R.I. OGILVIE, M.D.
Theophylline is eliminated almost entirely by biotransformation in the liver. It is not surprising that changes in liver function alter the disposition of theophylline: Patients with hepatic cirrhosis have a markedly reduced capacity to eliminate it (1). More subtle changes in liver function associated with alterations in dietary protein and carbohydrate (2) and smoking (3-5) have also been observed.
The enzymes responsible for biotransformation of theophylline in the liver are not known but probably include cytochrome P-448, which can be induced by substances contained in cigarette smoke such as 3,4-benzypyrene and related polycyclic hydrocarbons. This is a different enzyme system
OGILVIE R. Smoking and Theophylline Dose Schedules. Ann Intern Med. ;88:263–264. doi: 10.7326/0003-4819-88-2-263_2
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Published: Ann Intern Med. 1978;88(2):263-264.
Cardiology, Coronary Risk Factors, Smoking, Tobacco, Alcohol, and Other Substance Abuse.
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