the creation of. For example you mentioned diphenhydramine inhibiting the action of CYP2D6 which would help with morphine's metabolism. In fact 80% of morphine undergoes phase II glucuronidation which has nothing to do with P450, and I'd guess CYP2D6 is responsible for the minor but stronger hydromorphone metabolite. Diphenhydramine is also pschoactive in its own right as well.
 
in general all benzos are reduced in effect by smoking ...
don't smoke benzos. just eat them. their oral bioavailability is about as high as it goes...
 
^OP was asking about how smoking cigarettes effects the P450 enzyme system and what effect this has on the metabolism of other drugs.
 
Yeah Valium, Librium and zyprexa are 3 drugs i know of that are effected by tobacco. I'm sure there are others. I don't find that it affects clonazepam so much but then i think it is metabolized way differently then diazepam. If you stop smoking you might be able to get away with a lower dose. I don't know cause Ive always smoked on zyprexa. I personally don't find seroquel to work nearly as well atleast for manic symptoms but that's just my reaction to it.

Other anti-histamines do enhance the effects of opiates or should i say the drowsiness and maybe the euphoria as well. Doxylamine (otc in Canada and most places and sold as a sleep aid as well as in some NyQuil preparations), promethazine (phergan, histantil, etc sold OTC in some countries), hydroxyzine (prescription in north america atleast), etc potentiate the effects of opiates. Out of the ones ive tried i find hydroxyzine to be the best for potentiating opiates. It's easy as shit to get a script for it and doctors will hand it out like candy as a anti-histamine or sleep aid.
 
^^have u got a link to a chart saying that antihistamines other than dph are true potentiators to opiates or is it simply a combo to add some sedation?

it says dph is a potentiator for codeine. the people who made this chart must believe that the codeine high is mostly due to CG6 & not morphine otherwise it would make codeine weaker.
 
Anon54 said:
^^have u got a link to a chart saying that antihistamines other than dph are true potentiators to opiates or is it simply a combo to add some sedation?

it says dph is a potentiator for codeine. the people who made this chart must believe that the codeine high is mostly due to CG6 & not morphine otherwise it would make codeine weaker.
Click to expand...

It depends on when you took the cyp450 inhibitor. It could pass codeine, mostly unchanged into morphine. However, if your dosing schedule is correct. You could have the codeine metabolize into morphine, and then have the CYP450 kick in to slow down the morphine breakdown. Of course, this is up to individual dose/weight/size/type/gender/etc, and YMMV, but I personally find that taking cimetidine 45 mins before ingestion of codeiene does the trick quite well... It begins to inhibit the CYP450 enzymes right around when they would be fully passing the drug to the intestine, not beforehand, or after the drug is fully metabolized. So (in theory) the metabolized, but not broken down, morphine continues to circulate for a longer time in the peak plasma levels before being broken down into the final metabolites.
It's almost like a balancing act.
 
^Morphine is metabolized into inactives by phase II pathways which are not part of the CYP system. Inhibiting them does nothing but prevent conversion to hydromorphone and normorphine.

Even the effects of codeine are only very slightly due to the conversion to morphine (only noticible in fast metabolizers) and predominatly also phase II glucuronidation to c-6-g which also ignores CYP.

Most if not all of the benefits you are experiencing from diphenhydramine are placebo and increased sedation from diphenhydramine's psychoactive properties.
 
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