Influence of smoking on pharmacokinetics of medication
In a previous issue, a case report was presented in the Dutch Journal of Medicine (NTvG) of a patient who had variable clozapine levels after switching from regular cigarettes to an e-cigarette and vice versa.
Besides clozapine there are a number of other agents with a narrow therapeutic range where pharmacokinetics can be influenced by smoking.
This review describes the mechanisms of smoking-induced influence on the pharmacokinetics of medicines, and guidance will be provided regarding which medicines must be monitored more closely when patients change their smoking habits.
Finally, an overview is given on package insert information concerning dose adjustments for smokers and non-smokers.
Conflict of interest and financial support: none declared.