June 18, 2009 - 10:50am
I have a question that I have meant to ask my Dr. for a while but keep forgetting so I thought I would put it out to you guys. I am RX'd Xanax 2mg tid and I have read on the package insert that smoking reduces the effectiveness of Xanax. Is this true of all benzo's? If so, how much does it affect the drug and how does it reduce the effectiveness? Thanks in advance for any answers. Greg
June 18, 2009 - 12:46pm
#2
Touche'
I wouldn't want to put anyone in danger at all and that was certainly not my line of thought. I was just wondering the mechanics of the whole thing but you are right.I'll ask my Dr. next month.I never thought anyone would think that way but............................ya never know. If any of the moderators feel the same as AMom please take the post down or tell me how I can't figure out how. Thanks, Greg
June 18, 2009 - 1:08pm
#3
Smoking
can reduce plasma concentrations of Alprazolam by as much as 50% ...
June 18, 2009 - 5:25pm
#4
I have heard it does
and ask away...no problemo
June 18, 2009 - 7:12pm
#5
This is not
up for debate.
Read the P.I. Tobacco (nicotine,) induces certain liver enzymes which accelerate the elimination of Alprazolam. In some individuals, it can reduce plasma concentrations by as much as 50%. This is as factual as me telling you the grass is green.
Someone choosing to abuse the drug, (i.e. take more than prescribed,) is a seperate issue. Some doctors, aware that their patients are smokers, will initiate treatment at a higher doseage to compensate for this. This is not some secret, every doctor and pharmacist is aware of this "interaction."
P.S. Antifungal drugs and Grapefruit juice are claimed to increase the effectiveness of Alprazolam, all due to P450 interation/ induction.
June 18, 2009 - 7:41pm
#6
I was just about to post a
I was just about to post a topic similar to this asking if nicotine effected benzos. I found when I smoke a cigarette that it increased my anxiety. Its a stimulant and xanax is a mild tranquilizer so I can see how they shouldnt go together. I quit smoking cigarettes part because of the increased anxiety feeling.
June 20, 2009 - 7:35pm
#7
Can caffeine also cause
Can caffeine also cause anxiety? I figure since its also a stimulant that it would do so. I dont drink sodas so I really dont drink caffeine. I guess I do every once in awhile if there is caffeine in Arizona green tea or just regular ole Ice tea.
June 20, 2009 - 11:22pm
#8
JJ
It sure can. But it won't reduce the effect of your Xanax in the way nicotine does.
Any stimulant can cause anxiety, or can cause physical symptoms that lead to anxiety, (i.e. palpitations, feeling faint, etc.)
June 22, 2009 - 11:38am
#9
I wonder if it's the Nicotene
or some of the other 400 compounds in a cigarette. I smoke sometimes, depending on the day 2-3 packs.....and I need that other 50% of the alprazolam that's getting destroyed by smoking. Would a nicotene patch be a better alternative?
Ray
June 24, 2009 - 8:24pm
#10
str8tupdude
I doubt a patch, gum, or lozenge would be any better than smoking a cigarette when using Xanax, because you are still getting the Nicotine.
June 24, 2009 - 9:00pm
#11
Not the nicotine
Some of the other compounds result in an induction effect of liver enzymes that causes an increased metabolism of certain drugs that are broken down by these enzymes. Charbroiled food, believe it or not, has the same effect if consumed on a daily basis. Certain drugs, like Tegretol, and other antiseizure drugs, have the same effect. This effect does not occur with the first dose, as enzyme inhibitors work, but take several weeks (average of 5) to achieve the full enzyme induction effect. So, a chronic smoker may find their xanax or other benzo to be ineffective due to this phenomenon.
June 24, 2009 - 10:14pm
#12
nicotine and alprazolam no relation
I have never heard anyone claim that cigarettes decreased the efficacy of alprazolam until now. I also take clonazepam 2mg and used to take Valium 10mg; I get 2mg alprazolam x three daily.
In an earlier post in this thread, someone said that grapefruit juice enhances the effect of xanax, though grapefruit juice actually neutralizes xanax in the bloodstream. I will skip all the pharmacological mechanisms, but feel free to research. I haven't had any grapefruit in ten years.
Cigarettes are an unusual variable, because they have so many different effects on the smoker (psychological). Some people use a smoke to calm them, others use it to pep them up, etc. etc. This probably has a lot to do with people feeling 'less' of the xanax due to nicotine consumption.
Another post mentions the 400+ chemicals contained in cigarette smoke (aside from nicotine). This is a good point, but I still believe it is psychological, not chemical.
Anyone who uses xanax for legitimate purposes knows that if you can feel it and it reduces your anxiety, it is working, no matter how many cigarettes you smoke. Of course if nicotine makes you anxious, that would be like taking xanax with caffeine.
June 25, 2009 - 12:20am
#13
NJRx242
Are you saying if I start chewing the Nicorette I have, instead of smoking cigs (yeah I know it's bad) my Xanax will work better? Does this only apply to Xanax, or will it also affect Ativan, Doral, or Klonopin? Thanks in advance.
I know it wasn't smart, but one time I took a 1mg Xanax and ate 1/2 of a grapefruit. A short while later I was drooling. So anyone thinking of trying it please do not, it was the first and only time for me. I could have died, had I not been so lucky. It was at Christmas un-wrapping presents with extended family and was sort of embarrasing.
You really need to ask your MD that question. Any answer here could lead to a liability issue in my opinion. If it affects the benzo and how much could vary so greatly per person and per med that it would be like playing with fire if someone misread a response on here.
EXAMPLE ONLY: Yes, the info says it interfeers and reduces effectiveness. Wow, so that must be why I'm not feeling it working well enough, I'd better take more..... Well, I forgot I smoked a pack yesterday and usually only smoke half a pack, and now someone has OD'd.
Just my opinion, but I think this topic is dangerous, and I don't speak up like this much, for what it's worth.