Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Pharmacol. Jan 30, 2019; 8(2): 14-25
Published online Jan 30, 2019. doi: 10.5497/wjp.v8.i2.14
Tobacco smoking and its drug interactions with comedications involving CYP and UGT enzymes and nicotine
Naina Mohamed Pakkir Maideen
Naina Mohamed Pakkir Maideen, Department of Pharmacy, Dubai Health Authority, Dubai 4545, United Arab Emirates
Author contributions: Maideen NMP contributed to this article, as a solo author.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Naina Mohamed Pakkir Maideen, PhD, Pharmacist, Department of Pharmacy, Dubai Health Authority, Al Maktoum Bridge Street, Dubai 4545, United Arab Emirates. nmmaideen@dha.gov.ae
Telephone: +971-42-164952 Fax: +971-42-244302
Received: November 14, 2018
Peer-review started: November 14, 2018
First decision: December 18, 2018
Revised: January 20, 2019
Accepted: January 28, 2019
Article in press: January 28, 2019
Published online: January 30, 2019
Abstract

Tobacco smoking is a global public health threat causing several illnesses including cardiovascular disease (Myocardial infarction), cerebrovascular disease (Stroke), peripheral vascular disease (Claudication), chronic obstructive pulmonary disease, asthma, reduced female infertility, sexual dysfunction in men, different types of cancer and many other diseases. It has been estimated in 2015 that approximately 1.3 billion people smoke, around the globe. Use of medications among smokers is more common, nowadays. This review is aimed to identify the medications affected by smoking, involving Cytochrome P450 (CYP) and uridine diphosphate-glucuronosyltransferases (UGTs) enzymes and Nicotine. Polycyclic aromatic hydrocarbons (PAHs) of tobacco smoke have been associated with the induction of CYP enzymes such as CYP1A1, CYP1A2 and possibly CYP2E1 and UGT enzymes. The drugs metabolized by CYP1A1, CYP1A2, CYP2E1 and UGT enzymes might be affected by tobacco smoking and the smokers taking medications metabolized by those enzymes, may need higher doses due to decreased plasma concentrations through enhanced induction by PAHs of tobacco smoke. The prescribers and the pharmacists are required to be aware of medications affected by tobacco smoking to prevent the toxicity-associated complications during smoking cessation.

Keywords: Drug Interactions, Tobacco smoking, Cytochrome P450 enzymes, Uridine diphosphate-glucuronosyltransferases enzymes, Nicotine

Core tip: Use of medications among smokers is more common, nowadays. This review is aimed to identify the medications affected by smoking, involving cytochrome P450 (CYP) and uridine diphosphate-glucuronosyltransferases (UGTs) enzymes and Nicotine. The drugs metabolized by CYP1A1, CYP1A2, CYP2E1 and UGT enzymes might be affected by tobacco smoking and the smokers taking medications metabolized by those enzymes, may need higher doses due to decreased plasma concentrations through accelerated metabolism by Polycyclic aromatic hydrocarbons of tobacco smoke. The prescribers and the pharmacists are required to be aware of medications affected by tobacco smoking to prevent the toxicity-associated complications during smoking cessation.